Herbal medicinal products are an important option for the treatment of functional GI diseases in children - a systematic review

Herbal medicinal products play an important role in the treatment dyspepsia (FD) and irritable bowel syndrome (IBS) [1]. Given the high relevance of these indications in children (2), there is the need for treatment options applicable in this age group.

A systematic review was conducted focusing on FD and IBS in children, searching for clinical studies and reviews via PubMed-Medline complemented by hand searching and cross-referencing.

The search gained 79 hits for FD with 13 of which 2 were herbals. For IBS it gained 321 hits, 5 on herbal treatments. Herbal options mentioned for IBS were Psyllium, Peppermint oil and STW 5 (Iberogast) as well as Turmeric, Cannabis, Aloe vera and Ginger, with clinical studies in children mentioned only for Psyllium, STW 5 and Peppermint oil [1], [2], [3], [4], [5]. For FD Hippophae rhamnoides and STW 5 were identified with clinical evidence on both [1], [6]. Only Iberogast was mentioned for both diseases. A number of studies supported the therapeutic usefulness in children of all ages, retrospectively [7], [8] as well as prospectively [9]–[14]. Data from 44.315 children showed an excellent safety profile with only few mild side effects and a convincing rating of the therapeutic usefulness.

Herbal preparations provide effective treatment options in children with FD and IBSwith a low risk profile and therefore play a prominent role in their management. While Psyllium and Peppermint oil as well as Hippophae rhamnoides show evidence only for IBS or FD respectively, grades of evidence are most convincing for Iberogast likewise in FD and IBS.

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