Herbal Therapies in Functional Gastrointestinal Disorders: A Narrative Review and Clinical Implication

Abstract

The pathophysiology of functional gastrointestinal disorders (FGIDs) is still unclear and various complex mechanisms have been suggested to be involved. In many cases, improvement of symptoms and quality of life (QoL) in patients with FGIDs is difficult to achieve with the single-targeted treatments alone and clinical application of these treatments can be challenging owing to the side effects. Herbal preparations as complementary and alternative medicine can control multiple treatment targets of FGIDs simultaneously and relatively safely. To date, many herbal ingredients and combination preparations have been proposed across different countries and together with a variety of traditional medicine. Among the herbal therapies that are comparatively considered to have an evidence base are iberogast (STW-5) and peppermint oil, which have been mainly studied and used in Europe, and rikkunshito and motilitone (DA-9701), which are extracted from natural substances in traditional medicine, are the focus of this review. These herbal medications have multi-target pharmacology similar to the etiology of FGIDs, such as altered intestinal sensory and motor function, inflammation, neurohormonal abnormality, and have displayed comparable efficacy and safety in controlled trials. To achieve the treatment goal of refractory FGIDs, extensive and high quality studies on the pharmacological mechanisms and clinical effects of these herbal medications as well as efforts to develop new promising herbal compounds are required.

In Vitro Screening of East Asian Plant Extracts for Potential Use in Reducing Ruminal Methane Production

“…Moreover, enrichment of dietary linoleic acid (18:2), a precursor of bioactive conjugated linoleic acids [ 77 ], suggested that PA seeds might be a promising feed additive for ruminants. In addition, PA seeds have been widely used in Korean and Chinese traditional medicine for their roles in improving digestibility and intestinal motility (reviewed in [ 78 ]). Therefore, PA seeds could act as a source of fatty acids, probably replacing oil seeds that have been reported to decrease DM and neutral detergent fibre digestibility [ 19 ].…”

Paediatric functional abdominal pain disorders

“…• For those with postprandial distress syndrome, which is believed to be associated with problems in gastric emptying and accommodation, cyproheptadine is recommended as one of the first-line drugs 241,242 . The latest use of a peppermint oil-based preparation has also been shown to be beneficial [243][244][245] . The next step in treatment is the use of prokinetics, including 5-HT 4 agonists, and when those fail, 5-HT 1 receptor agonists such as buspirone, which relax the proximal stomach, are recommended 246 .…”

Patient Suffering in Chronic Digestive Diseases: Will Primary Care-Specialist Collaboration With Effective Interactive Communication and Integrative Medicine in the Plan of Care Improve Quality of Life?

“…Peppermint oil capsule is another herbal product that Alizia consumed daily to relieve bloating and flatulence. Peppermint oil is a safe and effective product for short-term treatment in functional GI disorders ( 14 ).…”

“…The usage of integrative approaches in the alleviation of digestive symptoms is widely reported in the literature ( 8 – 12 , 14 , 15 ). The patient in this case report also experienced symptom control by following a modified dietary plan, consuming special diets and herbal products, and engaging in mind–body relaxation techniques.…”