Open AccessMulti-target Treatment for Irritable Bowel Syndrome with STW 5: Pharmacological Modes of Action
Author(s) -
Hans–Dieter Allescher,
Rebecca Burgell,
Peter Malfertheiner,
Fermı́n Mearin
Publication year - 2020
Publication title -
journal of gastrointestinal and liver diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.641
H-Index - 48
eISSN - 1842-1121
pISSN - 1841-8724
DOI - 10.15403/jgld-814
Subject(s) - irritable bowel syndrome , medicine , intestinal permeability , gut microbiome , gastrointestinal disorder , functional gastrointestinal disorder , microbiome , gut–brain axis , etiology , motility , gastrointestinal transit , gastroenterology , gut flora , bioinformatics , immunology , biology , genetics
Irritable bowel syndrome (IBS) is a heterogeneous and complex functional gastrointestinal disorder with aglobal prevalence of approximately 11% and high geographic variation. IBS encompasses various symptomclusters considered to reflect complex patho-etiological mechanisms, and effective treatment options arelimited, with most medications targeting individual mechanisms and symptoms. Therefore, multi-targetedtreatment is required. IBS is currently viewed as a disorder of disturbed gut–brain interactions withabnormalities at different sites along the gut–brain axis, including altered gastrointestinal motility, visceralhypersensitivity, increased intestinal permeability, and altered gut microbiota. All of these abnormalitiesrepresent individual targets for STW 5, a herbal preparation with nine different extracts indicated for thetreatment of functional dyspepsia and IBS. As a multi-targeted medicinal drug, STW 5 possesses multiplepharmacodynamic effects. Several in vitro and in vivo studies have demonstrated STW 5 efficacy on numerousIBS patho-mechanisms targeting gastrointestinal smooth muscles, visceral afferent nerves, inflammation, gutpermeability, and the gut microbiome.