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.

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.