Heartburn, acid reflux, dyspepsia, nausea... Our formula targets the various gastric discomforts.

• The licorice Glycyrrhiza glabra holds especially its benefits of the glabridine. Its local antioxidant action makes it an ingredient of choice to preserve the stomach from the discomfort of acid reflux. 
• The olive tree (Olea Europaea) and the cactus (Opuntia ficus-indica) present interesting virtues in the care of the gastric discomfort and the acid rise by their contributions in polysaccharides and polyphenols.
• Sage helps to promote digestion and contributes to the normal functioning of the stomach.
• The vitamin B2 contributes to the maintenance of normal mucous membranes.

The benefits of licorice  

The notoriety of licorice root, and particularly of the species Glycyrrhiza glabra, is no longer to be demonstrated by its use in traditional Chinese medicine. Its virtues on the gastrointestinal sphere are widely referenced in the literature which highlights the antioxidant properties of the triterpenes and flavonoids it contains. It acts in particular on the production of mucus by the stomach, natural protection against the acidity of gastric secretions. And it makes it possible to limit the adhesion of the Helicobacter pylori bacterium to the stomach wall, thus contributing to reduce the discomfort of the acid rise.    

When to take the Stomach Formula?

Our Stomach Formula can be taken :

• In case of occasional reflux and known reaction to certain foods: take 3 capsules.
  - either as prevention, just after the meal and before the onset of reflux
  - or as soon as the reflux appears.

• In case of regular, even daily reflux: take 2 to 3 capsules according to the intensity, at the end of the meal that causes the most discomfort. It is possible to spread the 3 capsules over the day: 2 capsules after the meal that causes the most discomfort and 1 capsule after the other meal.

How many capsules?

• Children : Not recommended. 
• Adolescents: Not recommended.
• Adults: 2 to 3 capsules per day.
• Pregnant and breastfeeding women: 2 to 3 capsules per day. 

The Stomach Formula is suitable for pregnant and nursing women. 

Duration of one intake

• The Stomach Formula is taken as needed and can be repeated over 6 weeks. Beyond that, medical advice is recommended.

How to take the Stomach Formula?

• The capsules are to be taken with a large glass of water after the meal.  

The stomach in the digestion process

Digestion is a chemical process that degrades the food we ingest, but also a mechanical process that grinds and mixes it. Through its stages, digestion involves different organs that receive the food bolus (chewed food from the mouth) such as the stomach, intestines, or parallel organs involved with their secretions such as the pancreas, liver and gallbladder. 

Upon arrival of the food bolus, the stomach secretes digestive enzymes and gastric juices. The hydrochloric acid in these juices activates the digestive enzymes that break down the macronutrients in our food. The food bolus spends some time in the stomach (about 3-4 hours) where it is crushed and stirred, and then continues to the small intestine where enzymatic digestion continues.

Stomach function and acid reflux

It is thanks to muscles that the food bowl can progress through the digestive system. But due to a weakness of the sphincter, a muscle located at the junction of the esophagus and the stomach, the stomach can go up towards the esophagus. And because of the acidity contained in the stomach, it is easy to understand the term acid reflux and the unpleasant sensations that result. When they are repeated, these acid refluxes represent a real daily discomfort characterized as gastroesophageal reflux (GERD). It is estimated that 5-10% of adults suffer from GERD [1]. 

Acid reflux can also be the consequence of a more important gastro-duodenal damage due to the presence of Helicobacter pylori bacteria. This bacterium, which develops in the stomach, is responsible for a chronic infection of the stomach that is usually acquired during childhood and persists throughout life, resulting in chronic gastric ailments such as ulcers.
Finally, gastroesophageal reflux disease (GERD) can lead to dyspepsia, a digestive disorder characterized by chronic discomfort in the stomach. Dyspepsia is characterized by a feeling of poor digestion, rapid satiety, or stomach pain or heartburn.

Lifestyle and stomach  

Stress, diet... If many of our digestive problems result from our lifestyle, other specific conditions such as pregnancy, aging or obesity, also contribute.

In case of acid reflux, recognized hygienic and dietary measures can be implemented to improve digestive well-being [1] such as 

• Avoid eating large, fatty meals,   
• Avoid lying down or going to bed right after a meal, 
• Manage excess weight, 
• Identify foods that exacerbate these disorders due to individual susceptibility: alcohol, fatty foods, juices or excess raw vegetables...

Solutions against acid reflux

In the management of acid reflux and gastroesophageal reflux disease (GERD), proton pump inhibitors (PPIs) [2,3] are widely used. These drugs aim to reduce gastric acid secretion. Without prescription, they are an easy but sometimes inappropriate response and long-term use is not favorable. To date, few alternatives exist on the market [4]. 

Before resorting to drug solutions, changes in habits can limit most digestive discomforts such as acid reflux. But it is not always easy to maintain these habits on a daily basis. With its dietary supplements for the stomach, Nutraceutics can provide easy, effective solutions without harmful effects in the long term.

Licorice, ginger, mallow, dandelion, artichoke, sage... Numerous plants are recognized as suitable and effective solutions, and their references in the scientific literature show their proven and targeted benefits on stomach ailments [5-7]. 

Licorice [8-10]

Licorice, Glycyrrhiza sp., is a perennial plant of the Fabaceae family whose rhizome (root) is the part of interest. Its etymology comes from the Greek "glykos" for "sweet" and "Rhiza" for rhizome. The history of licorice and its consumption goes back to Antiquity and can be traced in Southeast Europe (Greece, Rome and Egypt) to Asia. It is one of the most used and prescribed plants in traditional Chinese medicine (9 out of 10 formulas would contain it) for its virtues, especially against inflammation and on the gastrointestinal sphere. Licorice is also widely used in Ayurvedic medicine. 

To date, 30 species of licorice have been identified, and among them, three are the most studied for their nutritional and pharmacological potential, and the only ones present in the Chinese pharmacopoeia: Glycyrrhiza glabra, Glycyrrhiza inflata, Glycyrrhiza uralensis.
The European pharmacopoeia also refers to the traditional use of these three species for their benefits in case of stomach-related problems [11].
Nevertheless, botanical differences (geographical origin, morphology...) between these species exist as well as their profile in compounds of interest which determines, consequently, distinct biological activities and benefits.

Globally, licorice root is widely used throughout the world as an active ingredient in many nutraceutical (in dietary supplements for heartburn and gastroesophageal reflux disease), cosmetic or food formulations [12]. In the form of extracts, in teas, tablets, capsules or in liquid solutions, dry root powder allows a variety of uses. The literature reports that licorice root, at the level of the stomach, protects the mucus cells and promotes the production of mucus. Thus, it would participate in the protection of the natural acidity of the stomach. Licorice root would also fight against the adhesion of the Helicobacter pylori bacteria which can accentuate the discomfort of acid reflux [13].

The active compounds of licorice [12,14]  

For more than 6 decades, licorice has attracted the interest of scientific research. About 300 compounds have been isolated in licorice root, such as terpenes and flavonoids (isoflavones, flavanols, isoflavans, flavanones, coumarins...). Among them, some triterpenes and flavonoids give the plant its biological benefits [15] .

The species Glycyrrhiza glabra is characterized by a high content of a particular isoflavonoid, glabridine. And it is the presence of this compound, one of the most studied on the digestive sphere [16], which gives licorice its benefits on digestive comfort at the level of the stomach. In general, Glycyrrhiza glabra is the species most used in licorice-based formulations, notably for its pharmacological activity [17,18]. 
Licorice is, moreover, very often characterized by a particular compound, glycyrrhizic acid (or glycyrrhizin) of the pentacyclic triterpenoid saponin group. Although it has a recognized pharmacological activity, glycyrrhizic acid is harmful at high doses (hypertension and renal insufficiency). This is why licorice extracts are often purified (they are "deglycyrrhizinated") and why a limit dose has been established for its use in food supplements. 

It should be noted that glycyrrhizic acid is referenced as a food additive (sweetener) to improve the organoleptic qualities of the food. Used as a non-sweetening flavoring agent, it gives a composition the sweet flavor of licorice. 

The Nutri&Co Stomach Formula

Strength in unity. For our Stomach Formula, which targets acid reflux, heartburn and gastric reflux, we have combined several active plant ingredients from plants with recognized and proven virtues for stomach comfort.
Liquorice, cactus, olive tree and sage compose our 100% natural formula for a complete approach on the gastric sphere by coupling thus specific and prolonged effects. 

• A patented licorice extract: 

Gutgard^® selected licorice extract is an extract standardized in glabridine, the molecule of interest of the Glycyrrhiza glabra species. Its patented extraction process allows it to be free of glycyrrhizinic acid. The efficacy, tolerance and safety of Gutgard^® have been demonstrated in 2 clinical studies which show an improvement in stomach-related discomforts including acid reflux:

- A study on 107 subjects [19] with Helicobacter pylori infection with a dosage of 150 mg over a period of 8 weeks.

- A study on 50 subjects [20] with dyspepsia with a dosage of 150 mg per day (in one or two doses: 2 x 75 mg) over a period of 30 days. 

• A patented cactus and olive extract for acid reflux: 

The extract Mucosave^TMFG^® combines an extract of cactus (Opuntia ficus-indica) source of polysaccharides and an extract of olive tree (Olea Europaea) source of polyphenols. We have selected these 2 extracts manufactured in Sicily for their richness in polysaccharides and polyphenols which are the source of their benefits on the stomach and its ailments. 

The efficacy, tolerance and safety of Mucosave^TMFG^® are supported by 2 clinical studies on acid reflux with a dosage of 400 mg per day on :

- 108 subjects over 8 weeks [21], 

- 100 subjects over 10 weeks [22].

• Sage extract:  

In the European Pharmacopoeia, sage (Salvia officinalis) is referenced for its use on the stomach sphere [23]. Recognized for its richness in antioxidant polyphenols, sage helps to promote digestion and the proper functioning of the stomach.

References

1. SNFGE Reflux Gastro-Œsophagien (RGO) Available online: https://www.snfge.org/content/reflux-gastro-oesophagien-rgo.
   
2. Reinberg, O. Inhibiteurs de La Pompe à Protons (IPP) : Peut-Être Pas Si Inoffensifs Que Cela. 2015, 11, 1665–1671.
3. Lassalle, M.; Le Tri, T.; Bardou, M.; Biour, M.; Kirchgesner, J.; Rouby, F.; Dumarcet, N.; Zureik, M.; Dray-Spira, R. Use of Proton Pump Inhibitors in Adults in France: A Nationwide Drug Utilization Study. Eur. J. Clin. Pharmacol. 2020, 76, 449–457, doi:10.1007/s00228-019-02810-1.
4. ANSM Près de 16 Millions de Personnes Ont Eu Une Prescription d’inhibiteurs de La Pompe à Protons (IPP) En 2015 En France Available online: https://ansm.sante.fr/actualites/pres-de-16-millions-de-personnes-ont-eu-une-prescription-dinhibiteurs-de-la-pompe-a-protons-ipp-en-2015-en-france.
5. González-Stuart, A.E.; McCallum, R.W. Medicinal Plants Used for Digestive Disorders – What the Gastroenterologist Needs to Know. Pract. Gastroenterol. 2015, 7.
6. Gao, X.; Liu, J.; Li, L.; Liu, W.; Sun, M. A Brief Review of Nutraceutical Ingredients in Gastrointestinal Disorders: Evidence and Suggestions. Int. J. Mol. Sci. 2020, 21, 1822, doi:10.3390/ijms21051822.
7. Salehi, M.; Karegar-Borzi, H.; Karimi, M.; Rahimi, R. Medicinal Plants for Management of Gastroesophageal Reflux Disease: A Review of Animal and Human Studies. J. Altern. Complement. Med. 2017, 23, 82–95, doi:10.1089/acm.2016.0233.
8. Maoyuan, J.; Shengjia, Z.; Shasha, Y.; Xia, L.; Xiguo, H.; Xiguo, H.; Xinyi, W.; Qin, S.; Rui, L.; Chaomei, F.; et al. An “Essential Herbal Medecine”-Licorice : A Review of Phytochemicals and Its Effects in Combination Preparations. J. Ethnopharmacol. 2019.
9. Fiore, C.; Eisenhut, M.; Ragazzi, E.; Zanchin, G.; Armanini, D. A History of the Therapeutic Use of Liquorice in Europe. J. Ethnopharmacol. 2005, 99, 317–324, doi:10.1016/j.jep.2005.04.015.
10. Liu, H.; Wang, J.; Zhou, W.; Wang, Y.; Yang, L. Systems Approaches and Polypharmacology for Drug Discovery from Herbal Medicines: An Example Using Licorice. J. Ethnopharmacol. 2013, 146, 773–793, doi:10.1016/j.jep.2013.02.004.
11. EMA Assessment Report on Glycyrrhiza Glabra L. and/or Glycyrrhiza Inflata Bat. and/or Glycyrrhiza Uralensis Fisch., Radix; 2013;
12. Husain, I.; Bala, K.; Khan, I.A.; Khan, S.I. A Review on Phytochemicals, Pharmacological Activities, Drug Interactions, and Associated Toxicities of Licorice ( Glycyrrhiza Sp.). Food Front. 2021, 2, 449–485, doi:10.1002/fft2.110.
13. Murray, M.T. Glycyrrhiza Glabra (Licorice). Pharmacol. Nat. Med. 2018, 11.
14. Hasan, Md.K.; Ara, I.; Mondal, M.S.A.; Kabir, Y. Phytochemistry, Pharmacological Activity, and Potential Health Benefits of Glycyrrhiza Glabra. Heliyon 2021, 7, e07240, doi:10.1016/j.heliyon.2021.e07240.
15. Yang, R.; Yuan, B.-C.; Ma, Y.-S.; Zhou, S.; Liu, Y. The Anti-Inflammatory Activity of Licorice, a Widely Used Chinese Herb. Pharm. Biol. 2017, 55, 5–18, doi:10.1080/13880209.2016.1225775.
16. Li, C.; Li, T.; Zhu, M.; Lai, J.; Wu, Z. Pharmacological Properties of Glabridin (a Flavonoid Extracted from Licorice): A Comprehensive Review. J. Funct. Foods 2021, 85, 104638, doi:10.1016/j.jff.2021.104638.
17. Pastorino, G.; Cornara, L.; Soares, S.; Rodrigues, F.; Oliveira, M.B.P.P. Liquorice ( Glycyrrhiza Glabra ): A Phytochemical and Pharmacological Review: Liquorice ( Glycyrrhiza Glabra ): A Review. Phytother. Res. 2018, 32, 2323–2339, doi:10.1002/ptr.6178.
18. El-Saber Batiha, G.; Magdy Beshbishy, A.; El-Mleeh, A.; M. Abdel-Daim, M.; Prasad Devkota, H. Traditional Uses, Bioactive Chemical Constituents, and Pharmacological and Toxicological Activities of Glycyrrhiza Glabra L. (Fabaceae). Biomolecules 2020, 10, 352, doi:10.3390/biom10030352.
19. Puram, S.; Suh, H.C.; Kim, S.U.; Bethapudi, B.; Joseph, J.A.; Agarwal, A.; Kudiganti, V. Effect of GutGard in the Management of Helicobacter Pylori : A Randomized Double Blind Placebo Controlled Study. Evid. Based Complement. Alternat. Med. 2013, 2013, 1–8, doi:10.1155/2013/263805.
20. Raveendra, K.R.; Jayachandra; Srinivasa, V.; Sushma, K.R.; Allan, J.J.; Goudar, K.S.; Shivaprasad, H.N.; Venkateshwarlu, K.; Geetharani, P.; Sushma, G.; et al. An Extract of Glycyrrhiza Glabra (GutGard) Alleviates Symptoms of Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study. Evid. Based Complement. Alternat. Med. 2012, 2012, 1–9, doi:10.1155/2012/216970.
21. Alecci, U.; Bonina, F.; Bonina, A.; Rizza, L.; Inferrera, S.; Mannucci, C.; Calapai, G. Efficacy and Safety of a Natural Remedy for the Treatment of Gastroesophageal Reflux: A Double-Blinded Randomized-Controlled Study. Evid. Based Complement. Alternat. Med. 2016, 2016, 1–8, doi:10.1155/2016/2581461.
22. Malfa, G.A.; Di Giacomo, C.; Cardia, L.; Sorbara, E.E.; Mannucci, C.; Calapai, G. A Standardized Extract of Opuntia ficus‐indica  (L.) Mill and Olea europaea  L. Improves Gastrointestinal Discomfort: A double‐blinded randomized‐controlled Study. Phytother. Res. 2021, 35, 3756–3768, doi:10.1002/ptr.7074.
23. EMA Assessment Report on Salvia Officinalis L., Folium and Salvia Officinalis L., Aetheroleum; 2016;