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Digestive Wellness

Protocols Fullscript Protocols
Digestive Wellness

Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

As a result, the Fullscript Integrative Medical Advisory team advises using an evidence-informed approach to protocol development. To simplify this process for practitioners, we have assembled a sampling of evidence-based standardized protocols that practitioners can use as a foundation when developing individualized protocols.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through C-quality evidence. These are categorized as follows:

A       Systematic review or meta-analysis
B       Randomized Double-Blind Placebo-Controlled (RDBPC)       2+ studies and/or 1 study with 50 + subjects 

C       Randomized Double-Blind Placebo-Controlled (RDBPC)       1 study 

Please refer to the complete Rating Scale for further information.

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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Digestive Wellness

Peppermint Oil

0.1-0.3mL (or 200mg), three times per day1,2,3,4,5

  • Significant reduction of abdominal pain and global symptoms, relative to placebo6
  • Benefits no longer present two weeks after supplement cessation6
Search for Peppermint Oil in the Fullscript catalog.

Soluble Dietary Fiber

20-35g of long-chain, intermediate viscous, soluble and moderately fermentable dietary fiber7

  • Safe and effective in improving global IBS symptoms, relative to placebo8
  • Form of soluble fiber used is important, since short-chain soluble and highly fermentable dietary fiber can result in rapid gas production that can aggravate symptoms in patients with IBS8
Search for Fiber in the Fullscript catalog

Probiotics

25-50 billion CFU, one to three times per day10

  • Effective in reducing symptoms and severity score in patients with IBS10
  • Specific strain recommendations remain to be concluded11,12
  • Current recommendations suggest using an equal dosage of lactobacillus and bifidobacterium species12
Search for Probiotics in the Fullscript catalog

L-Glutamine

0.25 g/kg of weight, once per day, minimum 14 days15,16

  • Glutamine has shown to improve intestinal permeability13,14,15,16
  • Acute glutamine administration has been linked to a decrease of gastro-intestinal symptoms and improvement in intestinal permeability in athletes competing in heat15
Search for L-Glutamine in the Fullscript catalog

References

7
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548066/
8
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/25070054
9
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/27372289
10
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356930/
12
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/25070051/
13
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/27440684