Updated: October 13th, 2020

By Mary Berger, Nutrition & Integrative Health AOC Herbal Medicine Student

Maintaining adequate gut health is important as it influences the  health of the rest of the body. If your gut is not digesting, absorbing, and assimilating the food you eat, then the rest of the body will suffer.  In the United States, 60-70 million people are affected by some type of digestive disease. Some of the more common ones include reflux (GERD), stomach ulcers, chronic constipation, and/or chronic diarrhea, which may fall under irritable bowel syndrome, hemorrhoids, celiac disease, and inflammatory bowel conditions. The prevalence of these disorders seems to be on the rise. It has been demonstrated that sometimes a disruption in the environment of your gut can lead to some of these disorders as well as other diseases that don’t exhibit gut-related symptoms.

Inside the gut, there is a living ecosystem of bacteria known as the microbiome.  The microbiome consists of good bacteria that promote health and bad bacteria that can lead to an unhealthy state. The health of your microbiome can be affected by antibiotic use,since antibiotics can kill both the good and bad bacteria. A person taking antibiotics needs to replenish their gut vitality through probiotics—either by eating fermented foods or by taking a supplement. Probiotics are good bacteria that help restore the gut to a healthy balance of good bacteria (also called intestinal flora). Additionally, these positive or good bacteria need to be fed in order to stay alive. Food for good bacteria is called prebiotics.

What is fascinating is that herbs can act as prebiotics for our microbiome. Some of the good bacteria that make their home in the gut include species such as Bifidobacterium, Lactobacillus (think yogurt), and Bacteroides.  Bacteria in your gut that can lead to disease include Citrobacter freundii and Klebsiella pneumoniae.  The study by Peterson et. al. (2018 ) examined if herbs typically used in Ayurvedic medicine for gut conditions could alter the development and the quantity of certain species of bacteria. The herbs examined here were slippery elm, licorice, and a combination of three dried fruits termed triphala.

Triphala is typically employed to help heal the epithelial lining in the gut, to enhance barrier function (keeping the gut from becoming leaky), and to improve absorption of nutrients. Licorice root is often used to help with irritation by providing a protective cover over the membrane lining, as a mild laxative, and to help decrease inflammation. Finally, slippery elm is used for healing the mucous membranes in the gut. These herbs have been used to treat inflammatory conditions such as ulcerative colitis, Crohn’s disease, GERD (hyperacidity), and membranes that might be compromised in any way.

Using in-vitro (outside the human body) methods, the authors found that these herbs helped promote the abundance of certain species of bacteria. Triphala significantly increased the abundance of bacteria Acidaminococcus and Sutterella. Slippery elm had the greatest impact on bacteria belonging to the family of Clostridium. Licorice demonstrated an increase to Bacteroides. This demonstrates that the herbs used can act as prebiotics to increasing numbers of good bacteria. In addition, licorice root was able to decrease the population of potential opportunistic invaders Enterococcus faecalis and Klebsiella pneumoniae. These potential disease-causing bacteria have been linked to the development of a leaky gut (intestinal permeability).


Peterson, C. T., Sharma, V., Uchitel, S., Denniston, K., Chopra, D., Mills, P. J., & Peterson, S. N. (2018). Prebiotic Potential of Herbal Medicines Used in Digestive Health and Disease. Journal of alternative and complementary medicine (New York, N.Y.), 24(7), 656–665. doi:10.1089/acm.2017.0422