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Treatment of irritable bowel syndrome with herbal preparations: Results of a double-blind, randomized, placebo-controlled, multi-centre trial
Abstract
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.
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“Both STW 5 and STW 5-II (20 drops three times daily for four weeks) modestly reduced total abdominal pain scores (STW 5, p = 0.0009 and STW 5-II, p = 0.0005) and IBS symptom scores (STW 5, p = 0.001; STW 5-II, p = 0.0003) after 4 weeks compared with placebo [45].”
From Plant-Derived Treatments for IBS: Clinical Outcomes, Mechanistic Insights, and Their Position in International Guidelines (2026) · cites this paper as [45]
In the citing paper
“Iberogast (STW-5 and STW-5 II) has also demonstrated clinical improvements across multiple trials”
From Plant-Derived Treatments for IBS: Clinical Outcomes, Mechanistic Insights, and Their Position in International Guidelines (2026) · cites this paper as [45]
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Citations
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Cited by
Guidelines on the irritable bowel syndrome: mechanisms and practical management
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Pastras, P., Aggeletopoulou, I., Bali, M., & Triantos, C. (2026) · Nutrients · doi:10.3390/nu18020183 · Cited by 1
Metadata
- Authors
- Madisch, A., Holtmann, G., Plein, K., & Hotz, J.
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2004-01-20
- Volume
- 19
- Issue
- 3
- Pages
- 271-279
- ISSN
- 0269-2813
- 1365-2036
- Cited by
- 172
- References
- 6
- Language
- en
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