The herbal preparation STW5 (lberogast^®) has potent and region‐specific effects on gastric motility

Abstract

Functional dyspepsia (FD) is amongst the most common functional gastrointestinal disorders. Symptomatic treatment includes the use of herbal preparations whose effects on gastric motility are unclear. The present study aimed at investigating the effects of STW 5 (Iberogast), a fixed combination of hydroethanolic herbal extracts, on gastric motility in vitro. Muscle strips from guinea-pig gastric fundus, corpus and antrum were set up in organ baths either in circular or longitudinal orientation. Addition of ethanol-free STW 5 to the organ baths (32-512 microg mL(-1)) dose-dependently evoked a sustained and reversible relaxation of circular and longitudinal fundus and corpus muscle strips without changes in phasic activity. In contrast, antral muscle strips responded to STW 5 with a significant increase in the contractile force of phasic contractions without changes in tone. All effects were resistant to tetrodotoxin (0.5 micromol L(-1)), atropine (1 micromol L(-1)), omega-conotoxin GVIA (0.5 micromol L(-1)), capsaicin (1 micromol L(-1)) or L-NAME (100 micromol L(-1)), suggesting that neither nerves nor nitric oxide pathways were involved. These data demonstrate that STW 5 profoundly alters gastric motility in a region-specific but not layer-specific manner and thus implicates Iberogast in the treatment of FD patients suffering from motility disorders with impaired fundus accommodation and/or antral hypomotility.

Effect of an Herbal Preparation, STW 5, in an Acute Model of Reflux Oesophagitis in Rats

“…In a sub-group analysis in patients with FD, it was found to relieve heartburn and other acid-related symptoms (40). It was also reported to improve gastric accommodation in guinea pigs as well as in humans (25,26), to reduce hypersensitivity to both mechanical and chemical stimuli in rat ileum in-situ (27,28), to enhance LES contractility (29), and to reduce acid output and improve mucosal protection (23,24).…”

“…Its mechanism of action seems to be multi-factorial, including anti-inflammatory and mucosal protective effects (23,24). It was also shown to improve gastric accommodation (25,26), reduce visceral hypersensitivity (27,28), and increase the tone of the lower oesophageal sphincter (LES) (29), all of which are factors that play an important role in the pathogenesis of GERD (30).…”

Adenosine A2A receptor contributes to the anti-inflammatory effect of the fixed herbal combination STW 5 (Iberogast®) in rat small intestinal preparations

“…STW 5 and STW 6 were dissolved in water. The concentrations of STW 5 were used according to Hohenester et al (2004). STW 6 was used in concentrations equivalent to its proportion in STW 5.…”

STW 5/Iberogast: multi-target-action for treatment of functional dyspepsia and irritable bowel syndrome

“…der Hälfte der Patienten beobachtet werden kann, zugeschrieben. Am Modell des Meerschweinchenmagens bewirkte STW 5/Iberogast eine signifikante, konzentrationsabhän-gige Tonusabnahme im Fundus-und Korpus, während sich im Antrum keine anhaltenden Wirkungen auf die tonische Aktivität ergaben [7]. Im Gegensatz dazu wurde im Antrum die phasische Aktivität gesteigert, und die Kontraktionsamplitude der Antrummuskelpräparate nahm nach Zugabe von STW 5/Iberogast signifikant zu (Abb.…”

“…1a. STW 5/Iberogast verringert den Tonus der Magenmuskulatur in Corpus und Fundus (1) und stimuliert die phasische Aktivität im Antrum (2)[7]. Abb.…”