Effect of STW 5-II (Iberogast-N) on Tolerance to Gastric Gas in Patients With Functional Dyspepsia. The IBO-2 Study

STW 5-II has been shown to improve numerous symptoms in functional dyspepsia. To determine if the herbal medicinal product STW 5-II may improve gastric gas transit and tolerance in patients with functional dyspepsia. In a parallel, randomized, double-blinded, placebo-controlled study, a gas challeng...

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Bibliographic Details
Authors: Aguilar, Ariadna|||0000-0002-2040-311X, Barber Caselles, Claudia|||0000-0003-4711-2731, Santos, Javier|||0000-0002-4798-5033, Lobo Álvarez, Beatriz|||0000-0003-3391-7125, Malagelada Prats, Carolina|||0000-0001-7097-1492, Serra Pueyo, Jordi|||0000-0003-2120-6270, Alcalá González, Luis Gerardo|||0000-0003-3247-1539
Format: article
Publication Date:2025
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:dnet:uabarcelona_::352146db51406a773d0590e449c0ecac
Online Access:https://ddd.uab.cat/record/328084
https://dx.doi.org/urn:doi:10.1111/nmo.70123
Access Level:Open access
Keyword:Bloating
Functional dyspepsia
Gastric gas
STW 5-II
Description
Summary:STW 5-II has been shown to improve numerous symptoms in functional dyspepsia. To determine if the herbal medicinal product STW 5-II may improve gastric gas transit and tolerance in patients with functional dyspepsia. In a parallel, randomized, double-blinded, placebo-controlled study, a gas challenge test was performed in 32 patients with functional dyspepsia and bloating after 2 weeks of treatment with (a) STW 5-II and (b) placebo. The challenge test consisted of continuous infusion of gas into the stomach (100 mL/min for 15 min) with simultaneous nutrient perfusion (315 kcal for 15 min, 210 mL final volume). Gas evacuation, symptom perception, and abdominal distension were continuously registered for 90 min. Gastric gas infusion was followed by a progressive start of gas evacuation from the rectum that was significantly accelerated when patients were on STW 5-II (319 ± 81 mL after 20 min infusion start), compared to placebo (80 ± 39 mL; p = 0.015), but this difference declined during the following 90 min of gas evacuation (final gas retention 470 ± 160 and 662 ± 179, STW 5-II and placebo, respectively, p = 0.431). Gas infusion was associated with a significant rise and posterior progressive decline in abdominal symptom perception (mainly bloating) that was significantly lower in patients treated with STW 5-II (mean score increment 0.8 ± 0.4) than in patients treated with placebo (score increment 2.1 ± 0.4; p = 0.036). There were no significant differences in abdominal distension between groups. STW 5-II improves tolerance to gastric gas in patients with functional dyspepsia and may be beneficial for the treatment of gas-related abdominal symptoms like bloating. EudraCT number: 2019-003976-38 In a parallel, placebo-controlled study with direct gas infusion into the stomach, STW 5-II reduced the perception of abdominal symptoms in patients with dyspepsia complaining of bloating when compared to placebo, with a minor effect on gas transit and evacuation, and no effect on visible abdominal distension.