Prophylactic effect of STW 5 in acute reflux esophagitis: Pharmacological evidence
Clinical studies in patients with functional dyspepsia [1, 2] show the efficacy of the herbal fixed combination STW 5 (Iberogast®) in reducing heartburn . The present study therefore aimed at investigating the effect of this phytomedicine, containing the fresh plant extract of Iberis amara totalis and drug extracts of peppermint leaf, chamomile flower, liquorice root, angelica root, caraway fruit, milk thistle fruit, melissa leaf and celandine herb, in an experimental model of reflux esophagitis, with a view of providing further pharmacological evidence for its therapeutic usefulness. Male Wistar rats were fasted for 18h before operating them under anesthesia and a ligature was performed between the fore-stomach and corpus and between stomach and pylorus to induce inflammation of the esophageal mucosa within a few hours. Four hours later, the rats were sacrificed. The gastric ligations led to ulcerative inflammation of the esophageal mucosa. To test the activity of STW 5, rats were treated with the drug daily for 5 successive days at dose levels ranging from 0.2 to 2ml/kg by oral gavage. On day 5, animals were anesthetized 3h after the last dose, and esophagitis was induced as described above. STW 5 led to a significant dose-dependent reduction of the ulcerative area. Measurement of myeloperoxidase activity and lipid peroxidation as well as inflammatory mediators, including TNFα and IL-1ß, and histopathological examination confirmed the anti-inflammatory activity of the drug and correlated well with its overall effects. Pantoprazole (5mg/kg) was used as a reference standard. The results indicate that the beneficial effect of STW 5 in heartburn as a symptom of functional dyspepsia could in part result from its antiinflammatory effect on the esophageal mucosa.
References: 1. Rösch, W. et al. (2006) Phytomedicine 13 SV 114–121; 2. Schmulson, M.J. (2008) Nature Clin Pract Gastroenterol Hepatol 5:136–137 3. Madisch, A. et al. (2007) Gut 56 III: A336