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BACK TO THE ROOTS? HERBAL EXTRACTS MODULATE PERISTALTIC REFFLEX OF RAT SMALL INTESTINE
M Storr1, B Yuece2, J Wallbach2, A Sibaev2, D Weiser3, O Kelber3
1Department of Medicine, University of Calgary, Calgary, Alberta; 2Department of Medicine, University-Munich, Munich; 3Scientific Department, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany
BACKGROUND: Motility related disorders of the gastrointestinal (GI) tract are often treated with herbal extracts. STW 5 (Iberogast™), a fixed combination of herbal extracts, is used in Europe for decades for functional GI disorders and is available in North America since 2006. The mechanisms by which the herbal extracts induce the beneficial effects are unknown.
AIM: Aim of the present study was to investigate whether the STW 5 and the individual herbal extracts influence the myenteric neuronal pathways underlying the peristaltic reflex of rat small intestine.
METHODS: The myenteric pathways of the peristaltic reflex were studied in 10 cm ileum segments and peristaltic activity was stimulated by electrical stimulation. Ascending and descending reflex responses and respective latencies were recorded. Effects of drugs are observed after adding the herbal extracts to the organ bath in a cumulative manner.
RESULTS: All reflex responses were blocked by tetrodotoxin and atropine indicating that they are mediated by neuronal, cholinergic mechanisms. STW 5 increased ascending reflex responses at lower concentrations and reduced ascending and descending reflex responses at higher concentrations. Additionally reflex latency is prolonged in the higher concentrations. This bidirectional response at different concentrations may be attributed to the composition of STW 5. The individual herbal extracts had individual, reproducible effects on the elicited reflex responses, showing concentration dependent effects which were reversible after washout.
CONCLUSION: Herbal extracts modulate small intestinal motility by effects on the myenteric regulation of the peristaltic reflex. These effects are reproducible and reversible and may be involved in the reported resolution of symptoms in patients with IBS and FD.
Funded by Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany