Chamomile (Matricaria chamomilla / recutita, flowers)

Chamomile is one of the best-evidenced herbal options for functional dyspepsia and mild GI spasm. EMA HMPC in 2015 granted chamomile flowers well-established-use status for symptomatic treatment of mild gastrointestinal disturbances: flatulence, spasm and mild dyspepsia. Chamomile is part of Iberogast – a combined herbal product with RCT-proven efficacy in functional dyspepsia. Per Rome IV criteria, diagnosis rests on post-prandial fullness, early satiety and epigastric pain without organic pathology. Taking 1.5–3 g of dried flowers as tea three times a day or an equivalent extract for 2–4 weeks is a reasonable first step. If symptoms persist beyond a month, or weight loss, haematemesis or melaena appear, gastroscopy is needed, not herbal tea.

ICD-10: K30 · ICD-11: DD90.3

Chamomile has moderate evidence for mild anxiety symptoms. Amsterdam et al. RCT (J Clin Psychopharmacol 2009) with chamomile extract 220 mg 1–5 times daily for 8 weeks in 57 patients with mild–moderate GAD showed a meaningful reduction in Hamilton anxiety scores vs placebo. Later studies by the same group gave mixed results, and no systematic review reaches a confident positive conclusion. EMA HMPC recognises chamomile for mild nervous tension within traditional-use status. NICE CG113 recommends CBT and SSRIs first-line for GAD – chamomile is only an add-on for mild symptoms. If chamomile was prescribed as monotherapy for diagnosed GAD or panic disorder in place of standard treatment, consider seeking a second opinion.

ICD-10: F41.9 · ICD-11: 6B0Z