Abstract
Irritable bowel syndrome (IBS) remains a prevalent and difficult-to-manage gastrointestinal condition. There is growing interest in the use of traditional medicine to manage IBS. In particular, curcumin, a biologically active phytochemical, has demonstrated anti-inflammatory and anti-oxidant properties and mucosal protective effects in rat models of colitis. This meta-analysis thus aimed to investigate the hypothesis that curcumin improves IBS symptoms. Using the keywords (curcumin OR turmeric OR Indian saffron OR diferuloylmethane OR curcuminoid) AND (irritable bowel syndrome OR IBS), a preliminary search on the PubMed, Medline, Embase, PsychINFO, Web of Science, and Google Scholar databases yielded 1080 papers published in English between 1 January 1988 and 1 May 2018. Five randomized, controlled trials were systematically reviewed and 3 were included in the final meta-analysis. Random-effects meta-analysis based on three studies and 326 patients found curcumin to have a beneficial albeit not statistically significant effect on IBS symptoms (pooled standardized mean difference from baseline IBS severity rating −0.466, 95% CI: −1.113 to 0.182, p = 0.158). This is the first meta-analysis to examine the use of curcumin in IBS. With its unique anti-oxidant and anti-inflammatory activities and ability to modulate gut microbiota, curcumin is a potentially useful addition to our armamentarium of agents for IBS. It also appears safe and well-tolerated, with no adverse events reported in the available trials. However, current findings are based on a considerably limited evidence base with marked heterogeneity. More robust clinical trials involving a standardized curcumin preparation and larger sample sizes should be encouraged.
Highlights
Irritable bowel syndrome (IBS) is an exceedingly common and debilitating gastrointestinal condition, characterized by chronic abdominal pain and a change in the frequency or form of stool [1]
It is well documented that following infective gastroenteritis, more than 10% of affected individuals go on to develop post-infectious IBS [5]
Using the keywords AND, a preliminary search on the PubMed, Medline, Embase, PsychINFO, Web of Science and Google Scholar databases yielded 1080 papers published in English between 1 January 1988 and 1 May 2018
Summary
Irritable bowel syndrome (IBS) is an exceedingly common and debilitating gastrointestinal condition, characterized by chronic abdominal pain and a change in the frequency or form of stool [1]. It affects an estimated 10% to 15% of the global population [2] and carries a significant disease burden in terms of decreased productivity, increased healthcare costs and reduced health-related quality of life [3]. It is well documented that following infective gastroenteritis, more than 10% of affected individuals go on to develop post-infectious IBS [5]. Current therapies are limited and based on a weak evidence base [10]
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