Peppermint and caraway oil, ginger, Rikkunshito and iberogast are natural remedies that may improve indigestion.
Indigestion, also known as functional dyspepsia, is an upper digestive tract disorder that can significantly impair one’s quality of life. Although it is not life threatening, studies have shown that it can impact work productivity and accumulate health care expenses. Several factors can cause indigestion such as diet, lifestyle, stress, infection, medication side effects or stomach’s inability to digest food. Symptoms of indigestion may vary among individuals, but typically include “burning” sensation in upper digestive tract, feeling full, nausea or vomiting. These symptoms are generally experienced for about a month and may resolve on their own.
Indigestion is difficult to diagnose and requires a physician to rule out other digestive disorders, such as acid reflux, irritable bowel syndrome, peptic ulcer disease or delayed gastric emptying. There are no particular tests for indigestion, until other digestive disorders are ruled out. The physician will need to gather the patient’s complete medical history, then determine if further tests will be required.
Modifying lifestyle and diet can help manage indigestion symptoms. Lifestyle modifications include reducing stressors, elevating head while sleeping and losing weight. Diet can be modified through small frequent meals and avoid food and beverages high in acidity and fat content, and beverages that may trigger indigestion.
According to a 2017 joint American-Canadian clinical guideline, the following medications are not indicated for indigestion, but have been studied for its treatment: proton-pump inhibitor (e.g. omeprazole), tricyclic antidepressant (e.g. amitriptyline), or prokinetic agent (e.g. domperidone). If the patient is unresponsive to the medications, then psychotherapy is another option that the guideline considers. Although the studies on psychotherapy have some significant benefits, the guideline recommends it as conditional and will depend on the patient’s time and motivation.
The clinical guideline does not recommend alternative treatments for indigestion, because these studies are unclear to make a strong conclusion. However, alternative treatments and natural remedies may be appropriate for those interested in exploring other options and when medications are unsatisfactory for treatment. A 2019 review investigated the following natural remedies: peppermint and caraway oil combination, ginger, Rikkunshito and iberogast.
Peppermint and caraway oil combination
- Studies on peppermint oil have shown to relax the digestive tract, while caraway oil acts synergistically with peppermint oil.
- Four studies with a total of 383 patients with indigestion were reviewed for the combination’s effectiveness and safety.
- Patients received either 90 mg peppermint oil and 50 mg caraway oil twice a day for four weeks, or a prokinetic agent or placebo.
- The combination of herbal oil extracts decreased pain intensity and improved patients’ pain scores. Patients tolerated the combination therapy well compared to placebo and prokinetic agents.
- Studies show that ginger accelerates the process of the stomach emptying its contents for further digestion.
- There was only one study with 11 patients with indigestion reviewed for ginger’s effectiveness.
- The patients received either 1.2 grams of ginger or placebo.
- Although ginger was well-tolerated compared to placebo, there was no significant improvement.
- Rikkunshito is a Japanese herbal preparation of several ingredients. Japan markets this herbal mix to help improve indigestion after two weeks of treatment.
- Four studies of 516 patients with indigestion were reviewed for its effectiveness and safety.
- The patients ingested either 2.5 or 7.5 grams two to three times daily for two or eight weeks, or placebo.
- Patients who received Rikkunshito treatment for eight weeks had the better data on improvements from indigestion symptoms. However, more safety data is needed.
- Iberogast, also known as STW5, is prepared from nine herbal extracts. The mix works together to regulate and relax the digestive tract.
- Two studies of 435 patients with indigestion were reviewed for its effectiveness and safety.
- The patients received either 20 drops three times daily for eight or 12 weeks or placebo.
- Iberogast improved indigestion symptoms and was well-tolerated compared to placebo.
Since there is no standard therapy to treat indigestion, natural remedies have been studied as an optional approach. Please consult a doctor before considering a natural remedy. Overall, the above natural remedies have been found to improve indigestion symptoms, however, more studies are needed to confirm these results, verifying safety.
Written by, Manuel Bangsil, PharmD, MBA, BCMAS
- Moayyedi P, Lacy BE, Andrews CN, Enns RA, Howden CW, Vakil N. ACG and CAG Clinical Guideline: Management of Dyspepsia [published correction appears in Am J Gastroenterol. 2017 Sep;112(9):1484]. Am J Gastroenterol. 2017;112(7):988-1013. doi:10.1038/ajg.2017.154
- Masuy I, Van Oudenhove L, Tack J. Review article: treatment options for functional dyspepsia. Aliment Pharmacol Ther. 2019;49(9):1134-1172. doi:10.1111/apt.15191