Patient - Irritable Bowel Syndrome (IBS) Herbal Medicine

  • Bundy R, Walker AF, Middleton RW, et al. "Artichoke leaf extract reduces symptoms of irritable bowel syndrome and improves quality of life in otherwise healthy volunteers suffering from concomitant dyspepsia: a subset analysis." Journal of Alternative & Complementary Medicine. 10(4): 667-9, 2004 Aug.

    This study looked at whether artichoke leaf extract (ALE) improves symptoms of irritable bowel syndrome (IBS) in otherwise healthy volunteers with accompanying indigestion. In two hundred and eight adults, IBS incidence, self-reported usual bowel pattern, and the Nepean Dyspepsia Index (NDI) were compared before and after a 2-month intervention period. There was a significant fall in IBS incidence of 26.4% after treatment. A significant shift in self-reported usual bowel pattern away from "alternating constipation/diarrhea" toward "normal" was observed. NDI total symptom score significantly decreased by 41% after treatment. Similarly, there was a significant 20% improvement in the total quality-of-life score after treatment. This report supports previous findings that ALE improves symptoms of IBS and health-related quality of life.

  • Bundy R, Walker AF, Middleton RW, Booth J. "Turmeric extract may improve irritable bowel syndrome symptomology in otherwise healthy adults: a pilot study." Journal of Alternative & Complementary Medicine. 10(6):1015-8, 2004

    This pilot study was undertaken to evaluate the effects of turmeric (Curcuma longa) extract on irritable bowel syndrome (IBS) in otherwise healthy adults. Two hundred and seven (207) people received either one or two tablets of a standardized turmeric extract daily for 8 weeks. Outcome measures included IBS prevalence, symptom-related quality of life and self-reported effectiveness. IBS prevalence decreased significantly in both groups between screening and baseline (41% and 57%), with a further significant drop of 53% and 60% between baseline and after treatment, in the one- and two-tablet groups respectively. Abdominal pain/discomfort scores were also reduced significantly by 22% and 25%. There were significant improvements in all except one of the quality of life scales of between 5% and 36% in both groups, approximately two thirds of all subjects reporting an improvement in symptoms after treatment, and there was a favorable shift in self-reported bowel pattern. Turmeric may help reduce IBS symptoms. Placebo controlled trials are now warranted to confirm these findings.

  • Grigoleit HG. Grigoleit P. "Peppermint oil in irritable bowel syndrome." Phytomedicine. 12(8):601-6, 2005 Aug.

    Sixteen clinical trials investigating the use of 180-200 mg of enteric-coated peppermint oil (PO) in irritable bowel syndrome (IBS) or recurrent abdominal pain were identified. Eight out of 12 placebo controlled studies show statistically significant effects in favor of peppermint oil. Average response rates in terms of "overall success" are 58% (range 39-79%) for peppermint oil and 29% (range 10-52%) for placebo. The three studies versus smooth muscle relaxants did not show differences between treatments. Adverse events reported were generally mild and transient. The authors suggest that peppermint oil (1-2 capsules three times a day over 24 weeks) may be the drug of first choice in IBS patients with non-serious constipation or diarrhea to alleviate general symptoms and to improve quality of life.

  • Kline RM, Kline JJ, Di Palma J, Barbero GJ. "Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children."" Journal of Pediatrics. 138(1):125-8, 2001.

    In a randomized, double-blind controlled clinical trial, 42 children with irritable bowel syndrome were given enteric-coated peppermint oil capsules or placebo. After two weeks, 75% of those receiving peppermint oil had reduced severity of pain associated with IBS. It is concluded that peppermint oil may be used as a therapeutic agent during the symptomatic phase of IBS.

  • Liu JP, Yang M, Liu YX, et al. Herbal medicines for treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD004116.

    This systematic review assessed the effectiveness and safety of herbal medicines in patients with IBS. Seventy-five randomized trials, including 7,957 participants with IBS and seventy-one different tested herbal medicines were compared with placebo or conventional pharmacologic therapy. Some herbal medicines, including a Standard Chinese herbal formula, individualized Chinese herbal medicines STW 5 and STW 5-II, Tibetan herbal medicine Padma Lax, traditional Chinese formula Tongxie Yaofang, and Ayurvedic preparations showed significantly improved global symptoms. Compared with conventional therapy in 65 trials testing 51 different herbal medicines, 22 herbal medicines demonstrated a statistically significant benefit for symptom improvement, and 29 herbal medicines were not significantly different than conventional therapy. No serious adverse events from the herbal medicines were reported. Positive findings from less rigorous trials should be interpreted with caution due to inadequate methodology, small sample sizes, and lack of confirming data. Some herbal medicines deserve further examination in high-quality trials.

  • Madisch A, Holtmann G, Plein K, et al. "Treatment of irritable bowel syndrome with herbal preparations: results of a double-blind, randomized, placebo-controlled, multi-centre trial." Alimententary Pharmacology & Therapeutics. 19(3):271-9, 2004.

    This study assessed the effectiveness and safety of a commercially available herbal preparation (STW 5) consisting of nine plant extracts, the research herbal preparation STW 5-II consisting of six plant extracts, and the bitter candytuft mono-extract in patients with irritable bowel syndrome. Two hundred and eight patients with irritable bowel syndrome were recruited to be part of this double-blind, placebo-controlled, multi-centre trial and were randomly assigned to receive one of the three treatments above or a placebo. In this trial STW 5 and STW 5-II were significantly better than placebo in reducing the total abdominal pain score and the irritable bowel syndrome symptom score at 4 weeks.