“…Increased LESP may lead to symptom improvement. Treatment of isolated muscle strips of guinea pig LES with STW 5 resulted in dose-dependent increase of basal tonus, whereas the directly adjacent gastric sling muscle and the pylorus remained unaffected indicating specificity to LES ( Table 1S , Supporting Information) 18 .…”
Section: Effects Of Stw 5 On Pathological Mechanisms Of Fgidsmentioning
Herbal combination preparations are widely used in traditional herbal medicine and are even established as modern evidence-based herbal medicinal products. The rationale behind such combinations is often questioned and assessing the contribution of each of the combination partners to overall activity is challenging. STW 5 (Iberogast) is such a combination with confirmed clinical efficacy in functional gastrointestinal disorders. It consists of nine plant extracts responsible for its multitarget function in these multifactorial diseases with their heterogeneous and overlapping pathomechanisms. This makes the combination an ideal candidate for the use of the newly described method of stepwise cluster analysis, a standardized procedure to transfer heterogeneous pharmacological data, from different models, into effect size categories. This allows for a stepwise cluster formation starting from the level of single tests up to the level of different pathomechanisms involved in the development of a certain disease, in this case functional dyspepsia subtypes and irritable bowel syndrome. In the current article, an overview on the pharmacological data on STW 5 and its single components is provided. The data are further analyzed using stepwise cluster formation, resulting in a summary of the different modes of action of STW 5 along with an evaluation of the contribution of the single constituents to the overall multitarget effects of the herbal combination preparation.
“…Increased LESP may lead to symptom improvement. Treatment of isolated muscle strips of guinea pig LES with STW 5 resulted in dose-dependent increase of basal tonus, whereas the directly adjacent gastric sling muscle and the pylorus remained unaffected indicating specificity to LES ( Table 1S , Supporting Information) 18 .…”
Section: Effects Of Stw 5 On Pathological Mechanisms Of Fgidsmentioning
Herbal combination preparations are widely used in traditional herbal medicine and are even established as modern evidence-based herbal medicinal products. The rationale behind such combinations is often questioned and assessing the contribution of each of the combination partners to overall activity is challenging. STW 5 (Iberogast) is such a combination with confirmed clinical efficacy in functional gastrointestinal disorders. It consists of nine plant extracts responsible for its multitarget function in these multifactorial diseases with their heterogeneous and overlapping pathomechanisms. This makes the combination an ideal candidate for the use of the newly described method of stepwise cluster analysis, a standardized procedure to transfer heterogeneous pharmacological data, from different models, into effect size categories. This allows for a stepwise cluster formation starting from the level of single tests up to the level of different pathomechanisms involved in the development of a certain disease, in this case functional dyspepsia subtypes and irritable bowel syndrome. In the current article, an overview on the pharmacological data on STW 5 and its single components is provided. The data are further analyzed using stepwise cluster formation, resulting in a summary of the different modes of action of STW 5 along with an evaluation of the contribution of the single constituents to the overall multitarget effects of the herbal combination preparation.
“…The primary studies [ 18 ] identified a dual mechanism of action on gastrointestinal motility, with a spasmolytic effect on ACh-induced contractions and a tonificating effect in the relaxed state. This has been confirmed in different pharmacological models [ 19 , 20 ] and in human isolated intestinal segments [ 21 ] as well as in inflamed intestinal tissue in vitro and in vivo [ 22 – 24 ]. Fig.…”
“…The rapid and region-specific action has been confirmed in a human study in vivo [ 26 ]. In the lower esophageal sphincter, a tonificating action mediated by L‑type Ca 2+ channels was identified in vitro [ 21 ]. The components of the herbal combination STW 5 have been shown to act synergistically in pharmacological studies [ 27 ].…”
SummaryThe prokinetic cisapride, an important therapeutic option in functional gastrointestinal (GI) disorders, was withdrawn from the market 15 years ago due to rare severe side effects. Likewise in 2014, the use of metoclopramide (MCP) and domperidone in functional GI disorders (FGID) was restricted, consequently leaving a therapeutic gap in clinical practice. A systematic review revealed that the herbal medicinal product (HMP) STW 5 presents a therapeutic option equivalent to MCP and cisapride. STW 5 is the only HMP for which efficacy has been shown in randomized controlled clinical trials (RCTs) in functional dyspepsia and irritable bowel syndrome, based on its multitarget effect on numerous etiological factors. Due to an outstanding favorable safety profile, STW 5 allows an effective and safe use in FGID without a limitation of the duration of the treatment.
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