[Dyspeptic pain and phytotherapy--a review of traditional and modern herbal drugs].

Gastrointestinal complaints rank among the most frequently reasons why people asking for medical advice. About 15-30% of the adult patients suffer from different various functional dyspeptic conditions. The therapy of functional gastrointestinal disorders is one of the domains of phytotherapeutic treatments. From ancient times on, bitter herbal drugs played a very important role in the therapy of patients with dyspeptic symptoms. The mechanisms of action of the bitters are not completely understood. But there are indications that they sensorially stimulate at even very small concentrations sensorially the secretion of the stomach as well as the digestive glands and strengthen the smooth musculature of the digestive tract (via the gustatory system, N. vagus and the enteric nervous system). Across the enteral nervous system the strengthened digestive tract seems to stimulate the CNS, leading to a general tonification. At higher dosages bitters probably directly affect the mucous membranes of the stomach and the bowel. Bitters often are combined with essential oils (some volatile oils as aromatic bitters, drug combinations of a volatile oil with a bitter). Essential oils act primarily as spasmolytics, carminatives and local anesthetics. In the last years several controlled studies were carried out with phytotherapeutic combinations (e.g. with Iberis amara, caraway oil, peppermint oil, curcuma extract, ginger extract) in which the herbal drugs proved to be superior compared to placebo and were as effective as prokinetics (studies according to evidence-based medicine). The traditional phytotherapeutic approach is based upon the illness- as well as the patient-related investigations referring to the effectiveness of bitter, acrid- and essential-oil drugs. Such a treatment is supported by a rich amount of various of kinds of individual empirical experience (experience-based phytotherapy). Important traditional medical systems like the Traditional Chinese Medicine, the Ayurvedic Medicine as well as the European 'Humoral Medicine' consider different aspects of the sick human being, like the constitution of the patient (holistic approach), and take qualities of herbal drugs, vegetarian food, and spices into account for therapeutic purposes.