Herbal medicines in functional dyspepsia—Untapped opportunities not without risks
Gwee, Kok-Ann Holtmann, Gerald Tack, Jan Suzuki, Hidekazu Liu, Jinsong Xiao, Yinglian Chen, Min-Hu Hou, Xiaohua Wu, Deng-Chyang Toh, Clarissa
Holtmann, Gerald
Tack, Jan
Suzuki, Hidekazu
Liu, Jinsong
Xiao, Yinglian
Chen, Min-Hu
Hou, Xiaohua
Wu, Deng-Chyang
Toh, Clarissa
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Alternative Title
Abstract
Background: Contemporary treatments for functional dyspepsia have limitations. Herbal medicine has been suggested as adjunctive treatment. With growing scientific recognition and public interests, an in-depth review of this is timely. Aims/Purpose: To evaluate the therapeutic potential and problems that may be associated with the adoption of herbal medicines in functional dyspepsia. Methods: We reviewed the treatment landscape of functional dyspepsia and assessed the scientific community's interest in herbal medicine. Preclinical pharmacological and clinical trial data were reviewed for several herbal medicines available in the market. Challenges associated with adoption of herbal medicine in mainstream medicine were critically evaluated. Results: We found that herbal medicines frequently comprise a combination of herbs with multiple reported pharmacological effects on gastrointestinal motility and secretory functions, as well as cytoprotective and psychotropic properties. We identified a number of commercially available herbal products that have undergone rigorous clinical trials, involving large numbers of well-defined subjects, reporting both efficacy and safety for functional dyspepsia. Persisting concerns include lack of rigorous assessments for majority of products, toxicity, consistency of ingredients, dose standardizations, and quality control. We provide a quality framework for its evaluation. Conclusions: We commend herbal medicine as a viable future option in managing functional dyspepsia. An attractive appeal of herbal medicine is the prospect to simultaneously target multiple pathophysiological mechanisms. Wider adoption and acceptance of herbal medicines in treatment algorithms of functional dyspepsia will require the application of the scientific rigor expected of chemical therapies, to all stages of their development and evaluation. © 2020 John Wiley & Sons Ltd
Keywords
functional dyspepsia, gastrointestinal physiology, herbal medicine, pharmacology, toxicity, treatment algorithms
Source Title
Neurogastroenterology and Motility
Publisher
Blackwell Publishing Ltd
Series/Report No.
Collections
Rights
Attribution 4.0 International
Date
2020-11-30
DOI
10.1111/nmo.14044
Type
Review