Characterized by pain, diarrhea, bloating, discomfort, and constipation, irritable bowel syndrome (IBS) can produce extreme discomfort that profoundly interferes with functionality and overall quality of life. Currently, the etiology of IBS remains unknown, and there is no treatment guaranteed to address the underlying pathology of the syndrome. Thus, all treatments for IBS are intended to treat symptoms rather than cure the condition. While a variety of conventional treatments exist, efficacy and tolerability vary, leaving many to seek out alternative and complementary options.
Now, a growing number of patients are looking toward a natural therapy which not only reduces the severity of episodes but may also reduce their chance of relapse. This therapy is curcumin, a medicinal molecule with a long history of human use by virtue of its herbal source, turmeric; curcumin exists in turmeric plants, which are commonly employed as a spice. As a bioactive chemical, however, curcumin is increasingly being explored for its potential medical use. In particular, curcumin is being recognized as a possible treatment for IBS owing to its potent anti-inflammatory properties. Paired with a reliable high-bioavailability delivery system, patients with IBS may be able to control their flare-ups preventively and more effectively than is possible with conventional treatment alone.
Countering IBS Inflammation With Curcumina review authored by Drs Pietro Dulbecco and Vincenzo Savarino and published in the World Journal of Gastroenterology, curcumin is a potent inhibitor of proinflammatory cellular signaling molecules in the gut. Controlling inflammation is critical in the context of IBS, as the disease has an inflammatory component of uncertain origin. In the course of their investigation into curcumin’s usefulness in treating digestive disorders, Drs Dulbecco and Savarino found that curcumin dampens the impact of nearly all of the major proinflammatory molecules in the gut via a handful of different mechanisms described by other researchers. These molecules include tumor necrosis factor alpha (TNFa), NF-kB, IL-2, and IL-12—all of which are among the body’s major tools for generating and sustaining inflammation.
Each of these molecules is relevant to irritable bowel syndrome. IBS patients experience elevated NF-kB concentrations along with generally elevated levels of other proinflammatory molecules. Such elevated levels of NF-kB means that cells are more prone to runaway inflammation incidents. When curcumin is present, however, the proinflammatory molecules may bond to curcumin, preventing their signal from reaching cells. Curcumin might thus stem the possibility of runaway inflammatory episodes if delivered to patients’ colon cells, significantly reducing flare-ups.
Using Curcumin to Modulate the Gut Microbiome
In addition to anti-inflammatory effects, Dulbecco and Savarino believe that curcumin has an additional mechanism that would be helpful to IBS patients: stabilizing the gut microbiome. Irritable bowel syndrome is partially characterized by a host microbiome that is divergent from the profile of a normal and healthy microbiome. This is caused by certain overstimulated T cells erroneously and transiently secreting chemicals which damage the extracellular matrix responsible for maintaining the integrity of the intestinal tissue. As the extracellular matrix is weakened, healthy gut microbiota have fewer viable habitats and are replaced by harmful bacteria. In IBS, this phenomenon isn’t widespread enough to cause permanent damage to the intestinal tissue, but it does make the intestines more vulnerable to future irritation—and, thus, IBS flare-ups—until the damage is repaired.
While curcumin can’t prevent the T cells from secreting these chemicals—which are distinct from the chemicals which cause inflammation—it can prevent these T cells from being produced in the first place. Because curcumin inhibits the action of one of the signaling molecules which causes T cells to differentiate into the matrix-degrading variant, it can lead to lower concentrations of these cells in the colon. There aren’t any studies specifically linking curcumin to improved microbiome health in IBS patients, but the evidence of their impact on T cells is undeniable.
Reducing IBS Pain With Curcumin
In addition to reducing flare-ups, curcumin also has the potential to reduce pain and discomfort associated with IBS when flare-ups do occur. This is due to the fact that curcumin impacts the gut’s ability to detect pain and refer pain signals elsewhere in the body. As a result, pain-related gastrointestinal symptoms may potentially be alleviated. According to Dulbecco and Savarino’s review, curcumin has been found to inhibit signals of burning, pain, and discomfort in the gut via its inhibition of the TRPV1 sensory transducer protein. This means that patients who supplement their diets with curcumin will experience less inflammation, less microbiome disruption, and, most likely, less discomfort. There’s also a chance that IBS patients will experience fewer relapses when they supplement with curcumin.
Learning From Curcumin’s Impact On IBDs
Each of the effects of curcumin is broadly applicable to not just IBS, but also other bowel diseases, and research on its impact on these conditions can give us greater insight into the potential of curcumin in the treatment of IBS. In particular, inflammatory bowel diseases (IBDs) are relevant to patients with IBS because many researchers believe that the two families of pathologies are deeply related and potentially even identical.
In a clinical trial examining curcumin’s impact on IBDs, Crohn’s disease and ulcerative colitis patients experienced significant benefits from curcumin supplementation. In patients with Crohn’s disease, supplementation with 360 mg of curcumin thrice daily led to a 55 point reduction in Crohn’s disease activity indices. If a patient experienced this kind of point drop in the context of mild to moderate Crohn’s, it might be enough to quantitatively declare their disease as in remission. This level of symptom reduction is extremely promising, particularly as the patients did not receive traditional treatment during the period of the study, indicating that curcumin can have a meaningful impact when used in isolation.
In ulcerative colitis patients, on the other hand, curcumin was administered in concert with regular medication. When curcumin was added to regular medication, 100% of the ulcerative colitis patients experienced significant improvements in their level of inflammation, and many were able to reduce their level of conventional medication intake as a result. A subsequent much larger controlled study of curcumin for ulcerative colitis further elucidated the efficacy of curcumin supplementation, finding that 20.5% of patients who received a placebo relapsed after treatment whereas only 4.65% who received curcumin relapsed. Significantly, the researchers who conducted the study found that the patients who received curcumin experienced much lower clinical indicators of ulcerative colitis severity, including morbidity.
The studies on IBD patients show that curcumin supplementation reliably decreases the gut’s ability to create large-scale inflammation and IBS patients can, therefore, benefit from the same mechanism if they have access to high-quality curcumin supplements.
Making Curcumin Bioavailable For Patient Reliefdesigned to optimize bioavailability show great promise in overcoming the compound’s obstacles to clinical application.
Dulbecco and Savarino speak enthusiastically about several new drug delivery mechanisms which might be used to create highly bioavailable curcumin supplements that could drastically improve the quality of life for IBS patients. With the help of these sophisticated drug delivery systems, patients gain access to the natural and highly tolerable curcumin that can give them the symptom relief and relapse protection that they are seeking. Physicians and patients can thus easily integrate specialized curcumin supplements into their regular IBS treatment plans to gain greater control over the disorder.
Bercik, P., Verdu, E. F., & Collins, S. M. 2005. Is irritable bowel syndrome a low-grade inflammatory bowel disease? Gastroenterology Clinics of North America, 34(2):235-245. https://www.ncbi.nlm.nih.gov/pubmed/15862932
Dulbecco, P., & Savarino, V. 2013. Therapeutic potential of curcumin in digestive diseases. World Journal of Gastroenterology, 19(48):9256-9270. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3882399/
Hanai, H., Iida, T., Takeuchi, K., Watanabe, F., & Maruyama, Y. 2006. Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial. Clinical Gastroenterology and Hepatology, 4(12):1502-1506. http://www.cghjournal.org/article/S1542-3565(06)00800-7/fulltext
Holt, P. R., Katz, S., & Kirshoff, R. 2005. Curcumin therapy in inflammatory bowel disease: a pilot study. Digestive Diseases and Sciences, 50(11):2191-2193. https://www.ncbi.nlm.nih.gov/pubmed/16240238/
Patwardhan, R. S., Checker, R., Sharma, D., Kohli, V., & Priyadarsini, K. 2011. Dimethoxycurcumin, a metabolically stable analogue of curcumin, exhibits anti-inflammatory activities in murine and human lymphocytes. Biochemical Pharmacology, 82(6):642-657. https://www.sciencedirect.com/science/article/abs/pii/S0006295211004072