Meta‐analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast)

Melzer, Jörg; Rösch, Wolfgang; Reichling, J.; Brignoli, Reto; Saller, Reinhard

doi:10.1111/j.1365-2036.2004.02275.x

Cited by 195 publications

(89 citation statements)

References 30 publications

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“…The herbal drug preparation STW 5 (a composition of garden angelica root, milk thistle fruits, caraway fruits, greater celandine, bitter candy tuft, liquorice root, chamo mile flowers, balm leaves and peppermint leaves) is one of the best-studied compounds. A meta-analysis that included the data of three randomized controlled trials showed that STW 5 decreased the severity of the most bothersome gastrointestinal symptoms compared with placebo without inducing serious adverse events 203 . In healthy volunteers, STW 5 enhanced gastric accommo dation 204 and antral phasic contractions.…”

Section: Pharmacological Treatment Of Epsmentioning

confidence: 99%

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

260

247

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| Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders. Functional dyspepsia comprises three subtypes with presumed different pathophysiology and aetiology: postprandial distress syndrome (PDS), epigastric pain syndrome (EPS) and a subtype with overlapping PDS and EPS features. Functional dyspepsia symptoms can be caused by disturbed gastric motility (for example, inadequate fundic accommodation or delayed gastric emptying), gastric sensation (for example, sensations associated with hypersensitivity to gas and bloating) or gastric and duodenal inflammation. A genetic predisposition is probable but less evident than in other functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). Psychiatric comorbidity and psychopathological state and trait characteristics could also play a part, although they are not specific to functional dyspepsia and are less pronounced than in IBS. Possible differential diagnoses include Helicobacter pylori infection and peptic ulceration. Pharmacological therapy is mostly based on the subtype of functional dyspepsia, such as prokinetic and fundus-relaxing drugs for PDS and acid-suppressive drugs for EPS, whereas centrally active neuromodulators and herbal drugs play a minor part. Psychotherapy is effective only in a small subset of patients, whereas quality of life can be severely affected in nearly all patients. Future therapies might include novel compounds that attempt to treat the underlying gastric and duodenal inflammation. NATURE REVIEWS | DISEASE PRIMERS VOLUME 3 | ARTICLE NUMBER 17081 | 1 PRIMER © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d .standard therapy for gastro -oesophageal reflux disease. Paediatric dyspeptic symptoms are being addressed in a separate classification effort 10 . This Primer covers functional dyspepsia in adults only, although we sporadically refer to paediatric functional dyspepsia when similarities exist. EpidemiologyThe population prevalence of functional dyspepsia is quite variable across the globe, with overall high numbers (10-40%) in Western countries and low numbers (5-30%) in Asia, independent of the respective functional dyspepsia definitions 11 . A large-scale health and nutrition survey from France 12 (which involved >35,000 people) identified that 15% of individuals had suspected functional dyspepsia, 28% had irritable bowel syndrome (IBS) and 6% had both. The population of patients who are affected by both IBS and functional dyspepsia has been reported to range between 10% and 27% in previous studies 13 and to approach 30% in popu lation samples; it could be even higher in specific populations 14,15 . This observation has given rise to the term 'overlap syndrome' (REF. 13), which calls into question the sensitivity and specificity of the Rome criteria, at least for IBS and functional dyspepsia. This argument is also supported by the observation that patients with functional dyspepsia m...

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Section: Pharmacological Treatment Of Epsmentioning

confidence: 99%

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

260

247

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“…Among the herbal medications, one of the best evaluated in prospective studies is Iberogast ® [57,58] . Iberogast ® is a combination of herbal medicines, which include Iberis, peppermint, and chamomile [58] .…”

Section: Herbal Medicationsmentioning

confidence: 99%

Drug treatment of functional dyspepsia

Mönkemüller

Malfertheiner

2006

WJG

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the role of Helicobacter pylori (H pylori ) in functional dyspepsia continues to be a matter of debate, recent data indicate that there is modest but clear benefit of eradication of H pylori in patients with functional dyspepsia. In addition, H pylori is a gastric carcinogen and if found it should be eliminated. Although there are no specific diets for patients with FD, it may be helpful to guide the patients on healthy exercise and eating habits.

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“…It was found that peppermint produces an inhibition of spontaneous peristaltic activity, reduces total gastrointestinal transit or gastric emptying, decreases the basal tone in the gastrointestinal tract, reduces the slow wave frequency in the esophagi, small intestine, which slows peristaltic movements, and inhibits potassium depolarization-induced responses in the intestine (Mizuno et al, 2006). It was observed that peppermint relaxed the lower esophageal sphincter, and that it was useful as an antispasmodic agent for double-contrast barium meal examination and in patients with dyspepsia (Melzer et al, 2004). Preliminary evidence suggests that the peppermint component, menthol, may protect against herpes simple virus.…”

Section: Peppermint (Mentha Piperita)mentioning

confidence: 99%

“…Preliminary research suggests that it blocks slow wave activity in the small intestine, which could slow peristaltic movement (Melzer et al, 2004). In a clinical trial of 98 patients receiving local radiation and systemic chemotherapy, chamomile oral rinse prevented mucositis secondary to radiation therapy and some types of chemotherapeutic drugs including asparaginase, cisplatin, cyclophosphamide, daunorubicin, doxorubicin, etoposide, hydroxyurea, mercaptopurine, methotrexate, procarbazine, and vincristine (McKay and Blumberg, 2006).…”

Section: Chamomile (Matricaria Recutita)mentioning

confidence: 99%

Risks and benefits of commonly used herbal medicines in Mexico

Rodríguez‐Fragoso

Reyes‐Esparza

Burchiel

et al. 2008

Toxicology and Applied Pharmacology

167

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In Mexico, local empirical knowledge about medicinal properties of plants is the basis for their use as home remedies. It is generally accepted by many people in Mexico and elsewhere in the world that beneficial medicinal effects can be obtained by ingesting plant products. In this review, we focus on the potential pharmacologic bases for herbal plant efficacy, but we also raise concerns about the safety of these agents, which have not been fully assessed. Although numerous randomized clinical trials of herbal medicines have been published and systematic reviews and meta-analyses of these studies are available, generalizations about the efficacy and safety of herbal medicines are clearly not possible. Recent publications have also highlighted the unintended consequences of herbal product use, including morbidity and mortality. It has been found that many phytochemicals have pharmacokinetic or pharmacodynamic interactions with drugs. The present review is limited to some herbal medicine that are native or cultivated in Mexico and that have significant use. We discuss the cultural uses, phytochemistry, pharmacological and toxicological properties of the following following plant species: Nopal (Opuntia ficus), Peppermint (Mentha piperita), Chaparral (Larrea divaricata), Dandlion (Taraxacum officinale), Mullein (Verbascum densiflorum), Chamomile (Matricaria recutita), Nettle or Stinging Nettle (Urtica dioica), Passionflower (Passiflora incarmata), Linden Flower (Tilia europea), and Aloa (Aloa vera). We conclude that our knowledge of the therapeutic benefits and risks of some herbal medicines used in Mexico is still limited and efforts to elucidate them should be intensified.

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Meta‐analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast)

Cited by 195 publications

References 30 publications

Functional dyspepsia

Functional dyspepsia

Drug treatment of functional dyspepsia

Risks and benefits of commonly used herbal medicines in Mexico

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