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[Home](/Home) > [Articles](https://drdanwool.com/blog) > [Iberogast](https://drdanwool.com/blog/iberogast-gut-health)

Medically reviewed by [Dr. Dan Wool, NMD](https://www.linkedin.com/in/drdanwool/)

 Arizona-licensed Naturopathic Physician and  Gastroenterology Specialist

 Updated: May 19, 2026

Quick Summary:

- Iberogast is a multi-herb liquid supplement used for IBS, bloating, indigestion, and functional dyspepsia. It has been studied clinically for over 60 years, primarily in Europe.
- Clinical trials show Iberogast reduces IBS symptom scores and outperforms placebo for functional dyspepsia, with effects comparable to some standard pharmaceutical prokinetics.
- Though generally well tolerated, Iberogast contains Greater Celandine, which has been linked to rare but serious liver injury. It is not safe during pregnancy or breastfeeding.
- Iberogast works best as part of a broader gut health plan. It is not a cure, and a naturopathic provider can help determine if it is right for your specific digestive condition.

## Overview

If you have ever struggled with bloating, persistent indigestion, or the unpredictable bowel habits of[irritable bowel syndrome (IBS),](/ibs-treatment) you have likely searched for something that works without the side effects of prescription drugs.

Iberogast, a liquid herbal supplement originally developed in Germany, has attracted growing attention in the United States for exactly that reason. It has been prescribed and studied in Europe for more than six decades, and its clinical track record is more robust than most over-the-counter gut health products.

But like all herbal medicines, it comes with nuances that matter. This article gives you an honest, evidence-based look at what Iberogast can and cannot do for your digestive health.

## What Is Iberogast?

Iberogast (also known in clinical literature as STW 5) is a liquid phytopharmaceutical — a plant-based medicine — that combines extracts from nine medicinal herbs. It was originally developed in Germany by Steigerwald Arzneimittelwerk and has since been acquired and distributed globally by Bayer Consumer Health. It became available in the United States in 2024.

The nine herbs in the original European formulation are Iberis amara (bitter candytuft), Greater Celandine, [Licorice root](/blog/dgl), [Chamomile flower,](https://drdanwool.com/blog/chamomile-gut-health) Caraway fruit, Peppermint leaf, Lemon Balm leaf, Angelica root, and Milk Thistle fruit. The U.S. version marketed by Bayer uses six of these herbs, removing Greater Celandine, Angelica root, and Milk Thistle from the U.S. label formulation for consumer safety reasons.

Iberogast is taken as liquid drops, typically 20 drops added to a warm or cold beverage three times daily before or during meals. It is also available in softgel capsule form. It is classified as a dietary supplement in the United States and is sold over the counter without a prescription.

## Benefits of Iberogast

Iberogast is not a single-target supplement. Its multi-herb formula works on several different systems in the digestive tract at the same time, which is one reason it has shown broad effects in clinical research.

The primary documented benefits include relief from indigestion and upper abdominal discomfort, reduction in bloating and gas, improvement in [IBS](/ibs-treatment) symptoms including both constipation-predominant and diarrhea-predominant types, reduction in nausea, decreased heartburn and reflux symptoms, and support for healthy gastric motility (the movement of food through your digestive tract).

The herbs in the formula each contribute distinct actions:

- Chamomile helps regulate stomach muscle contractions and reduces gastric acidity.
- Peppermint relaxes intestinal muscles and addresses bloating and cramping.
- Lemon Balm has a calming effect on gut nerves and smooth muscle.
- Licorice root supports the gut lining and helps regulate acid levels.
- Caraway , in combination with peppermint, has been shown to relieve indigestion.
- Iberis amara , the namesake herb, helps stimulate and relax specific muscles in the digestive tract to normalize movement.

Together, these herbs address acid regulation, gut motility, gut nerve sensitivity, inflammation, and gut lining integrity — all key factors in functional digestive disorders.

## Important Considerations of Iberogast (Including Contraindications)

Iberogast is not appropriate for everyone. Before starting it, you should be aware of the following important safety information.

- Pregnancy and breastfeeding: Iberogast should not be used during pregnancy or while breastfeeding. This is a firm contraindication listed by the manufacturer.

- Liver disease or elevated liver enzymes: The original nine-herb formulation contains Greater Celandine (Chelidonium majus), which has been associated with rare but serious cases of drug-induced liver injury (DILI), including at least one case requiring liver transplantation.[6] While the U.S. version sold by Bayer does not list Greater Celandine on its label, some formulations sold internationally still contain it. Anyone with a history of liver disease, elevated liver enzymes, or prior drug-induced liver injury should avoid Iberogast entirely and consult their physician before use.

- Medications: If you are taking any prescription or over-the-counter medications, check with your healthcare provider before using Iberogast. Herbal-drug interactions are possible, particularly with anticoagulants, sedatives, or medications metabolized by the liver.

- Allergies: Iberogast contains herbs in the daisy/Asteraceae family. People with known allergies to chamomile, ragweed or related plants should use caution.

- Alcohol content: Iberogast liquid drops contain a small amount of alcohol, which is used as an extraction solvent. While the amount per dose is minimal, individuals with alcohol sensitivity, liver conditions, or those in recovery should be aware of this.

- Children and adolescents: Safety data in pediatric populations is limited. Consult a pediatrician before use in children.

Stop use immediately and seek medical attention if you develop jaundice (yellowing of the skin or eyes), dark urine, severe fatigue, or upper right abdominal pain while taking Iberogast, as these may be signs of liver injury.

## What Research Says About Iberogast for Gut Health

Iberogast has a more substantial evidence base than most herbal digestive supplements available on the U.S. market.

- A comprehensive review published in BMC Complementary Medicine and Therapies summarized 12 clinical trials conducted since 1990 examining STW 5 for [functional dyspepsia (FD)](/blog/functional-dyspepsia)and [IBS](/ibs-treatment). Double-blind, randomized, placebo-controlled studies found statistically significant symptom improvements, with one study reporting efficacy comparable to the standard prokinetic drug cisapride. The overall incidence of adverse drug reactions across these trials was reported at 0.04 percent.[1]

- A separate randomized, double-blind, placebo-controlled study using STW 5 in 208 IBS patients found that Iberogast reduced IBS symptom scores by 1.5 points more than placebo — a result that was both clinically meaningful and statistically significant (p < 0.0004). Improvements were seen across multiple IBS subtypes including diarrhea-predominant, constipation-predominant, and mixed presentations.[1]

- Research published in Alimentary Pharmacology and Therapeutics examined the effects of Iberogast on gastric motility in healthy men using a double-blind crossover study. Investigators found that Iberogast increased proximal gastric volume (gastric relaxation) and improved antral contractions — two key motility mechanisms relevant to bloating and functional dyspepsia — without significantly affecting pyloric or duodenal pressures.[4]

- Regarding safety, the same PMC review noted that clinical trials found no hepatotoxicity in controlled studies. However, post-marketing case reports published in peer-reviewed journals including Gastro Hep Advances and the American College of Gastroenterology have documented rare cases of Iberogast-associated DILI, primarily linked to Greater Celandine in older formulations.[5,6] This highlights the importance of using current U.S.-labeled formulations and disclosing all herbal supplement use to your physician.

The overall picture from the research is one of a well-studied herbal preparation with meaningful clinical benefit for functional GI disorders and a generally favorable safety profile, with important exceptions that must be respected.

## What to Expect with Use of Iberogast

Iberogast is not a fast-acting rescue medication. Most people who respond to it do so gradually over one to several weeks of consistent use. Here is what to expect:

- Weeks 1-2: Some people notice mild improvement in bloating, gas, and post-meal comfort. Others may not notice much change yet.

- Weeks 2-4: If Iberogast is working for you, this is typically when more consistent symptom relief becomes apparent — less indigestion, more predictable bowel habits, reduced nausea with meals.

- Timing matters: For best results, take Iberogast before or during meals, three times per day. Skipping doses reduces its effectiveness.

- Taste and tolerance: The drops have an herbal, slightly bitter taste. Adding them to warm tea, water, or juice makes them more palatable for most people. A small number of people experience mild GI discomfort when starting, which often resolves within the first week.

It is reasonable to evaluate effectiveness after four weeks of consistent daily use. If you have not experienced meaningful improvement by then, it may not be the right fit for your specific digestive condition, and you should speak with a healthcare provider about alternatives.

## Alternatives to Iberogast

If Iberogast is not appropriate for you — due to pregnancy, liver concerns, or a lack of response — there are several other well-supported options to discuss with your provider.

- Peppermint oil (enteric-coated capsules): Strong evidence supports enteric-coated peppermint oil for IBS, particularly for abdominal pain and cramping. It is one of the most researched single-herb gut interventions available.

- Probiotics: Specific strains such as Lactobacillus rhamnosus GG, Bifidobacterium infantis, and certain multi-strain formulas have demonstrated benefit for IBS and dysbiosis-related symptoms.

- Low-FODMAP diet: A structured dietary elimination protocol that has strong clinical support for IBS management, particularly when guided by a knowledgeable practitioner.

- Digestive enzymes: For people with enzyme insufficiency, bloating after meals, or fat malabsorption, targeted enzyme supplementation can address root causes that herbal motility agents do not.

- Functional gut testing: Rather than trialing supplements in sequence, working with a naturopathic physician or gastroenterology specialist to identify root causes — such as [SIBO](/sibo), dysbiosis, or [food sensitivities](/blog/foodsensitivitytesting) — leads to more targeted and durable results.

## The Bottom Line on Iberogast

Iberogast stands out in a crowded field of gut health supplements because it actually has clinical evidence behind it. For people dealing with [functional dyspepsia](/blog/functional-dyspepsia), [IBS](/blog/ibs-d-guide), [bloating](/bloating-treatment-scottsdale), or chronic indigestion who prefer a plant-based approach, it is one of the more reasonable options to explore. Its multi-target mechanism addresses several key aspects of gut function at once — something few single-ingredient supplements can claim.

That said, Iberogast is not a cure, and it is not risk-free. The liver safety signals — particularly with formulations containing Greater Celandine — are real and documented in peer-reviewed literature. Always disclose herbal supplement use to your physician, choose reputable U.S.-labeled formulations, and stop use immediately if you develop any signs of liver dysfunction.

For best results, Iberogast works best as one component of a comprehensive naturopathic gut health plan — not as a standalone fix. If your digestive symptoms are chronic, progressive, or significantly affecting your quality of life, a proper evaluation with a naturopathic physician or gastroenterology specialist is the most important first step.

### Frequently Asked Questions About Iberogast

### Is Iberogast safe for long-term use?

Quick Answer: Iberogast has been used for over 60 years with a generally low rate of adverse events (0.04% in clinical trials), but long-term safety — especially for the liver — is not fully established. Regular monitoring is advisable for extended use.

Full Answer: Clinical trial data spanning over three decades shows an adverse drug reaction rate of approximately 0.04%. However, rare but serious liver injury cases have been reported in post-marketing surveillance, primarily linked to the Greater Celandine component in older nine-herb European formulations. The current U.S. six-herb formulation reduces some of this risk. If using Iberogast beyond 4 to 8 weeks, it is prudent to have your liver enzymes checked by a healthcare provider, particularly if you have any pre-existing liver concerns or take other medications metabolized by the liver.

### Can Iberogast be taken with other medications?

Quick Answer: Iberogast may interact with certain medications, including blood thinners, sedatives, and liver-metabolized drugs. Always consult your doctor or pharmacist before combining it with any prescription or OTC medication.

Full Answer: Because Iberogast contains multiple herbal extracts with pharmacologically active compounds, the potential for herb-drug interactions exists. Herbs like Licorice can affect blood pressure medications and corticosteroids. Chamomile has mild anticoagulant properties that could theoretically potentiate blood thinners. Peppermint can affect the absorption of some drugs by relaxing the lower esophageal sphincter. There are no large interaction studies specifically on Iberogast as a combined formulation. For safety, disclose its use to your prescribing physician before starting it alongside other treatments.

### Does Iberogast actually work for IBS?

Quick Answer: Yes, clinical evidence supports its use for IBS. Randomized trials show Iberogast reduces IBS symptom scores significantly more than placebo, including improvements in pain, bloating, diarrhea, and constipation.

Full Answer: In one of the most rigorous trials, 208 IBS patients were randomized to Iberogast or placebo for four weeks. Iberogast reduced IBS symptom scores by 1.5 points more than placebo — a result that was statistically significant (p < 0.0004). Improvements were seen across IBS subtypes, including diarrhea-predominant, constipation-predominant, and mixed presentations. A comprehensive review of 12 clinical trials also confirmed these findings. While it is not a cure for IBS, Iberogast addresses multiple aspects of functional gut dysfunction simultaneously, which may explain its broader symptom relief compared to single-target treatments.

### Can I take Iberogast if I am pregnant?

Quick Answer: No. Iberogast is contraindicated during pregnancy and breastfeeding. The manufacturer explicitly advises against use during these periods.

Full Answer: The safety of Iberogast's herbal constituents during pregnancy has not been established through clinical trials. Several herbs in the formula, including Greater Celandine and Angelica root in older formulations, have been associated with uterine-stimulating effects in traditional medicine literature. Additionally, the herbal alcohol content in the liquid drops raises further concerns during pregnancy. Until robust safety data exists, Iberogast should be avoided entirely during pregnancy and while breastfeeding. If you are seeking naturopathic support for digestive symptoms during pregnancy, work with a qualified provider who can recommend safer options.

### How does Iberogast compare to omeprazole or other acid reducers?

Quick Answer: Iberogast targets gut motility, nerve sensitivity, and inflammation — not just acid. It addresses different mechanisms than proton pump inhibitors (PPIs) like omeprazole and may suit people with functional dyspepsia without true acid overproduction.

Full Answer: Proton pump inhibitors like omeprazole are designed specifically to suppress stomach acid production and work well for acid reflux driven by true hyperacidity or GERD. However, many people with functional dyspepsia have normal or even low acid, with symptoms driven by poor gastric motility, gut nerve hypersensitivity, or impaired gastric emptying. In these cases, acid suppressants may not address the actual problem — and long-term PPI use carries its own set of risks including magnesium depletion and increased infection risk. Iberogast operates on entirely different mechanisms and has shown efficacy comparable to the prokinetic drug cisapride in at least one clinical trial, making it a more functionally relevant option for motility-driven dyspepsia.

### What are the side effects of Iberogast?

Quick Answer: Common side effects are mild and include nausea, stomach upset, and allergic reactions in sensitive individuals. The most serious — though rare — side effect is drug-induced liver injury, particularly with formulations containing Greater Celandine.

Full Answer: In clinical trials, the incidence of adverse drug reactions was very low at approximately 0.04%. The most commonly reported adverse reactions are hypersensitivity reactions including skin rash, itching, and shortness of breath in predisposed individuals. At the more serious end, case reports published in peer-reviewed gastroenterology journals have documented Iberogast-associated drug-induced liver injury (DILI), ranging from elevated liver enzymes to acute hepatitis. In rare instances, severe liver failure requiring transplantation has occurred, mostly associated with Greater Celandine in the original nine-herb formulation. Stop use immediately and seek medical care if you develop yellowing of the skin or eyes, dark urine, or severe abdominal pain while using this product.

## Are You Ready to Fix Your Gut?

Struggling with your gut health? [Dr. Dan Wool](/about) offers personalized, natural solutions at his Scottsdale naturopathic practice.[Book a free 15-minute discovery call today](/booking) and take the first step toward lasting digestive relief.

Disclaimer:

For educational purposes only — not medical advice, diagnosis, treatment or advertising for consumer purchase. Dr. Dan Wool and affiliates make no effectiveness claims about supplements, hormones, peptides or other therapeutics beyond cited clinical evidence and regulatory approval. Always consult a qualified healthcare provider before starting, changing, or stopping any medical or wellness program.

About the Author

## Dr. Dan Wool, NMD

[Dr. Dan Wool](/about) is a naturopathic doctor who specializes in gastroenterology, hormones and men's health in Scottsdale, Arizona. [Set up a free 15-minute discovery call with Dr. Wool today! ](https://drdanwool.com/booking)

[Read more about Dr. Wool's Gut Health Journey](/about)

## References:

[1] Rosch W, Vinson B, Sassin I. A randomised clinical trial comparing the efficacy of a herbal preparation STW 5 with the prokinetic drug cisapride in patients with dysmotility type of functional dyspepsia. Z Gastroenterol. 2002;40:401-8. Also: Malfertheiner P, et al. "STW 5 (Iberogast) — A safe and effective standard in the treatment of functional gastrointestinal disorders." Best Pract Res Clin Gastroenterol. 2013;27(3):309-23. PMC: [https://pmc.ncbi.nlm.nih.gov/articles/PMC3580135/](https://pmc.ncbi.nlm.nih.gov/articles/PMC3580135/)

[2] Madisch A, Holtmann G, Plein K, Hotz J. Treatment of irritable bowel syndrome with herbal preparatio…