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Herbal medicinal products for inflammatory bowel disease: A focus on those assessed in double-blind randomised controlled trials.

Study Design

Type
Review
Population
inflammatory bowel disease patients
Inflammatory bowel disease patients frequently use herbal products as complementary or alternative medicines to current pharmacotherapies and obtain information on them mainly from the internet, social media, or unlicensed practitioners. Clinicians should therefore take a more active role and become knowledgeable of the mechanisms of action and potential drug interactions of herbal medicines for which evidence of efficacy is available. The therapeutic efficacy and safety of several herbal medicines have been studied in double-blind randomised controlled trials (RCTs). Evidence of efficacy is available for Andrographis paniculata extract; curcumin; a combination of myrrh, extract of chamomile flower, and coffee charcoal; and the Chinese herbal medicines Fufangkushen colon-coated capsule and Xilei san in patients with ulcerative colitis; and Artemisia absinthium extract and Boswellia serrata resin extract in patients with Crohn's disease. However, most of this evidence comes from single small RCTs with short follow-up, and the long-term effects and safety of their use have not yet been established. Thus, our findings indicate that further appropriately sized RCTs are necessary prior to the recommended use of these herbal medicines in therapy. In the meantime, increasing awareness of their use, and potential drug interactions among physicians may help to reduce unwanted effects and adverse disease outcomes.

Research Insights

  • Artemisia→Improved Crohn's Disease Activity

    Evidence of efficacy is available for ... Artemisia absinthium extract and Boswellia serrata resin extract in patients with Crohn's disease

    Effect
    Beneficial
    Effect size
    Small
  • Myrrh→Improved Inflammatory Bowel Disease Activity

    Evidence of efficacy is available for a combination of myrrh, extract of chamomile flower, and coffee charcoal ... in patients with ulcerative colitis

    Effect
    Beneficial
    Effect size
    Moderate
  • Myrrh→Improved Ulcerative Colitis Activity

    Evidence of efficacy is available for ... a combination of myrrh, extract of chamomile flower, and coffee charcoal; ... in patients with ulcerative colitis

    Effect
    Beneficial
    Effect size
    Small
  • Turmeric→Improved Inflammatory Bowel Disease Activity

    Evidence of efficacy is available for a combination of myrrh, extract of chamomile flower, and coffee charcoal ... in patients with ulcerative colitis

    Effect
    Beneficial
    Effect size
    Moderate
  • Turmeric→Improved Ulcerative Colitis Activity

    Evidence of efficacy is available for ... a combination of myrrh, extract of chamomile flower, and coffee charcoal; ... in patients with ulcerative colitis

    Effect
    Beneficial
    Effect size
    Small

Adverse Events Reported

  • Turmeric→Overall tolerability

    The therapeutic efficacy and safety of several herbal medicines have been studied in double-blind randomised controlled trials (RCTs).

    Finding
    Reported
  • Myrrh→Overall tolerability

    The therapeutic efficacy and safety of several herbal medicines have been studied in double-blind randomised controlled trials (RCTs).

    Finding
    Reported
  • Artemisia→Overall tolerability

    The therapeutic efficacy and safety of several herbal medicines have been studied in double-blind randomised controlled trials (RCTs).

    Finding
    Reported
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