hypericum and Irritable-Bowel-Syndrome

St John's wort (SJW) is known to effectively treat patients with mild-to-moderate depression. Antidepressants are frequently used to treat irritable bowel syndrome (IBS). To date, no study that examines the efficacy of SJW in IBS has been carried out. The aim of this study was to evaluate the efficacy of SJW in IBS after 12 weeks.. In this randomized, double-blind, placebo-controlled trial, 70 participants with an established diagnosis of IBS were randomized and assigned by concealed allocation to either SJW or placebo. Both treatment arms were balanced on symptom subtype. The primary end point was self-reported overall bowel symptom score (BSS) at 12 weeks. Secondary end points were individual BSS for diarrhea (D-BSS), constipation (C-BSS), pain or discomfort, and bloating; adequate relief (AR) of IBS on at least 50% of the last 4 weeks of therapy; and IBS quality-of-life score at 12 weeks.. In all, 86% of the participants were women, and the median age was 42 years. Overall, 29% had C-IBS, 37% D-IBS, and 31% had mixed IBS. Both groups reported decreases in overall BSS from baseline, with the placebo arm having significantly lower scores at 12 weeks (P=0.03) compared with SJW. These patterns of improvement were mirrored in the secondary end points with the placebo group faring better than the SJW-treated group, with significant differences observed at week 12 for D-BSS (P=0.03) and percent with AR (P=0.02). A similar proportion of subjects in each treatment group (SJW: 51% vs. placebo: 54%) believed that the study drug they received decreased IBS life interferences (P=0.79).. SJW was a less effective treatment for IBS than placebo.

Topics: Administration, Oral; Adolescent; Adult; Aged; Double-Blind Method; Female; Humans; Hypericum; Irritable Bowel Syndrome; Logistic Models; Male; Middle Aged; Phytotherapy; Placebos; Quality of Life; Treatment Outcome

Irritable bowel syndrome (IBS) patients usually manifest autonomic nerve dysfunctions and abnormal psychological behaviors. This study was to assess autonomic nervous system (ANS) response to different stressor as well as evaluate effects of antidepressive treatment of Saint John's Wort Extract in women with IBS.. Thirty women with IBS and 20 healthy women underwent serial ANS function tests. Five-minute-short-time heart rate variability (HRV) spectral analysis were assessed at a stress or resting recording period. Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to measure their anxiety and depression conditions. After 8-weeks' antidepressant treatment, groups of IBS repeated the tests above. Subjects also completed a GI symptom diary once daily during the 2 weeks before therapy and for 2 weeks in the last scheduled therapy session.. IBS-group showed a higher score in HAMA and HAMD (p < 0.01) and showed a significant increase in the low frequency band/high frequency band ratio (L/H) during the period in different stimuli (p <0.01), which was significantly different from controls. After 8-weeks' antidepressive treatment, L/H showed a significant decrease (p < 0.05) response to different stressor, which was significantly different from pre-treatment. Gastrointestinal (GI) symptoms of IBS were also relieved significantly.. Antidepressive treatment can improve the conditions of psychology and the ANS reactivity to stress in patients with IBS.

Topics: Autonomic Nervous System; Female; Heart Rate; Humans; Hypericum; Irritable Bowel Syndrome; Phytotherapy; Plant Extracts