Herbal Medicines for the Management of Irritable Bowel Syndrome
A Systematic Review
Keywords:
Herbal medicine, Irritable Bowel Syndromes, Complementary MedicineAbstract
Irritable Bowel Syndrome (IBS) is a chronic digestive disorder, which is characterized by abdominal pain, bloating, diarrhea and constipation periods. The etiology is unknown. Based on the different mechanisms in the etiology, treatment focuses on controlling symptoms. Due to the longtime of syndrome, inadequacy of current treatments, financial burden for patients and pharmacologic effects, several patients have turned to the use of complementary and alternative medicine (CAM). Complementary and alternative treatments for IBS include hypnosis, acupuncture, cognitive behavior therapy, yoga, and herbal medicine. Herbal medicines can have therapeutic effects and adverse events in IBS. The aim of this study was to evaluate the efficacy of herbal medicines in the control of IBS, and their possible mechanisms of action were reviewed. Herbal medicines are an important part of the health care system in many developing countries It is important for physicians to understand some of the more common forms of CAM, because some herbs have side effects and some have interactions with conventional drugs. However herbal medicines may have therapeutic effects in IBS, and further clinical research is needed to assess its effectiveness and safety.
References
Hyams JS. Irritable bowel syndrome, functional dyspepsia, and functional abdominal pain syndrome.
Adolesc Med Clin. 2004; 15(1): 1-15. doi: 10.1016/S1547336803000032. PMID: 15272253.
Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, et al. Childhood functional
gastrointestinal disorders: child/adolescent. Gastroenterology. 2006; 130(5): 1527-37. doi:
1053/j.gastro.2005.08.063. PMID: 16678566.
Ohman L, Simrén M. Pathogenesis of IBS: role of inflammation, immunity and neuroimmune interactions.
Nat Rev Gastroenterol Hepatol. 2010; 7(3): 163-73. doi: 10.1038/nrgastro.2010.4. PMID: 20101257.
Hyams JS, Burke G, Davis PM, Rzepski B, Andrulonis PA. Abdominal pain and irritable bowel syndrome
in adolescents: a community-based study. J Pediatr. 1996; 129(2): 220-6. doi: 10.1016/S0022- 3476(96)70246-9. PMID: 8765619.
Noras MR, Yousefi M, Kiani MA. Complementary and Alternative Medicine (CAM) Use in Pediatric
Disease: A Short Review. International Journal of Pediatrics. 2013; 1(2): 45-9.
Bahrami HR, Noras M, Saeidi M. Acupuncture Use in Pediatric Disease: A Short Review. International
Journal of Pediatrics. 2014; 2(3.2): 69-72.
Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions. version 5.1.0. The
Cochrane Collaboration. 2011. Available from: http://handbook.cochrane.org
Grindlay D, Reynolds T. The Aloe vera phenomenon: a review of the properties and modern uses of the
leaf parenchyma gel. J Ethnopharmacol. 1986; 16(2-3): 117-51. doi: 10.1016/0378-8741(86)90085-1.
PMID: 3528673.
Spanier JA, Howden CW, Jones MP. A systematic review of alternative therapies in the irritable bowel
syndrome. Arch Intern Med. 2003; 163(3): 265-74. doi: 10.1001/archinte.163.3.265. PMID: 12578506.
Hutchings HA, Wareham K, Baxter JN, Atherton P, Kingham JG, Duane P, et al. A randomized, cross- over, placebo-controlled study of Aloe vera in patients with irritable bowel syndrome: effects on patient
quality of life. ISRN Gastroenterol. 2011; 2011: 206103. doi: 10.5402/2011/206103. PMID: 21991499,
PMCID: PMC3168391.
Odes HS, Madar Z. A double-blind trial of a celandin, Aloe vera and psyllium laxative preparation in adult
patients with constipation. Digestion. 1991; 49(2): 65-71. doi: 10.1159/000200705. PMID: 1800188.
Davis K, Philpott S, Kumar D, Mendall M. Randomized double‐blind placebo‐controlled trial of aloe
vera for irritable bowel syndrome. Int J Clin Pract. 2006; 60(9): 1080-6. doi: 10.1111/j.1742- 1241.2006.00980.x. PMID: 16749917.
Khedmat H, Karbasi A, Amini M, Aghaei A, Taheri S. Aloe vera in treatment of refractory irritable bowel
syndrome: Trial on Iranian patients. J Res Med Sci. 2013; 18(8): 732. PMID: 24379854, PMCID:
PMC3872617.
Walker AF, Middleton RW, Petrowicz O. Artichoke leaf extract reduces symptoms of irritable bowel
syndrome in a post‐marketing surveillance study. Phytother Res. 2001; 15(1): 58-61. PMID: 11180525.
Bundy R, Walker AF, Middleton RW, Marakis G, Booth JC. 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. J Altern Complement Med. 2004; 10(4): 667-9. doi:
1089/acm.2004.10.667. PMID: 15353023.
Emendörfer F, Emendörfer F, Bellato F, Noldin VF, Cechinel-Filho V, Yunes RA, et al. Antispasmodic
activity of fractions and cynaropicrin from Cynara scolymus on guinea-pig ileum. Biol Pharm Bull. 2005;
(5): 902-4. PMID: 15863902.
Brinkhaus B, Hentschel C, Von Keudell C, Schindler G, Lindner M, Stützer H, et al. Herbal medicine with
curcuma and fumitory in the treatment of irritable bowel syndrome: a randomized, placebo-controlled,
double-blind clinical trial. Scand J Gastroenterol. 2005; 40(8): 936-43. PMID: 16173134.
Bundy R, Walker AF, Middleton RW, Booth J. Turmeric extract may improve irritable bowel syndrome
symptomology in otherwise healthy adults: a pilot study. J Altern Complement Med. 2004; 10(6):1015-8.
doi: 10.1089/acm.2004.10.1015. PMID: 15673996.
Miquel J, Bernd A, Sempere JM, Díaz-Alperi J, Ramírez A. The curcuma antioxidants: pharmacological
effects and prospects for future clinical use. A review. Arch Gerontol Geriatr. 2002; 34(1): 37-46. doi:
1016/S0167-4943(01)00194-7. PMID: 14764309.
Gilani AH, Shah AJ, Ghayur MN, Majeed K. Pharmacological basis for the use of turmeric in
gastrointestinal and respiratory disorders. Life Sci. 2005; 76(26): 3089-105. doi: 10.1016/j.lfs.2004.12.021.
PMID: 15850601.
Wan H, Chen Y. Effects of ant depressive treatment of Saint John's wort extract related to autonomic
nervous function in women with irritable bowel syndrome. Int J Psychiatry Med. 2010; 40(1): 45-56. doi:
2190/PM.40.1.d. PMID: 20565044.
Saito YA, Rey E, Almazar-Elder AE, Harmsen WS, Zinsmeister AR, Locke GR, et al. A randomized,
double-blind, placebo-controlled trial of St John's wort for treating irritable bowel syndrome. Am J
Gastroenterol. 2010; 105(1): 170-7. doi: 10.1038/ajg.2009.577. PMID: 19809408.
Rahimi R, Nikfar S, Abdollahi M. Efficacy and tolerability of Hypericum perforatum in major depressive
disorder in comparison with selective serotonin reuptake inhibitors: a meta-analysis. Prog
Neuropsychopharmacol Biol Psychiatry. 2009; 33(1): 118-27. doi: 10.1016/j.pnpbp.2008.10.018. PMID:
Butterweck V, Schmidt M. St. John's wort: role of active compounds for its mechanism of action and
efficacy. Wien Med Wochenschr. 2007; 157(13-14): 356-61. doi: 10.1007/s10354-007-0440-8. PMID:
Rahimi R, Abdollahi M. Herbal medicines for the management of irritable bowel syndrome: a
comprehensive review. World J Gastroenterol. 2012; 18(7): 589-600. doi: 10.3748/wjg.v18.i7.589. PMID:
, PMCID: PMC3281215.
Liu JH, Chen GH, Yeh HZ, Huang CK, Poon SK. Enteric-coated peppermint-oil capsules in the treatment
of irritable bowel syndrome: a prospective, randomized trial. J Gastroenterol. 1997; 32(6): 765-8. doi:
1007/BF02936952. PMID: 9430014.
Cappello G, Spezzaferro M, Grossi L, Manzoli L, Marzio L. Peppermint oil (Mintoil) in the treatment of
irritable bowel syndrome: a prospective double blind placebo-controlled randomized trial. Dig Liver Dis.
; 39(6): 530-6. doi: 10.1016/j.dld.2007.02.006. PMID: 17420159.
Merat S, Khalili S, Mostajabi P, Ghorbani A, Ansari R, Malekzadeh R. The effect of enteric-coated,
delayed-release peppermint oil on irritable bowel syndrome. Dig Dis Sci. 2010; 55(5): 1385-90. doi:
1007/s10620-009-0854-9. PMID: 19507027.
Khanna R, MacDonald JK, Levesque BG. Peppermint oil for the treatment of irritable bowel syndrome: a
systematic review and meta-analysis. J Clin Gastroenterol. 2014; 48(6): 505-12. doi:
1097/MCG.0b013e3182a88357. PMID: 24100754.
Grigoleit HG, Grigoleit P. Peppermint oil in irritable bowel syndrome. Phytomedicine. 2005; 12(8): 601-6.
doi: 10.1016/j.phymed.2004.10.005. PMID: 16121521.
Logan AC, Beaulne TM. The treatment of small intestinal bacterial overgrowth with enteric-coated
peppermint oil: a case report. Altern Med Rev. 2002; 7(5): 410-7. PMID: 12410625.
Grigoleit HG, Grigoleit P. Pharmacology and preclinical pharmacokinetics of peppermint oil.
Phytomedicine. 2005; 12(8): 612-6. doi: 10.1016/j.phymed.2004.10.007. PMID: 16121523.
Hiki N. Peppermint oil reduces gastric motility during the upper gastrointestinal endoscopy. Nihon Rinsho.
; 68(11): 2126-34. PMID: 21061544.
Bijkerk CJ, de Wit NJ, Muris JW, Whorwell PJ, Knottnerus JA, Hoes AW. Soluble or insoluble fibre in
irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ. 2009; 339: b3154.
doi: 10.1136/bmj.b3154. PMID: 19713235, PMCID: PMC3272664.
Bijkerk CJ, Muris JW, Knottnerus JA, Hoes AW, de Wit NJ. Systematic review: the role of different types
of fibre in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2004; 19(3): 245-51. doi:
1111/j.0269-2813.2004.01862.x. PMID: 14984370.
Ford AC, Talley NJ, Spiegel BM, Foxx-Orenstein AE, Schiller L, Quigley EM, et al. Effect of fibre,
antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and
meta-analysis. BMJ. 2008; 337: a2313. doi: 10.1136/bmj.a2313.
Vejdani R, Shalmani HR, Mir-Fattahi M, Sajed-Nia F, Abdollahi M, Zali MR, et al. The efficacy of an
herbal medicine, Carmint, on the relief of abdominal pain and bloating in patients with irritable bowel
syndrome: a pilot study. Dig Dis Sci. 2006; 51(8): 1501-7. doi: 10.1007/s10620-006-9079-3. PMID:
Published
Issue
Section
License
Copyright (c) 2020 KNOWLEDGE KINGDOM PUBLISHING
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.