Clinically proven herbs for every day gastrointestinal challenges.
Subject: Gastrointestinal diseases
Medicine, Botanic
Medicine, Herbal
Author: Boyd, Michelle
Pub Date: 12/22/2011
Publication: Name: Australian Journal of Medical Herbalism Publisher: National Herbalists Association of Australia Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 National Herbalists Association of Australia ISSN: 1033-8330
Issue: Date: Winter, 2011 Source Volume: 23 Source Issue: 4
Accession Number: 275312591
Full Text: Around 30% of the population suffer from Functional Gastrointestinal Disorders (FGIDs), typically Functional Dyspepsia (FD) and Irritable Bowel Syndrome (IBS). The vast complexity of pathophysiological multicausality of these conditions poses a therapeutic dilemma. Further, there is an overlap of IBS and FD wherein around 30% of these cases suffer from both. (1,2) Fortunately, there is a specifically clinically proven multi-targeted solution which addresses the whole symptom spectrum and underlying causes associated with these conditions--it's a 50 year old herbal medicine called Iberogast[R] (STW 5).

Iberogast is a multi-component formulation of 9 herbal extracts namely Iberis amara, Angelica archangelica, Matricaria recutita, Carum carvi, Silybum marianum, Melissa officinalis, Mentha x piperita, Chelidonium majus and Glycyrrhiza glabra. Iberogast has been subjected to extensive toxicology and pharmacology studies, with proven efficacy established to date in 19 international clinical trials involving over 45,000 patients of all ages. Iberogast's 9 herbal extracts act as a whole delivering a multitargeted action which performs synergistic and additive effects. In short, Iberogast, with an immense collection of quality, safety and efficacy data, is the most extensively investigated herbal medicine for the treatment of FGIDs. (3,4,5,6,8)

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Iberogast has specifically clinically proven activity that consistently targets all the important symptoms of FGIDs (e.g. nausea, vomiting, heartburn, abdominal discomfort or pain, bloating, constipation and diarrhoea) via actions on gastrointestinal (GI) tone modulation, inflammatory processes and visceral hypersensitivity of the GI tract.

Iberogast influences the motility of the whole GI tract. In FD, Iberogast has a multi-targeted effect on the stomach which normalises dysfunctional gastrooesophageal motility by toning the lower oesophageal sphincter, inducing fundus relaxation and promoting the required level of antrum musculature tone and contractility. (9,10) Iberogast has demonstrated increased basic tone of GI tissues and significantly diminishes colon spasms.

Iberogast has anti-inflammatory effects with anti-ulcerogenic properties by reducing gastric acid formation, increasing mucin secretion and delivery of anti-inflammatory prostaglandin PGE2 as well as inhibiting inflammation-inducing leukotrienes. (2)

During the development of FGIDs several post-inflammatory conditions manifest in altered intestinal flora or altered mucosa properties, which can possibly increase sensitivity to GI stimuli in healthy persons. (11) Iberogast increases protective glutathione, reduces myeloperoxidase activity and normalises inflammatory mediators TNF[alpha], II-1[beta] and ICAM-1. (2)

Iberogast normalises visceral hypersensitivity which causes the majority of FGID symptoms. FGID patients perceive stimuli from ingested food and digestion processes much stronger than is adequate. Iberogast significantly reduces the impulse rate of signal of the stimulated nerve and diminishes the activation response to sensory visceral nerves to mechanical, chemical and inflammatory stimuli. (3,11) Motor and sensory reactions in the GI tract are transferred via mediator substances binding at specific receptors; predominantly substances similar to serotonin and opiate. Iberogast showed binding properties on serotonergic and muscarinic receptors which could explain the way Iberogast mediates effects on motility and sensitivity. (11)

Iberogast research continues in Australia where it is currently being evaluated for clinical efficacy alongside esomeprazole (Nexium[R]) in a randomised placebo-controlled trial involving 480 patients with FD. This trial is taking place at the Royal Adelaide Hospital and is funded by an NHMRC grant.

References: (1.) Ford et al. Clinical Gastroenterology and Hepatology 2009 (2.) Extract from symposium on 'Functional GI Diseases: Solving the Therapeutic Dilemma', part of European Bridging Meeting in Gastroenterology Nov 2010, Berlin. (3.) Buchert D et al. Z Phytother 1994; 15:24-25. 4. Madisch A et al. Z Phytother 2001; 39:1-8. (5.) Rosch W et al. Z Gastroenterol 2002; 40:401-408. (6). Von Arnim U et al. Am J Gastroenterol 2007; 102:1268-1275. (7.) Madisch A et al. Ailment Pharmacol Ther 2004: 19:271-279. (8.) Leichtle K In-House Research Report, Steigerwald 1999. (9.) Hohenester B et al. Neurogastroenterol Motil 2004; 16:765-773. (10.) Pilichiewicz AN et al. Am J Gastroenterol 2007; 102:1276-1283. (11.) Vinson B'Development of Iberogast: Clinical Evidence for Multicomponent Herbal Mixtures' cited in Botanical Medicine from Bench to Bedside, Eds. R. Cooper & F Kronenberg, Liebert Publishers.

Michelle Boyd, Naturopath, Herbalist, Lecturer and head of practitioner education at Flordis, focuses on a specifically clinically proven herbal medicine for the treatment of gastrointestinal discomfort.
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