Plain language summary
Inflammatory bowel disease (IBD) is characterised by chronic intestinal inflammation. Conventional drug treatment is effective, but may cause adverse effects. The beneficial effects of turmeric on intestinal inflammation have been shown in animal and adult human studies. The aim of this pilot study was to test the tolerability of curcumin extract in children with IBD at different doses. The doses of curcumin extract tested were 500mg twice a day for two weeks, increasing to 1g twice a day for three weeks, increasing to 2g twice a day for three weeks. These doses was taken in addition to patients standard drug treatment. The curcumin was well tolerated at all three of these doses by patients who completed the study (nine children aged 11-18 years with IBD (Crohn's or UC)) in remission or with mild disease. Some symptoms were reported by the majority of patients during the study but these were mild, not clearly related to curcumin and did not require the dose of curcumin to be reduced. Two patients reported ‘gassiness’ at all three doses. Two patients with UC went into remission. Disease activity improved in patients with Crohn's. No participants experienced a relapse or worsening of symptoms during the study. This pilot study suggests that curcumin extract may be taken in combination with conventional medicine without clinically significant side- or adverse-effects, though larger studies are needed to fully assess the safety and efficacy of curcumin in children with IBD.
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is characterized by chronic intestinal inflammation in the absence of a recognized etiology. The primary therapies are medications that possess anti-inflammatory or immunosuppressive effects. Given the high use of complementary alternative medicines in pediatric IBD, a prospective tolerability study of curcumin, an herbal therapy with known anti-inflammatory effects, was conducted to assess possible dosage in children with IBD. METHODS Prospectively, patients with Crohn disease or ulcerative colitis in remission or with mild disease (Pediatric Crohn's Disease Activity Index [PCDAI] <30 or Pediatric Ulcerative Colitis Activity Index [PUCAI] score <34) were enrolled in a tolerability study. All patients received curcumin in addition to their standard therapy. Patients initially received 500 mg twice per day for 3 weeks. Using the forced-dose titration design, doses were increased up to 1 g twice per day at week 3 for a total of 3 weeks and then titrated again to 2 g twice per day at week 6 for 3 weeks. Validated measures of disease activity, using the PUCAI and PCDAI, and the Monitoring of Side Effect System score were obtained at weeks 3, 6, and 9. RESULTS All patients tolerated curcumin well, with the only symptom that was consistently reported during all 3 visits being an increase in gassiness, which occurred in only 2 patients. Three patients saw improvement in PUCAI/PCDAI score. CONCLUSIONS This pilot study suggests that curcumin may be used as an adjunctive therapy for individuals seeking a combination of conventional medicine and alternative medicine.
Methodological quality
Jadad score
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1
Allocation concealment
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Not applicable
