Does St John’s Wort cause bloating? (5 factors)

This article will discuss whether Saint John’s Wort causes bloating. It will explore research findings on this topic and mention factors that influence the occurrence of St. John’s Wort-induced bloating. Finally, the article will provide suggestions on what to do if you experience bloating while taking St. John’s Wort.

Does St John’s Wort cause bloating?

Saint John’s Wort may cause bloating in some people. The most commonly reported side effects of St. John’s Wort are gastrointestinal problems. However, St. John wort has a good safety profile, and the bloating it causes is usually tolerable.

While bloating is an uncomfortable symptom that can occur while taking SJW, not everyone may experience it as a side effect. Moreover, some people may have potential factors that can contribute to this discomfort.

If you experience bloating while taking St. John’s Wort, try taking it with food. Moreover, try to identify the foods and habits that trigger bloating and avoid them. Eating yogurt, drinking certain herbal teas, and taking OTC medications for your bloating may help.

If your bloating is severe and persistent, however, it is advisable to visit a doctor.

What does research suggest?

There isn’t enough research that specifically investigates bloating as a side effect of Saint John’s Wort. However, multiple studies have studied its gastrointestinal side effects in general.

For instance, one study that investigated the safety and efficacy of SJW found gastrointestinal discomfort to be the most common side effect, affecting 0.6% of the participants. Moreover, in another investigation, 18 out of 3250 people suffered from ST. John’s Wort-induced gastrointestinal side effects [1,2].

Furthermore, one study compared the safety profiles of fluoxetine and St. John’s Wort. It found that the only side effect that was reported by more than 2% of the people was GI disturbances. GI disturbances were reported by only 5% of SJW-treated individuals, in comparison to 6% of fluoxetine-treated patients [3].

What factors influence St. John’s Wort-induced bloating?

Multiple factors may influence the occurrence of bloating while taking St. John’s Wort. For instance, taking a high dose of SJW or jumping to a higher dose without applying proper dose titration can lead to intolerance and bloating. High doses may cause other GI side effects as well.

Furthermore, lack of physical activity and dehydration can contribute to bloating while taking St. John’s Worts. People who tend to eat large meals and fatty foods are also more likely to get bloated while administering SJW. Carbonated drinks, alcohol, and cigarettes can also increase the risk of bloating. 

Additionally, overstressed people are more likely to experience SJW-related bloating, as high stress levels may increase cortisol, resulting in water retention and bloating.

Medications and conditions that influence St. John’s Wort-induced bloating

The concurrent administration of other bloating-inducing medications can increase St. John’s Wort-related bloating. Moreover, certain conditions may also increase the occurrence of this side effect. Examples of these medications and conditions are mentioned below [4]:

Medications Conditions
Oral contraceptives and hormone replacement therapy Irritable Bowel Syndrome
Certain NSAIDs ,like ibuprofen and aspirin Menstruation and pregnancy
Opioids and tramadol Small-intestine bacterial infection
Cholestyramine Chronic constipation
Antidepressants like Celexa and Pristiq Food intolerances

What to do if you experience bloating while taking SJW?

If you experience St. John’s Wort-induced bloating, try taking it with food to minimize gastrointestinal irritation. Moreover, certain lifestyle modifications can help reduce the risk of experiencing bloating while taking SJW.

For instance, to minimize bloating in general, it is advisable to eat small, frequent meals rather than big ones. Furthermore, ensure drinking enough water; aim for around 3 liters per day. Engaging in regular exercise is also recommended. These tips can improve digestion and prevent bloating.

You should also identify the foods that trigger your bloating and avoid them. Moreover, certain herbal drinks may help relieve SJW-related bloating, such as green tea, chamomile tea, and anise tea. You may also try including yogurt in your diet; its probiotics help enhance gut health.

If SJW-induced bloating persists despite these management strategies, you should discuss this with a doctor, especially if you have a history of digestive issues. They may reduce your dose and monitor your symptoms to assess tolerance. They may also recommend taking medications for your bloating.

For instance, they may recommend OTC anti-gas medications like simethicone or prescribe medications for underlying digestive conditions such as irritable bowel syndrome.

What are the other side effects of St. John’s Wort?

Saint John’s Wort can cause other side effects. Some of its common side effects are mentioned below [5]:

  • Rash
  • Restlessness
  • Anxiety
  • Headache
  • Dry mouth
  • Fatigue
  • Sedation

Other more serious side effects include liver injury, kidney injury, induction of mania, and hypertensive crisis. It may also cause serotonin syndrome if taken with an antidepressant. Thus, it is advisable to avoid taking SJW with antidepressants like Celexa or sertraline.

Understanding the link between St. John’s Wort and bloating

Based on my research, I found that Siant John’s Wort can cause bloating, especially in people with a history of gastrointestinal issues. However, I believe that St. John’s Wort-induced bloating is tolerable and can be managed.

If you experience bloating while taking St. John’s Wort, I recommend taking it with food. I also suggest improving your eating habits, eating yogurt, and drinking herbal teas. Identifying and avoiding the foods and habits that increase your bloating may also be helpful.

If St. John’s Wort-related bloating doesn’t go away, you may need to visit a doctor. They will assess your risk factors, such as high stress levels, an unhealthy diet, a lack of physical activity, concurrent medications, and the presence of gastrointestinal diseases, and determine the appropriate management strategy.

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References

1.-

Woelk H, Burkard G, Grünwald J. Benefits and risks of the hypericum extract LI 160: drug monitoring study with 3250 patients. J Geriatr Psychiatry Neurol. 1994 Oct;7 Suppl 1:S34-8. doi: 10.1177/089198879400700110. PMID: 7857506. https://pubmed.ncbi.nlm.nih.gov/7857506/

2.-

Paul Hammerness, Ethan Basch, Catherine Ulbricht, E.-P. Barrette, Ivo Foppa, Samuel Basch, Steve Bent, Heather Boon, Edzard Ernst. St. John’s Wort: A Systematic Review of Adverse Effects and Drug Interactions for the Consultation Psychiatrist. Psychosomatics, Volume 44, Issue 4, 2003, Pages 271-282. ISSN 0033-3182. https://doi.org/10.1176/appi.psy.44.4.271.

3.-

Schrader, E. on behalf of the Study Group. Equivalence of St John’s wort extract (Ze 117) and fluoxetine: a randomized, controlled study in mildmoderate depression. International Clinical Psychopharmacology 15(2):p 61-68, March 2000. https://link.springer.com/article/10.1007/s002280050519

4.-

Seo AY, Kim N, Oh DH. Abdominal bloating: pathophysiology and treatment. J Neurogastroenterol Motil. 2013 Oct;19(4):433-53. doi: 10.5056/jnm.2013.19.4.433. Epub 2013 Oct 7. PMID: 24199004; PMCID: PMC3816178. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816178/

5.-

Canenguez Benitez JS, Hernandez TE, Sundararajan R, Sarwar S, Arriaga AJ, Khan AT, Matayoshi A, Quintanilla HA, Kochhar H, Alam M, Mago A, Hans A, Benitez GA. Advantages and Disadvantages of Using St. John’s Wort as a Treatment for Depression. Cureus. 2022 Sep 22;14(9):e29468. doi: 10.7759/cureus.29468. PMID: 36299970; PMCID: PMC9587902. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9587902/