Iberogast supplement benefit STW5
March 9 2017 by
Ray Sahelian, M.D. a source of integrative health information

Iberogast is a fixed combination of several medicinal herbal extracts for the treatment of functional dyspepsia and irritable bowel syndrome. It is also known as STW 5, a combination of nine plant extracts, and widely used in the treatment of gastrointestinal disorders, including functional dyspepsia and irritable bowel syndrome for which the involvement of an inflammatory etiology is discussed.

Herbs found in Iberogast product
Proprietary blend of the following herbal extracts: German chamomile (Matricaria recutita) flower, clowns mustard (Iberis amara) plant, angelica (Angelica archangelica) root and rhizome, caraway (Carum carvi) fruit, milk thistle (Silybum marianum) fruit, lemon balm (Melissa officinalis) leaf, celandine (Chelidonium majus) aerial part, licorice (Glycyrrhiza glabra) root, and peppermint (Mentha x piperita) leaf.

Colon cancer
Phytomedicine. 2013. Mechanisms of the anti-proliferative and anti-inflammatory effects of the herbal fixed combination STW 5 (Iberogast) on colon adenocarcinoma (HT29) cells in vitro. Several conventional pharmaceuticals like non-steroidal anti-inflammatory drugs (NSAIDS) or selective cyclooxygenase-2 (COX-2) inhibitors have been demonstrated to exert anti-proliferative effects and to induce apoptosis in a variety of cell lines, e.g. colon, stomach, or prostate cancer cells.

Iberogast for functional dyspepsia
STW 5, a phytopharmacon for patients with functional dyspepsia: results of a multicenter, placebo-controlled double-blind study.
Am J Gastroenterol. 2007. von Arnim U, Peitz U, Vinson B, Gundermann KJ, Malfertheiner P. Otto-von-Guericke-Universität Magdeburg, Zentrum für Innere Medizin, Germany.
Functional dyspepsia constitutes a complex picture with a variety of epigastric symptoms. This multicenter, placebo-controlled, double-blind study evaluated the efficacy and tolerability of the herbal drug STW 5, mainly comprising a fresh plant extract from Iberis amara. A total of 315 patients were treated with 3 x 20 drops/day of either STW 5 or placebo, of them 158 were treated with STW 5 and 157 with placebo. Gastrointestinal Symptom Score showed improvement during the treatment period. The STW 5 group improved 6.9 points up to day 56, placebo group by 5.9. H. pylori did not influence the results. This placebo-controlled study with an 8-wk treatment period documents the efficacy of STW 5 in functional dyspepsia.

Mucositis induced by chemotherapy medications
The herbal extract, Iberogast, improves jejunal integrity in rats with 5-Fluorouracil (5-FU)-induced mucositis.
Cancer Biol Ther. 2009; Wright TH, Yazbeck R, Lymn KA, Whitford EJ, Cheah KY, Butler RN, Feinle-Bisset C, Pilichiewicz AN, Mashtoub S. Centre for Paediatric and Adolescent Gastroenterology, Children, Youth and Women's Health Service, Adelaide, SA, Australia.

Effect of Iberogast on smooth muscles
Spasmolytic and tonic effect of Iberogast STW 5 in intestinal smooth muscle.
Phytomedicine. 2006. Department of Pharmacology, Institute of Pharmaceutical Sciences, University of Tübingen, Germany.
The effects of Iberogast, a combination of Iberis amara fresh plant extract, and other eight plant extracts as well as single extract components including extracts from Menthae piperitae folium, Matricariae flos and Liquiritiae radix, were assayed in guinea pig ileum with or without stimulation with acetylcholine or histamine, in order to find a possible effect on the contractility of intestinal smooth muscle. Iberogast decreased acetylcholine- and histamine-induced contraction of guinea pig ileum. This was also true for extracts of Menthae piperitae folium, Matricariae flos and L. radix. Extract from Iberia amara, however, showed no spasmolytic action; in contrary, it increased the basal resting tone and contraction of atonic ileal segments. This was also true when Iberogast was employed. A spasmolytic action of Iberogast could also be observed in duodenum, jejunum and colon. These data are the first to show not only the spasmolytic effects of Iberogast and its component extracts in intestinal muscle but also the tonicising effects of Iberogast through its component Iberis amara extract in relaxed intestinal muscle. Thus, pharmacological evidence suggests a dual-action principle and may explain, at least in part, the clinically observed therapeutic efficacy of Iberogast in both hypotonic and spastic dysmotility symptoms of functional dyspepsia and irritable bowel syndrome.

Ulcerative colitis, not effective
J Evid Based Complementary Altern Medicine. 2014. Clinical and structural effects of traditional Chinese medicine and the herbal preparation, Iberogast, in a rat model of ulcerative colitis. Plant-sourced formulations such as Iberogast and the traditional Chinese medicine formulation, Cmed, purportedly possess anti-inflammatory and radical scavenging properties. We investigated Iberogast and Chinese medicine independently, for their potential to decrease the severity of the large bowel inflammatory disorder, ulcerative colitis. Sprague Dawley rats. Neither Iberogast nor Cmed achieved statistical significance for daily metabolic parameters or colonic crypt depth.

Questions
I was just browsing through your site looking for information on Iberogast. I read your article on IBS and was wondering if it would be worthwhile to mention Iberogast as being an option. I do not suffer from IBS, but someone close to me does, hence my online investigation.
   After briefly reviewing the research on Iberogast, it appears that some early studies look promising. However, I don't have clinical experience with it so I have no first hand knowledge whether it is effective for IBS.

I would like to take Iberogast with dinner but that is when I take my vitamins. Is there any known interaction? Should I take my vitamins at a separate meal just to be sure? Some of the possible side effects of the ingredients (e.g. chamomile and licorice root) are alarming. How concerned should one be if taking only one dose a few times a week?
   I am not aware of studies regarding the combination of this herbal formula but I doubt any major interactions would occur. I personally prefer taking vitamins before or with breakfast. The herbs in this product appear to be relatively safe but it is a good idea to take breaks from use.

Would Iberogast be acceptable to alleviate intestinal symptoms associated with recurring adenocarcinomas of the small bowel?
   I have not seen such studies to know whether it would be of benefit.