Treatment of irritable bowel syndrome with herbal preparations

results of a double-blind, randomized, placebo-controlled, multi-centre trial

MADISCH, A.
HOLTMANN, G.
PLEIN, K.
HOTZ, J.

†Medical Department I, Technical University Hospital, Dresden, Germany
‡Division of Gastroenterology and Hepatology, University Hospital, Essen, Germany
§Department of Gastroenterology, General Hospital, Celle, Germany

Correspondence to: Dr G. Holtmann, Professor of Medicine, University Hospital Essen, Department of Gastroenterology and Hepatology, Hufelandstr. 55, 45122 Essen, Germany. E-mail: [email protected]

*Deceased.

Accepted for publication 25 November 2003

Alimentary Pharmacology & Therapeutics 19(3):p 271-279, February 2004.

SUMMARY

Background

Herbal medications have been used in many countries for the treatment of patients with irritable bowel syndrome. Controlled data supporting the efficacy of these treatments in patients with irritable bowel syndrome are lacking.

Aim

To assess the efficacy and safety of a commercially available herbal preparation (STW 5) (nine plant extracts), the research herbal preparation STW 5-II (six plant extracts) and the bitter candytuft mono-extract in patients with irritable bowel syndrome.

Methods

Two hundred and eight patients with irritable bowel syndrome were recruited after standardized diagnostic work-up into a double-blind, placebo-controlled, multi-centre trial and were randomly assigned to receive one of four treatments: commercially available herbal preparation STW 5 (n = 51), research herbal preparation STW 5-II (n = 52), bitter candytuft mono-extract (n = 53) or placebo (n = 52). The main outcome variables were the changes in total abdominal pain and irritable bowel syndrome symptom scores.

Results

Two hundred and three patients completed the trial. STW 5 and STW 5-II were significantly better than placebo in reducing the total abdominal pain score (intention-to-treat: STW 5, P = 0.0009; STW 5-II, P = 0.0005) and the irritable bowel syndrome symptom score (intention-to-treat: STW 5, P = 0.001; STW 5-II, P = 0.0003) at 4 weeks. There were no statistically significant differences between the bitter candytuft mono-extract group and the placebo group (P = 0.1473, P = 0.1207).

Conclusions

The commercially available herbal preparation STW 5 and its research preparation STW 5-II are both effective in alleviating irritable bowel syndrome symptoms.