Dyspepsia and phytotherapy - A review of traditional and modern herbal drugs

Gastrointestinal complaints rank among the most frequently reasons why peop le asking for medical advice. About 15-30% of the adult patients suffer fro m different various functional dyspeptic conditions. The therapy of functio nal gastrointestinal disorders is one of the domains of phytotherapeutic tr eatments. From ancient times on, bitter herbal drugs played a very importan t role in the therapy of patients with dyspeptic symptoms. The mechanisms o f action of the bitters are not completely understood. But there are indica tions that they sensorially stimulate at even very small concentrations sen sorially the secretion of the stomach as well as the digestive glands and s trengthen the smooth musculature of the digestive tract (via the gustatory system, N. vagus and the enteric nervous system). Across the enteral nervou s system the strengthened digestive tract seems to stimulate the CNS, leadi ng to a general tonification. At higher dosages bitters probably directly a ffect the mucous membranes of the stomach and the bowel. Bitters often are combined with essential oils (some volatile oils as aromatic bitters, drug combinations of a volatile oil with a bitter). Essential oils act primarily as spasmolytics, carminatives and local anesthetics. In the last years sev eral controlled studies were carried out with phytotherapeutic combinations (e.g. with lberis amara, caraway oil, peppermint oil, curcuma extract, gin ger extract) in which the herbal drugs proved to be superior compared to pl acebo and were as effective as prokinetics (studies according to evidence-b ased medicine), The traditional phytotherapeutic approach is based upon the illness- as well as the patient-related investigations referring to the ef fectiveness of bitter, acrid- and essential-oil drugs. Such a treatment is supported by a rich amount of various of kinds of individual empirical expe rience (experience-based phytotherapy). Important traditional medical syste ms like the Traditional Chinese Medicine, the Ayurvedic Medicine as well as the European 'Humoral Medicine' consider different aspects of the sick hum ane being, like the constitution of the patient (holistic approach), and ta ke qualities of herbal drugs, vegetarian food, and spices into account for therapeutic purposes.