Updated on February 8, 2023
Characterized by pain, diarrhea, bloating, discomfort, and constipation, irritable bowel syndrome (IBS) can produce extreme discomfort that profoundly interferes with functionality and quality of life. Currently, the etiology of IBS remains unknown, and there is no therapy guaranteed to address the underlying pathology of the syndrome. Thus, all therapeutic options for IBS are currently intended to address symptoms rather than cure the condition. Although a variety of conventional therapies exist, their efficacy and tolerability vary, leaving many to seek out alternative and complementary options.
Now, a growing number of patients are exploring the possible relationship between curcumin and IBS. Curcumin has a long history of human use by virtue of its herbal source, turmeric; curcumin is a compound of the turmeric plant, which is commonly utilized as a spice. As a bioactive compound, however, curcumin is being investigated for its potential therapeutic uses. In particular, curcumin is being recognized as a possible therapy for IBS owing to its ability to support the body’s natural inflammatory response. Paired with a reliable high-bioavailability delivery system, patients with IBS might be able to address their symptoms more effectively than is possible with conventional therapy alone.
Understanding the relationship between curcumin and IBS requires a consideration of curcumin’s bioactive properties. According to a 2013 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. Maintaining a normal inflammatory response in the gut is critical in the context of IBS, because the disease has an inflammatory component of uncertain origin. In the course of their investigation into curcumin’s usefulness in treating digestive complaints, Drs Dulbecco and Savarino found that curcumin down-regulates 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 substances that generate and sustain inflammation.
Each of these proinflammatory molecules is relevant to IBS patients, who experience elevated NF-kB concentrations along with generally elevated levels of other proinflammatory molecules. Elevated levels of NF-kB means that cells are more prone to runaway inflammation incidents. When curcumin is present, however, the proinflammatory molecules bond to curcumin, down-regulating their ability to adversely impact the body. Curcumin might thus provide therapeutic benefit for an IBS flare-up when delivered to patients’ colon cells.
In addition to helping maintain the body’s natural inflammatory response, Dulbecco and Savarino believe that curcumin has another mechanism that is 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 that 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, although this phenomenon isn’t sufficiently widespread to cause permanent damage to the intestinal tissue, it does make the intestines more vulnerable to future irritation—and, thus, IBS flare-ups—until the damage is repaired.
Although curcumin can’t restrict the T cells’ ability to secrete these chemicals—which are distinct from the chemicals that cause inflammation—curcumin can down-regulate T cell production. Because curcumin down-regulates the action of one of the signaling molecules that causes T cells to differentiate into the matrix-degrading variant, it can lead to lower concentrations of these cells in the colon. Although there aren’t any studies specifically linking curcumin to better microbiome health in IBS patients, the evidence of their beneficial impact on T cells is undeniable.
In addition to having a remedial benefit for flare-ups, curcumin also has the potential to address the GI discomfort associated with IBS when flare-ups do occur. This is due to the fact that curcumin apparently impacts the gut’s ability to detect discomfort and refer its signals elsewhere in the body. As a result, discomfort-related gastrointestinal symptoms might potentially be alleviated. According to Dulbecco and Savarino’s review, curcumin down-regulates the signals of burning and discomfort in the gut via its inhibition of the TRPV1 sensory transducer protein. This means that patients who supplement their diets with curcumin are likely to experience less microbiome disruption and, most likely, less discomfort. There’s also a likelihood that IBS patients will experience less severe relapses when they supplement with curcumin.
Each of curcumin’s beneficial effects is broadly applicable to not just IBS, but also other bowel conditions, and research on its impact on these conditions provides greater insight into the potential of curcumin to address IBS symptoms. In particular, inflammatory bowel diseases (IBDs) are relevant to IBS patients because many researchers believe the two families of pathologies are deeply related and potentially even identical.
In an open label, pilot study of five patients examining curcumin’s impact on IBDs, Crohn’s disease, and ulcerative colitis, the participants 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. This level of symptom reduction is extremely promising, particularly because the patients did not receive conventional therapy 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, when curcumin was administered in concert with regular medication, 100 percent of ulcerative colitis patients experienced significant symptom improvement, and many were able to adjust their level of conventional medication intake accordingly. A large controlled study in 2015 of curcumin for ulcerative colitis further elucidated the efficacy of curcumin supplementation, finding that 20.5 percent of patients who received a placebo relapsed, whereas only 4.65 percent who received curcumin relapsed. Significantly, the researchers who conducted the study found that the patients who received curcumin experienced more positive clinical indicators of ulcerative colitis severity.
These studies on IBD patients indicate that curcumin supplementation helps maintain the gut’s normal inflammatory response, and IBS patients can, therefore, benefit from the same mechanism if they have access to high-quality curcumin supplements.
The potential for curcumin and IBS is profound owing to curcumin’s ability to naturally regulate the gastrointestinal tract and up-regulate the body’s own mechanisms to address IBS symptomatology. However, the path to clinical curcumin use is more difficult than it might seem at first. Curcumin is notorious for being poorly absorbed by body’s cells, as documented by Dulbecco and Savarino. Due to its low bioavailability, curcumin molecules aren’t present in large enough quantities for long enough periods of time to have a therapeutic effect when consumed as part of the turmeric plant. However, new formulations of nutritional supplements designed to optimize curcumin’s bioavailability show great promise in overcoming the compound’s obstacles to clinical application.
Dulbecco and Savarino speak enthusiastically about several new nutrient delivery mechanisms that might be used in creating highly bioavailable curcumin supplements that could enhance the quality of life for IBS patients. With the help of these sophisticated nutrient delivery systems, patients gain access to the natural and highly tolerable curcumin that can give them the natural symptom relief they are seeking. Physicians and patients can thus easily integrate specialized curcumin supplements into their daily IBS regimen to gain greater control over their therapy.
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