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What is Iberogast? Does this herbal remedy have any potential for treatment of irritable bowel syndrome?

Dr. Brown: Iberogast is an herbal medicine being used in the treatment of irritable bowel syndrome in Germany and other European countries since 1968. To date, its use in the United States has been limited. This herbal compound is also known as STW 5 and is an herbal plant mixture that consists of nine different plant extracts*. Iberogast is named for the fresh herb Iberis amara (Clown's mustard plant) which may be its most active component. Each of the extracts in Iberogast has been shown to have effects on intestinal movement (gut motility) and sensitivity. This medicine has been shown to have both spasmolytic and a pro-kinetic (improve gut movement) effect. Animal studies have demonstrated Iberogast spasmolytic property is mainly in the small and large intestine while its motility improving function also affect the stomach as well as intestine. Obviously, these effects could result in a significant symptom relief in patients with functional dyspepsia, as well as irritable bowel syndrome. Additionally, Iberogast has been shown to have anti-inflammatory and antioxidant capabilities. Given that there are some studies that suggest an inflammatory component to irritable bowel syndrome, its role as an anti-inflammatory agent is certainly intriguing. Finally, the drug may have protective properties secondary to its ability to stimulate local mucus production in the gastrointestinal tract. Recent well-controlled clinical trials have shown that Iberogast is capable of improving the symptoms of bloating and abdominal pain and disturbances in bowel habits and has been used successfully in irritable bowel syndrome and functional dyspepsia. To date, there is no case report of serious side effects associated with the use of the compound at its current recommended dose. There is also report of long-term benefit in those individuals who responded to this medication for at least four months after stopping the medicine. Response rates, which typically are defined as at least a 50% reduction in symptoms, occur in 62 to 84% of patients taking Iberogast. Long-term trials, beyond four months are not available. The drug is in the form of liquid and it is taken three times daily with meal. It seems that Iberogast is a viable option for individuals with IBS who have not favorably responded to other alternatives. This is particularly true for symptoms of bloating and abdominal pain. To date, there are no clinical trials combining this drug with other medications typically prescribed for irritable bowel syndrome but there is no data to support drug interaction with other medications used for the treatment of constipation and diarrhea in the setting of IBS. *Herbal extracts in 1 milliliter of Iberogast: Clown's mustard plant (Iberis amara) Chamomile flower (Matricariae flos) Angelica root (Angelicae radiz) Caraway fruit (Cavi fructus) Milk thistle fruit (Cardui mariae fructus) Melissa leaf (Melissae folium) Celandine herbs (Chelidonii herba) Licorice root (Liquiritiae radiz) Peppermint leaf (Menthae piperitae folium)
2008-03-22 07:55:02

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