Is herbal medicine effective in irritable bowel syndrome? Results of a randomised, placebo-controlled, double-blind clinical trial

S26 pediatric patients with chronic constipation. All three patients were under the age of 2 years with bowel movements ranging from once per week to every 3–4 days. Previous unsuccessful care involved medical advice with dietary changes and the use of cod liver or mineral oil. Following a trial of chiropractic care using a combination of high-velocity, low-amplitude thrusts and a manually assisted, hand-held instrument to sites of spinal segmental dysfunction, the patients’ constipation resolved as demonstrated by an increased frequency in bowel movements at once to every 1–2 days with accompanying soft stool without straining and pain. 10.1016/j.eujim.2008.08.048

Is herbal medicine effective in irritable bowel syndrome? Results of a randomised, placebocontrolled, double-blind clinical trial B. Brinkhausa,b, C. Hentschelb, G. Schindlerb, M. Lindnerb, H. Stu ¨tzerc, R. Kohnend, S.N. Willicha, c W. Lehmacher , E.G. Hahnb a

Institute for Social Medicine, Epidemiology and Health Economics, Charite´ University Medical Center, Berlin, Germany b Department of Medicine I, Friedrich-AlexanderUniversity of Erlangen Nuremberg, Erlangen, Germany c Institute of Medical Statistics, Informatics and Epidemiology (IMSIE), University of Cologne, 50931 Cologne, Germany d IMEREM Institute for Medical Research Management and Biometrics, Nuremberg, Germany Objectives: The use of complementary and alternative medicine such as herbal medicine is common among Irritable bowel syndrome (IBS) patients. The aim of this study was to determine the efficacy of two herbal remedies used in the treatment of IBS. Methods: IBS patients were randomly assigned in this randomised, doubleblind, placebo-controlled trial to one of three treatment groups: 1.) Curcuma xanthorriza 60 mg daily (curcuma group) (n ¼ 24), 2.) Fumaria officinalis 1500 rng daily (fumitory group) (n ¼ 24) and 3.) placebo (n ¼ 58). The study treatment was applied three times a day for 18 weeks. The main outcome parameters were changes in global patient ratings of IBS-related pain and distension on a visual analogue scale (0–50 mm) between baseline and at the end of treatment. Additional outcome parameters included global assessments of changes in IBS symptoms and psychosocial stress caused by IBS. Results: 106 patients (mean age 48712 years, 63% women) were included in the intention-to-treat group. IBS-related pain decreased by 0.9711.5 (mm7SD) in the fumitory group, 0.3k9.9 in the placebo group and increased by 2.07k9.5 in the curcuma group (p ¼ 0.81). IBS-related distension decreased by 1.4712.5 in the curcuma group, 2.1279.2 in the placebo group and

Oral presentations increased by 0.379.3 in the fumitory group (p ¼ 0.48). Additionally, the global assessment of changes in IBS symptoms and psychological stress due to IBS did not differ significantly among the three treatment groups. Conclusion: Results of this trial showed that neither Curcuma nor Fumaria had any therapeutic benefit over placebo in patients with IBS. The use of these herbs for the treatment of IBS cannot be recommended. 10.1016/j.eujim.2008.08.134

Japanese phytotherapy (Kampo) in functional dyspepsia and diarrhea-type irritable bowel syndrome: Clinical observation in German patients H. Reissenweber University of Munich LMU, Department of Internal Medicine, Research Unit for Japanese Phytotherapy (Kampo), Munich, Germany Introduction: The administration of plant-based crude drug formulae has a history of more than 1500 years in Japan. Originating in China, Japanese Phytotherapy (Kampo) obtained specific features in Japan. Recent decades saw a revival of Kampo accompanied by a scientific reevaluation and critical examination of its relevance in modern health care. Meanwhile, Kampo has already proven considerable value in the treatment of chronic and functional disorders of modern Japanese society. One specific formula, Rikkunshi-to (TJ-43), has been widely accepted for its use in functional disorders of the stomach and the gastrointestinal motility in Japan. Patients often present with an overlap of symptoms of the upper gastrointestinal tract accompanied by diarrhea-type irritable bowel syndrome. We here present data of clinical observations in outpatients treated with this Kampo medicine in Germany. Methods: 22 patients, mean age 52 (77) with symptomatic functional upper and lower gastrointestinal complaints were scored according to a five-scale symptom score before treatment, after 1 month, 2 months and 3 months of treatment. The symptoms evaluated were: epigastric fullness, epigastric pain, nausea, abdominal pain, bloating and diarrhea. For each symptom intensity and frequency from 0 to 4 were scored. Primary endpoint was the change in the total functional gastrointestinal disorder score. Results: A clinically meaningful improvement of symptoms by more than 50% was found after 3 months of treatment with Rikkunshi-to. Especially the improvement of epigastric pain, bloating and diarrhea was remarkable. Conclusion: In this clinical observation with a limited Western study population, preliminary evidence could be obtained that Rikkunshi-to (TJ-43) is a safe, tolerable and efficacious treatment for symptomatic functional upper and lower gastrointestinal complaints, especially accompanied by diarrhea. The data should be confirmed by a randomized placebo-controlled clinical trial. 10.1016/j.eujim.2008.08.049