A burning issue

burning issue

It’s often overshadowed by more ‘serious’ digestive conditions such as bloating and other IBS-type symptoms, but the discomfort caused by gastroesophageal reflux disease (GERD) is no less debilitating. Claire Lavelle investigates natural ways to treat it this burning issue

Finding a reliable solution for the burn-ing pain, tightness in the throat and sour taste that characterize gastroesophageal reflux disease (also referred to as acid reflux or GERD) can be a challenge, especially for those not wanting to rely on antacids or prescribed medication long-term. What’s more, in a world in which we’ve come to rely on the ‘quick fix’, it often takes longer than we’d like or expect to heal our bodies naturally, says nutritionist Ben Atkinson.

“Clinically, we can treat acid reflux by removing common gastrointestinal stressors and harmful microbes, replace any missing digestive constituents such as enzymes and hydrochloric acid, repopulate the gut with beneficial bacteria and repair the gut wall so that harmful substances are less able to get through and cause inflammation,” he continues. 

“For instance, garlic extract has natural antimicrobial properties, while l-glutamine can aid intestinal cell wall repair. However, these are lifestyle interventions that take time, and everybody responds differently. Some people might see a difference in a week; others might take months. It’s not something that happens overnight.”

That’s not to say there aren’t other ways to soothe the pain of acid reflux while treating it naturally and giving the body the time it needs to repair and heal. One of the most popular remedies is aloe vera juice, which is the nutrient-rich thick liquid that comes from the aloe vera plant. When purified (look for the terms ‘decolourized’ or ‘organic’ on the label), it can help the digestive system work optimally because of the enzymes it contains that help to break down fats and sugars. 

“We have a number of customers with acid reflux who use our brand to reduce symptoms, and they report great success,” says Lauren Rabenda, marketing manager for Simplee Aloe. Indeed, a recent study of participants with chronic GERD showed that all 79 subjects experienced relief from their symptoms while taking aloe vera juice. The researchers concluded that ‘aloe vera … provides a safe and effective treatment for reducing the frequency of GERD symptoms, and should therefore be suggested as an effective supplement for patients suffering with GERD’. 

“It’s increasingly common for people to reach for vitamin B6, zinc and omega-3 now in a quest to improve gut health”

Aloe vera is also a powerful antioxidant and anti-inflammatory, making it useful in combatting oxidative stress (whereby the body is unable to counter-balance or detoxify the harmful effects of unstable molecules called free radicals, which harm the cells of the body and are thought to be key factors in the development of GERD). And there’s more – its antimicrobial properties help protect against H. pylori, a common bacteria that grows in the digestive tract and attacks the stomach lining. Combine this with the fact that aloe vera reduces the amount of gastric acid the body produces, and it’s easy to see why it’s such a valuable tool in our armoury against acid reflux. 

Probiotics and beyond
Another popular way to boost digestive health is with ‘friendly’ bacteria – or prebiotics and probiotics. Because acid reflux is often associated with poor digestive function, it follows that easing the inner workings of the gut will alleviate symptoms. However, industry experts and consumers alike are broadening their horizons when it comes to supplements that can help, says Lorna Driver-Davies, senior nutritional therapist at Wild Nutrition. “It’s increasingly common for people to reach for vitamin B6, zinc and omega-3 now in a quest to improve gut health,” she explains. “Omega-3 and selenium help with inflammation while zinc helps with the production of digestive enzymes, which reduce the risk of a leaky gut. The B vitamins help our bodies convert the food we eat into energy.” 

Studies show too that vitamin D deficiency is commonly diagnosed among patients with inflammatory bowel disease (IBD). In fact, a pilot study conducted by the University of Sheffield that looked at the effects of vitamin D supplementation in IBS sufferers showed that increased levels resulted in reduced pain and less discomfort due to symptoms, Andrew Thomas, founder of BetterYou highlights. “In other words, those with higher vitamin D levels enjoyed better quality of life,” he says. “But I truly believe that you have to look at improving digestive health holistically – it’s a combination of factors, of which boosting levels of vitamin D appears to be one, rather than being able to hang your hat on one thing and say, ‘That’s the answer’.”

To that end, there is increased focus on the importance of digestive enzymes, with poor digestive enzyme production increasingly implicated in food allergies and conditions such as eczema. “It means that the food we eat is insufficiently digested, which hinders absorption,” says Driver-Davies. “Stress and the ageing process can both play a part, and bloating, burping and ‘burning’ after meals are common symptoms.” 

Wild Nutrition introduced its Digestive Enzyme Complex to help those experiencing problems, and such was the need that the product promptly sold out. “Digestive health is the cornerstone of wellbeing,” says Driver-Davies. “I hear so many stories of ill health that begin with: ‘It all started when I had a stomach upset, or had to take antibiotics …’, which upset gut flora significantly. So much of what ails us can be traced back to the gut.”

Can exercise help with GERD?
The short answer is yes – although as you’d expect, it’s not quite as simple as that, says Jenny Carson, technical supervisor for Viridian Nutrition. “Research shows that moderate amounts of exercise (defined as 30-60 minutes of aerobic activity three times a week for six weeks), is excellent at improving the diversity of the microbiome and supporting the production of beneficial bacteria,” she explains. “However, excessive amounts of exercise, such as training for Iron Man-type activities, puts the body under huge amounts of stress which increases the risk of conditions such as IBS or leaky gut, where bacteria and toxins are able to pass through the gut wall. This can cause classic digestive issues such as bloating, as well as nutritional deficiencies.”

This more moderate approach is backed up by research that found the Chinese martial art tai chi – which combines deep breathing with a sequence of flowing movements – improved both immune function and inflammation of the gut. “The studies show that it’s essential to differentiate between all types of exercise, but it seems that current Government guidelines of 150 minutes of moderate activity every week is what we should aim for,” says Carson.

Shops with a view

Carol Henshaw, owner of Nature’s Remedies in Southport, says that the symptoms her customers tell her about aren’t always those you’d associate with poor gut health, until you dig a bit deeper. 

“They might be worried about their poor memory, or ‘brain fog’, or their child’s ADHD-type symptoms,” she says. “This group is at least equal to the number of people to whom I recommend probiotics for ‘classic’ digestive problems, such as bloating. But if you regard the gut as our second brain, it follows that as well as the B vitamins, including folic acid, and EFAs we’d more commonly suggest, supplements that aid gut health can help with these increasingly common problems. The two I recommend the most are BioKult and Optibac.” 

Barbara Louvrou, naturopathic nutritionist at Healthy Spirit in Bath, says that a lot of her customers are surprised to hear that their GERD could be as a result of too little stomach acid. “It sounds counter-intuitive, but low acidity means that the sphincter valve at the top of the stomach doesn’t need to work as hard and the muscle becomes weak, allowing stomach acid to flow back into the oesophagus,” she says. 

“I recommend A. Vogel’s Digestian to rebalance acidity levels and help with indigestion. I also recommend Viridian Digestive Aid to help boost production of digestive enzymes (the older we get, the fewer we naturally produce) and Nature’s Plus GI Natural Digestive Wellness for overall gut health. We get really positive feedback from those three products.”


Mightidophilus 12 – 10 billion 

Au Naturel UK
Tel: 08000 851697
E-mail:  [email protected]

Our top selling supplement includes 12 of the most important strains of beneficial bacteria. Each serving provides 20billion friendly micro-organisms. Our delayed release capsules ensure the friendly bacteria pass through harsh stomach acids and into the small intestine, which maximises survival of the micro-organisms.  Available in 30 & 100 capsule. 


FSC Oil of Peppermint

Tel: 0800 083 0356
E-mail:  [email protected]

Peppermint is a popular culinary and medicinal herb. The major active ingredient of the peppermint plant is its pure oil. The essential oil is obtained by steam distillation of peppermint aerial parts (leaves, stems and shoots). Peppermint is one of our most popular herbs and has a variety of uses. As with all FSC supplements, FSC Oil of Peppermint 50mg is made in the UK with the finest ingredients and based on widely recognised scientific evidence of their health qualities.  Recommended to take one to two capsules daily with food. 


Digeston  Plus

HealthAid Ltd, HealthAid House
Tel: 020 8426 3400
E-mail: [email protected]

Digeston® Plus – Advanced support for Digestive Well-being!HealthAid Digeston® Plus is a unique blend of purely vegan digestive enzymes combined with fruit extracts such as pineapple and papaya that are well known for their naturally occurring digestive enzymes to enable the breakdown of food. The formula is boosted with a superior blend of 600 million viable bacterial strains of Lactobacillus and Bifidobacterium to help replenish the body’s good bacteria. The formulation also contains chloride in the form of calcium chloride that is proven to contribute to healthy digestion through the production of hydrochloric acid in the stomach.. 

Digeston® Plus retails at £9.99 for 30 tablets. Contact HealthAid Ltd on 020 8426 3400 for purchase and stockist information or visit www.healthaid.co.uk.


Microbiome Formula Once Daily Women’s

Kinetic Natural Products Distributor
Tel: 08450 725 825
E-mail:  [email protected]

Formulated by Dr Perlmutter, Microbiome Formula provides the most diverse , shelf-stable blend of 16 live bacterial strains. Clinically proven strains support women’s intimate flora (L.reuteri, L.fermentum and L.rhamnosus) all while supporting digestive and immune health. Each daily serving provides 50 billion CFU of live cultures, resistant to antibiotics, stomach and bile acids and complemented with digestion friendly, certified organic prebiotic fibres. Devoid of artificial ingredients, dairy, gluten and soya, the formula is also Non-GMO Project verified. For more information or to order visit www.kinetic4health.co.uk, email [email protected]  or call 08450 725 825.


Nature’s Answer, Liquid Ginger

Kinetic Natural Products Distributor
Tel: 08450 725 825
E-mail:  [email protected]

Nature’s Answer takes great care to bring you the highest quality of Ginger, in a convenient liquid extract. Nature’s Answer Ginger supports intestinal and digestive health and promotes overall good health and wellbeing. Liquid Ginger is absorbed faster than tablets or capsules and is more potent than tinctures. Holistically Balanced™ by Nature’s Answer guarantees that the constituents of the extract are in the same synergistic ratios as in the plant. Each serving of Nature’s Answer Ginger delivers 1,000mg of pure ginger extract. Ginger is authentic, safe and effective. For more information or to order visit
www.kinetic4health.co.uk, email [email protected]  or call 08450 725 825.


Lamberts® Acidophilus Extra 10

Lamberts Healthcare Ltd
Tel: 01892 554313
E-mail:  [email protected]

Providing Lactobacillus acidophilus and Bifidobacterium – 10 billion live bacteria per capsule Lamberts® was one of the first companies to produce live bacteria capsules in the UK (over 30 years ago) and we’ve developed expertise in this area. To ensure proven targeted release for acid-sensitive ingredients like live bacteria, we have:
• Specifically used delayed release capsules.  These innovative capsules target release after an extended time period, protecting the live bacteria from degradation in the stomach.
• A special desiccant built into the tube wall of the pot.
• Refrigerated storage conditions until despatch.
• Vegetarian capsules made of plant-based cellulose with a 3 times lower moisture content than typical gelatin-based ones.


Apple Cider Vinegar 

Lifeplan Products Ltd
Tel: 01455 556281
E-mail:  [email protected]

Lifeplan’s Apple Cider Vinegar Complex is an exciting addition to their Digestive and Live Culture range. This unique formula provides the botanicals Dandelion and Burdock, together with Sea Kelp, Apple Cider Vinegar and Chloride.  The product contributes to normal digestion by the production of hydrochloric acid in the stomach.  Having the right amount of stomach acid is essential for the breakdown of foods and the absorption of certain nutrients. This easy to take Apple Cider Vinegar product comes in vegetarian capsules, requires no diluting and is kind to teeth. Registered with the Vegan Society.


Symbiotic 7 with prebiotic & 7 bacteria strands

Link Nutrition
Tel: 020 7881 0046
E-mail:  [email protected]

Link Nutrition’s Symbiotic 7 contains seven probiotic strains carefully selected for their potential to resist the upper digestive tract and colonize the lower digestive tract. These probiotic strands are supported by individual scientific studies showing general improvement in gut health and digestive comfort when consumed regularly. Alongside 40 billion bacterial units, Symbiotic 7 also contains a prebiotic in the form of acacia gum fibre. Furthermore, it does not to be refrigerated, making it easier to take a daily symbiotic when and where it is convenient. 


Stress Buster!

The Natural Health Practice Ltd
Tel: 01892 507598
E-mail:  [email protected]

Tranquil Woman Support from NHP supports women managing a busy lifestyle in today’s stressful world. Contains all the B vitamins, with extra B5 (for the reduction of tiredness and fatigue), chromium for the maintenance of normal blood glucose levels, vitamin B12 which contributes to normal functioning of the nervous system and normal psychological function. It also contains L-theanine to help both physically and emotionally, along with Siberian ginseng, aloe vera and curcumin. Kosher approved, Vegan and Vegetarian Society registered and Halal approved.


DigestEeze® (Milk Thistle)

Natures Aid Ltd
Tel: 01772 686231
E-mail:  [email protected]

Natures Aid DigestEeze® (Milk Thistle) is a traditional herbal medicinal product used to relieve the symptoms associated with occasional over indulgence of food and drink – such as indigestion and upset stomach – based on traditional use only.  Each Natures Aid DigestEeze® tablet contains 137.5-165mg of Standardised Milk Thistle extract (equivalent to between 2750mg and 6600mg of Milk Thistle fruit) – corresponding to 82.5mg Silymarin calculated as Silibinin. Suitable for vegetarians and vegans. Natures Aid DigestEeze® (Milk Thistle), 60 tablets, RRP £9.95. 


Bounty Pro  

The Nature’s Bounty Co. Ltd
Tel: +44 (0) 1442 890 355
E-mail:  [email protected]

Unique to the market, Nature’s Bounty® Bounty Pro Gummies provide 2 billion “friendly” bacteria. These gummies contain a special live culture (B. coagulans) that’s naturally found in the intestinal microflora and proven to reach the digestive system alive. B. coagulans is a clinically studied strain of “good” bacteria.
• 2 billion friendly bacteria per serve
• Proven to reach the digestive system alive
• Contains clinically studied bacterial strain B coagulans
• Raspberry and pineapple flavour, made with natural fruit flavours
• Free of sugar, gelatin and gluten – suitable for vegetarians and vegans
• No artificial colours, flavours, or preservatives


Apple Cider

New Nordic Ltd
Tel: 0800 389 1255
E-mail: [email protected]

Apple Cider Vinegar – Breakdown of Fats and Health Fluid Balance. – The easy and convenient way to take apple cider vinegar. Apple Cider™ is the tablet you need when you live life to the full. The unique bioactive herbal and nutrient combination contained in each tablet contributes to a normal efficient digestion and break down of fats. The tablet, which is manufactured in Sweden, contains highly concentrated apple cider vinegar powder in combination with globe artichoke and dandelion extracts plus choline “liver-vitamin”. The globe artichoke contributes to a normal break down and digestion of fats in the intestines and choline contributes to normal fat metabolism and the maintenance of a normal liver function.



New Nordic Ltd
Tel: 0800 389 1255
E-mail: [email protected]

The affect of yeast? Many of us live with yeast in our body, without ever thinking about it. Researchers have showed that high concentrations of yeast suppressing plant extracts have a positive influence. Dida combines ingredients to help you feel good. Taking Dida is a long-term solution to help control yeast, bloating, sugar cravings, and upset stomach. Did is the tablet you need to reduce fermentation and formation of gas in the gastrointestinal tract. The unique bioactive nutrient, herbal and spice oil recipe contained in each tablet contributes to the maintenance and function of your gastrointestinal tract and its mucous membrane lining.



Tel: 0370 3341575
E-mail:  [email protected]

A poorly functioning gut can have an enormous impact on health and wellbeing.  DigestPro is an innovative formulation that combines digestive enzymes including protease, lipase and lactase, the amino acid glutamine and probiotics.  Digestive enzymes help break down food so that nutrients can be easily absorbed. Glutamine, directly feeds intestinal mucosa, reducing gastro-intestinal permeability. The beneficial bacteria Lactobacillus acidophilus and Bifidobacterium bifidum, help to restore and rebalance intestinal health, break down food and aid with the absorption of nutrients.  Email: [email protected] Website: www.holfordirect.com


Pro-Ven Probiotics Adult Acidophilus & Bifidus – 25 Billion

Pro-Ven Probiotics
Tel: 01639 825107
E-mail:  [email protected]

Good digestive health is key to overall health and Pro-Ven Probiotics products contain the comprehensively studied Lab4 and Lab4b groups of bacteria, which have been shown in clinical studies to support digestion in adults, children and babies. Using proprietary production processes that ensure the stability of the live bacteria in combination with appropriate vitamins, minerals and other nutrients, the Pro-Ven Probiotics products are specifically designed for every lifestage. Pro-Ven Adult Acidophilus & Bifidus – 25 Billion is suitable for vegetarians, gluten free and has no dairy ingredients. A pack contains 30 capsules, each providing 12.5 billion Lab4 bacteria.


Thompson’s Slippery Elm Food 

Sunshine Health Ltd
Tel: 01453 751395
E-mail:  [email protected]

There are a few products that have been around as long as Thompsons’ Slippery Elm Food. That, undoubtedly indicates its success. It soothes and sustains at times of distress, whether convalescing or simply needing to line the digestive tract and nourish. Slippery Elm Food malted or unmalted makes a smooth porridge or a drink and is easily digested by the most delicate stomachs. A Slippery Elm Food drink before bedtime may encourage sound restful sleep. For more information visit www.sunshinehealthshop.co.uk 


Viridian Nutrition’s High Potency Digestive Aid

Viridian Nutrition
Tel: 01327 878050

High Potency Digestive Aid is a vegan combination of enzymes, peppermint, ginger and betaine hydrochloride (HCl), to help promote a healthy, well-balanced environment for digestion to take place with optimum efficiency. Viridian’s betaine hydrochloride provides a plant based form of HCl. Supplied as 30/190/150 vegan caps. Also available partnered with organic Milk Thistle in a festive pack for the winter season. Viridian Nutrition, founded on the principles of Purity, Environment and Charity. Dedicated to the continued success of the specialist health food store.


Peppermint Oil Plus (Delayed Release Caps)

Viridian Nutrition
Tel: 01327 878050

A unique combination of peppermint essential oil with ginger and caraway extracts. Featuring a delayed-release capsule to avoid digestion and deliver the ingredients where they are needed. The formula provides Peppermint leaf oil (Mentha x piperita) equivalent to 0.2ml of essential peppermint oil, Caraway seed extract (Carum carvi) equivalent to 640mg of caraway seed and Ginger root extract (Zingiber officinale equivalent to 350mg of ginger rhizome (root). Available as 30/90 vegan caps. Viridian Nutrition, founded on the principles of Purity, Environment and Charity. Dedicated to the continued success of the specialist health food store.


Silicea Gastro intestinal gel

World foods brand management ltd
Tel: 01782 366080
E-mail: [email protected]

Exciting new studies on the original Silicea Gastrointestinal  have led to the authorised claim for the treatment of IBS symptoms. Importantly, Silicea is produced without the need for preservatives which can be often aggravate digestive problems, and earlier this year Silicea teamed up with the largest IBS charity theibsnetwork.org which offers good advice and support to IBS sufferers. Silicea Gastrointestinal gel is presented in easy dose sachets , making them perfect for travelling and ready when you need them.


Good Health Naturally – Prescript Biotics

Wholesale Health Ltd
Tel: 01606 889905
E-mail:  [email protected]

Good digestion is crucial for good health, as it helps us absorb vital nutrients our bodies need. Prescript Biotics™ “Bio-identical” SBO Probiotics Consortia™ delivers an all-natural source of x8 essential soil-based bacteria, custom cultured (and encapsulated with their own nutrient-rich food source for long-lasting efficacy: a proprietary blend of humic and fulvic acids), to help naturally renew the gut and create a healthy harmony among good and bad gut bacteria. Each vegetable capsule has been meticulously manufactured to the highest standard, and is free from any chemicals, toxins, and GMOs. For trade enquiries, please call us on 01606 889905 or visit www.wholesalehealthltd.co.uk


Good Health Naturally – Essential Digestive Plus™

Wholesale Health Ltd
Tel: 01606 889905
E-mail:  [email protected]

Essential Digestive Plus™ is a unique, professional strength digestive enzyme formula, specifically formulated using only the highest quality ingredients to help naturally aid digestion and mineral absorption. Each serving delivers 11 essential digestive enzymes & derivatives, added peptidase & protease for improved gluten digestion, and Fruta-Fit® Inulin – naturally occurring soluble dietary fibres scientifically proven to support the formation and function of well-balanced gut flora. Essential Digestive Plus™ contains no added artificial colours or preservatives and is suitable for vegetarians and vegans. For trade enquiries, please call us on 01606 889905 or visit www.wholesalehealthltd.co.uk


BetterYou DLux 3000 Vitamin D Oral Spray

Tel: 01226 814030
E-mail:  [email protected]

An optimal strength vitamin D oral spray to support bones, teeth, muscle function and a healthy immune system. Each spray contains an effective nutritional dosage of 3000IU of vitamin D, delivering an optimum daily dosage into the bloodstream via the inner cheek. BetterYou’s DLux 3000 Oral Spray is a fast, effective and convenient alternative to tablets and capsules, supporting a healthy lifestyle. 


Digestive Health 

BioCare® Ltd
Tel: 0121 433 3727 
[email protected]

At BioCare we believe that good digestion is the cornerstone of health. With festive overindulgence just around the corner, now is the time to stock up on our digestive offerings for your customers.

Live bacteria: • Everyday BioAcidophilus – contains 10 billion of the clinically-researched ‘LAB4’ combination per capsule, with two specific proprietary strains of Lactobacillus acidophilus along with Bifidobacterium bifidum and Bifidobacterium lactis. They come in convenient 7 day strips, with no need for refrigeration.
Intestinal support: • GI Complex – high strength, powdered complex containing vitamin A which supports the maintenance of mucous membranes such as those lining the digestive tract, vitamin C and E which contribute to the function of the immune system and protection of cells from oxidative stress, along with L-glutamine, N-acetyl glucosamine (NAG), whey protein, and live bacteria.
Gastric support: • Slippery Elm Intensive – high strength powder containing slippery elm with zinc, gamma oryzanol, licorice, marshmallow, and aloe vera. Slippery elm is a source of mucilage which supports mucous membranes and soothes the digestive tract. Zinc has a role in the process of cell division and protection of cells from oxidative stress, and licorice helps to maintain balance and comfort in the digestive system.
Enzymes: • Polyzyme Forte – high potency enzyme complex containing a combination of vegetable-derived enzymes such as bromelain, lipase, protease, amylase, cellulose, lactase, and maltase, with Lactobacillus acidophilus. These enzymes can survive against the harsh pH of stomach acid. Digestive enzymes help to break down food, such as protein, carbohydrates and fat, into smaller particles ready for absorption.
Motility: • Psyllium Intensive – high strength powder combining LAB4 live bacteria with fructooligosaccharides (FOS) and inulin, as well as psyllium husk fibre to support intestinal transit and function and the maintenance of a healthy bowel. It also provides prune, pectin, and burdock.



Tel: 01460  243230
[email protected]

A major factor in digestive health is the approximately 100 trillion micro-organisms (most of them bacteria, but also viruses, fungi, and protozoa) which reside in the human gastrointestinal tract.* In fact, the microbiome (which weighs more than the brain) may now be thought of as a virtual organ of the body. Each of us will have a completely different mix of these microbes – like our gut fingerprint. Dysbiosis (either a qualitative or quantitative change in the gut microbial community) is commonly observed in many gut related conditions.* There is a strong association between reduced diversity and disease, which indicates that a species-rich gut ecosystem is more robust against environmental influences. Microbial diversity is therefore generally seen as a good indicator of a “healthy gut.”* 

One way to encourage microbial diversity within the gut is by eating a diet high in prebiotic fibres and polyphenols to encourage growth of a variety of beneficial species.* In particular, researchers have found that those individuals who eat a wide variety of plant foods (over 30 different types a week), have significantly greater microbial diversity and lower antibiotic-resistant species.8 This was regardless of other dietary factors.

Probiotics and traditionally fermented foods are a further way to support digestive health. The World Health Organisation defines probiotics as “live microorganisms that provide health benefits to the host when ingested in adequate amounts”. Their mechanisms of action are wide-ranging, but essentially they act to modify the gut microbiota, increasing levels of beneficial species, thereby helping us to digest our food and synthesise nutrients such as B vitamins, vitamin K and short-chain fatty acids;* strengthening the gut epithelial barrier;* inhibiting pathogens* and interacting with the immune system* (70% of which is located in the gut).* Probiotics have been shown in numerous clinical trials to be of benefit in a number of digestive conditions. For example, earlier this year the largest-ever clinical trial of live bacteria supplements in IBS ever conducted, found that Bio-Kult Advanced Multi-Strain Formulation (containing * different strains) significantly improved overall symptom severity and quality of life in moderate-to-severe IBS-diarrhoea patients.*