Turmeric Curcumin Put to the Test for Inflammatory Bowel Disease
"Curcumin seems to be a promising and safe medication for maintaining remission in patients with quiescent ulcerative colitis."
My video Striking with the Root: Turmeric Curcumin and Ulcerative Colitis tells the story how this amazing discovery was made, and how curcumin stacks up against pharmacological interventions. (Photo by Lucy Turner on Unsplash)
Despite evidence going back 40 years that the turmeric spice component curcumin possesses significant anti-inflammatory activity, it wasn’t until 2005 that it was first tested on inflammatory bowel disease. Why did it take so long? Well, who’s going to fund such a study? Big Curry? Even without corporate backing, individual physicians from New York decided to ask the next five patients with ulcerative colitis who walked through their office doors to start curcumin supplements.
"Ulcerative colitis (UC) is a debilitating, chronic, relapsing-remitting [i.e., it comes and goes] IBD [inflammatory bowel disease] that afflicts millions of individuals throughout the world and produces symptoms that impair quality of life and ability to function." As with most diseases, we have a bunch of drugs to treat people, but sometimes these medications can add to disease complications, most commonly nausea, vomiting, headaches, rash, fever, and inflammation of the liver, pancreas, and kidneys, as well as potentially wiping out our immune system and causing infertility. Most ulcerative colitis patients need to be on drugs every day for the rest of their lives, so we need something safe to keep the disease under control.
So how did those five patients do on the spice extract? Overall, all five subjects improved by the end of the study, and four of the five were able to decrease or eliminate their medications. They had "more formed stools, less frequent bowel movements, and less abdominal pain and cramping. One subject reported decreased muscle soreness, commonly felt after his exercise routine." This, however, was what’s called an open-label study, meaning the patients knew they were taking something so some of the improvement may have just been the placebo effect. In 2013, another small open-label pilot study found encouraging results in a pediatric population, but what was needed was a larger scale, double-blind, placebo-controlled trial.
And, researchers obliged. They took a bunch of people with quiescent ulcerative colitis and gave them either turmeric curcumin along with their typical anti-inflammatory drugs, or a placebo and their drugs. In the placebo group, 8 out of 39 patients relapsed, meaning their disease flared back up. In the curcumin group, however, only 2 out of 43 relapsed, significantly fewer. And, relapse or not, clinically, the placebo group got worse, while the curcumin group got better. Endoscopically, which is objectively visualizing the inside of their colons, doctors saw the same thing: trends towards worse or better.
The results were stunning: a 5 percent relapse rate in the curcumin group compared with a 20 percent relapse rate in the conventional care group. It was such a dramatic difference that the researchers wondered if it was some kind of fluke. Even though patients were randomized to each group, perhaps the curcumin group just ended up being much healthier through some chance coincidence, so maybe it was some freak occurrence rather than curcumin that accounted for the results? So, the researchers extended the study for another six months but put everyone on the placebo to ensure the initial findings were not some aberration. The curcumin was stopped to see if that group would then start relapsing, too—and that’s exactly what happened. Suddenly, they became just as bad as the original placebo group.
The researchers concluded: "Curcumin seems to be a promising and safe medication for maintaining remission in patients with quiescent ulcerative colitis." Indeed, no side effects were reported at all. So, "Curry for the cure?" asked an accompanying editorial in the journal of the Crohn’s and Colitis Foundation of America. "Can curcumin be added to our list of options with respect to maintaining remission in ulcerative colitis? What is noteworthy about this trial is the fact that not only did the authors demonstrate a statistically significant decrease in relapse at 6 months, but a statistically significant improvement in the endoscopic index as well. Equally telling is the fact that upon withdrawal of curcumin the relapse rate quickly paralleled that of patients treated initially with placebo, implying that curcumin was, in fact, exerting some important biologic effect."
Similarly, a Cochrane review concluded in 2013 that curcumin may be a safe and effective adjunct therapy. Cochrane reviews take all the best studies meeting strict quality criteria and compile all the best science together, which is normally a gargantuan undertaking. Not so in this case, however, as there is really just that one good study.
Turmeric is one of the most popular trending topics, and I encourage you to check out the most popular turmeric videos, including:
• Which Spices Fight Inflammation?
• Turmeric Curcumin for Prediabetes
• Speeding Recovery from Surgery with Turmeric
• Heart of Gold: Turmeric vs. Exercise
• Turmeric Curcumin and Pancreatic Cancer
• Treating Alzheimer’s with Turmeric
• Back to Our Roots: Turmeric and Cancer
• Who Shouldn’t Consume Curcumin or Turmeric?
• Boosting the Bioavailability of Curcumin
• Turmeric Curcumin and Osteoarthritis
• Turmeric or Curcumin: Plants vs. Pills
For more on ulcerative colitis and inflammatory bowel disease, see:
• Preventing Ulcerative Colitis with Diet
• Treating Ulcerative Colitis with Diet
• Titanium Dioxide and Inflammatory Bowel Disease
• Preventing Crohn’s Disease with Diet
• Bowel Wars: Hydrogen Sulfide vs. Butyrate
• Wheatgrass Juice for Ulcerative Colitis
Michael Greger, M.D.