Caraway — a spice that calms the gut?

Aim of the study: This systematic review summarizes published data on Menthacarin, the proprietary combination of peppermint oil and caraway oil, in the treatment of functional gastrointestinal disorders. Efficacy was assessed by meta-analysis of placebo-controlled trials.

Results: Five randomized trials involving 580 patients were found, demonstrating significant effects of Menthacarin on symptoms of functional dyspepsia (FD) compared to placebo or similar effects compared to a reference drug. Seven other studies reported favorable results on therapeutic application in FD patients with concomitant Helicobacter pylori infection, in irritable bowel syndrome (IBS), and on tolerability in FD patients from 12 years of age. Three trials in FD with 249 patients were eligible for meta-analysis. Results demonstrate a significant reduction in pain intensity (standardized mean difference: 0.80; 95% confidence interval (CI): 0.39-1.21) and in item 2 of the Clinical Global Impression Scale (risk ratio: 2.65; 95% CI: 1.81-3.87) for Menthacarin. Menthacarin was shown to be effective and safe for the treatment of FD and represents a promising option for symptoms of IBS.

Aim of the study: According to Rome IV, functional dyspepsia is diagnosed with the presence of dyspepsia in the absence of organic or metabolic causes. FD caused by several factors, such as impaired gastric accommodation and hypersensitivity to gastric distention. Several studies have reported the effectiveness of herbal medicine on FD. This article, thus, reviews Persian herbal medicine in FD.

Results: We found 34 clinical trials with 15 herbs and 4 compound herbal remedies like Asparagus racemosus, Brassica oleracea, Cynara scolymus, Ocimum basilicum, Mentha longifolia, Mentha pulegium, Mentha piperata, Pimpinella anisum, Nigella sativa, Mastic gum, Curcuma longa, Pistatio Atlantica, Glycyrrhiza glabra, Solanum tuberosum and Zingiber officinale and compound remedies of Rosa damascene & Crocus sativus, Trachyspermum copticom & Apium graveolence, Carum carvi & Mentha pipperata, Gingiber officinalis & Cynara scolymus are effective in functional dyspepsia. Many people use herbal and traditional remedies for the treatment of disorders such as gastrointestinal disorders, especially in Asian countries. Several studies reported the efficacy of herbal medicine in functional dyspepsia. Although their mechanisms are not fully understood, it seems they can modulate GI motility and improve symptoms of FD.

Aim of the study: In disorders of gut-brain interaction including functional dyspepsia and irritable bowel syndrome, clinical focus has shifted from pathophysiological criteria to symptoms.

Results: During treatment, all assessed abdominal symptoms showed significant (p < 0.001), clinically meaningful improvements, with standardized effect sizes of 0.83-1.05 for change from baseline. The number of days/week with symptom impact or incomplete spontaneous bowel movements almost halved, while days/week with normal stool consistency increased (all p < 0.001). Health-related quality of life significantly improved (p < 0.001) and Menthacarin was well tolerated. The study demonstrates patient-relevant improvement in gastrointestinal symptoms during treatment with Menthacarin while underlining its favorable tolerability profile.

Aim of the study: Phytotherapeutics are gaining influence in the treatment of gastroenterological diseases. Their popularity and growing evidence of efficacy contribute to their integration into medical guidelines.

Results: The safety and tolerability of the phytotherapeutics were rated as predominantly "very good" to "acceptable". Some clear recommendations for the use of phytotherapeutics to treat gastroenterological diseases show their great potential. Due to their wide range of effects, phytotherapeutics can be used very well as a complement to conventional medicines in case of complex regulatory disorders. However, further methodologically well-conducted impact studies would be helpful in order to be able to make further recommendations.

Aim of the study: Herbal medicinal products with a broad activity spectrum may be promising alternatives to treat functional gastrointestinal disorders (FGD). Menthacarin® is a drug with a fixed combination of peppermint and caraway oils, which is clinically used to treat FGD-associated symptoms.

Results: The findings revealed a strong muscle inhibitory and pro-secretory action of peppermint and caraway oils at clinically relevant concentrations. Both actions were nerve-independent. The inhibition of contractility was mediated by inhibition of L-type calcium channels. The effects on muscle and epithelial activity may contribute to the beneficial effects observed in patients with FGD.

Aim of the study: With growing evidence linking food antigens to inflammation and symptoms, our objective was to review the evidence for the impact of dietary factors on functional dyspepsia (FD) pathogenesis. FD is a common gastrointestinal disorder characterised by postprandial fullness, early satiety, epigastric pain, and burning.

Results: Fourteen studies met inclusion criteria, evaluating seven key dietary categories: FODMAPs/wheat, prebiotics/probiotics, capsaicin, peppermint-caraway and cinnamon oils, herbal therapies, medications, and ginger-based interventions. High-FODMAP foods, gluten, and capsaicin were linked to symptom exacerbation, with some studies noting impaired epithelial barrier function, immune activation, or microbiota alterations. Interventions with anti-inflammatory or microbiota-modulating effects, including probiotics, peppermint-caraway oil, herbal formulations, and ginger-based supplements, were found to mitigate symptoms. Our findings show that specific dietary components can be implicated in inducing inflammation and symptoms in FD. Stress and anxiety might be another triggering factor for FD; hence, we see the utility of antidepressants in some cases.

Aim of the study: Peppermint oil and caraway oil are established remedies in gastroenterological medicine because of their spasmolytic/analgesic effects. We investigated whether Menthacarin, a combination of both oils, exerted anti-inflammatory effects in a dextran sodium sulphate (DSS, 2%) murine model of colitis.

Results: Menthacarin-treated mice compared to controls showed improved macroscopical and microscopical parameters and lower BW loss during the course of colitis. Menthacarin changed the colonic cytokine profile towards a regulatory/anti-inflammatory phenotype. Menthacarin attenuates experimental colitis and may be a promising add-on therapy for the treatment of IBD.