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Cited by 11Curcumin's Biomedical ApplicationsSaffron Plant Research StudiesComplementary and Alternative Medicine Studies

The DOI matches its Crossref record; 52 of the 52 references it cites were found in a registry or an index; none of the 111 sources its claims cite is checked for support yet.

A systematic review of the efficacy and safety of turmeric in the treatment of digestive disorders

Open access

Abstract

Turmeric has been gaining popularity as a treatment option for digestive disorders, although a rigorous synthesis of efficacy has not been conducted. This study aimed to summarize the evidence for the efficacy and safety of turmeric in the treatment of digestive disorders, including inflammatory bowel diseases (IBD), irritable bowel syndrome (IBS), dyspepsia, gastroesophageal reflux disease, and peptic ulcers. Literature searches were conducted in Medline, EMBASE, AMED, the Cochrane Central Register of Control Trials, and Dissertation Abstracts from inception to November 15, 2021. Dual independent screening of citations and full texts was conducted and studies meeting inclusion criteria were retained: randomized controlled trials (RCT) and comparative observational studies evaluating turmeric use in people of any age with one of the digestive disorders of interest. Extraction of relevant data and risk of bias assessments were performed by two reviewers independently. Meta‐analysis was not conducted due to high heterogeneity. From 1136 citations screened, 26 eligible studies were retained. Most studies were assessed to have a high risk of bias, and many had methodological limitations. Descriptive summaries suggest that turmeric is safe, with possible efficacy in patients with IBD or IBS, but its effects were inconsistent for other conditions. The efficacy of turmeric in digestive disorders remains unclear due to the high risk of bias and methodological limitations of the included studies. Future studies should be designed to include larger sample sizes, use rigorous statistical methods, employ core outcome sets, and adhere to reporting guidance for RCTs of herbal interventions to facilitate more meaningful comparisons and robust conclusions.

Overview

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TL;DR

This systematic review of 26 studies found mixed efficacy for turmeric/curcumin in digestive disorders, with some favorable signals in IBD and IBS but no meta-analysis due to high heterogeneity. Turmeric appeared safe, with no significant safety differences versus placebo or active comparators.

Key findings

  • The review included 26 studies (25 RCTs and 1 randomized crossover trial); 14/26 (54%) were assessed as high risk of bias and the remaining 12 as unclear. Meta-analysis was not performed due to high heterogeneity.
  • IBD (9 studies, 533 patients): all studies reported beneficial responses, but significant findings were limited to curcumin extract ≥1000 mg/day or bio-enhanced curcumin <1000 mg/day; low-dose curcumin extract and curcumin enema were non-significant. In CD, curcumin 1500 mg/day did not significantly differ from placebo for endoscopic or clinical relapse at 6 months, but severe endoscopic recurrence was greater with curcumin (p = 0.034).
  • IBS (5 studies, 551 patients): mixed-formula curcumin products were significantly better than placebo in two studies (e.g., IBS-SSS p < 0.001; IBS-QoL adjusted difference of differences = 9.19 [95% CI 3.13–15.25]), but a third found no significant IBS-SSS difference (MD = 24.10, p = 0.26). Curcumin extracts showed no significant differences versus placebo, fumitory, or between doses.
  • Dyspepsia, ulcers, and H. pylori: dyspepsia (5 studies, 511 patients) showed curcumin extract beneficial versus placebo but not versus active comparators. For gastric ulcers, antacid produced more complete healing than 750 mg/day curcumin (94.1% vs 70.6%, p < 0.05); for duodenal ulcers, 6000 mg/day curcumin did not differ from placebo (25.4% vs 28.1%, p = 0.736). In H. pylori, 2100 mg/day curcumin had lower eradication than triple therapy (5.9% vs 78.9%, p < 0.001), while a mixed-formula curcumin product was similar to quadruple therapy (55.8% vs 62.2%, p > 0.05). No studies suggested significant safety differences, though two reported withdrawal due to adverse events in the turmeric group.

Methods

  • Systematic review with an a priori protocol, reported per PRISMA 2020. Searches were conducted in Medline, EMBASE, AMED, the Cochrane Central Register of Control Trials, and Dissertation Abstracts from inception to November 15, 2021, plus manual bibliography searches.
  • Eligible studies were RCTs and comparative observational studies in people of any age with IBD, IBS, dyspepsia, GERD, or peptic/gastric/duodenal ulcers; interventions were curcumin or derivatives at any dose, duration, or route; comparators were placebo, active comparator, or no treatment; animal studies were excluded. After screening 1173 references, 26 studies were included.
  • Dual independent screening and data extraction were performed, with risk of bias assessed using Cochrane ROB-1. Meta-analysis was not conducted due to high heterogeneity; findings were synthesized descriptively by condition, with Chi-squared or Fisher’s exact tests in Stata where raw data allowed, and forest plots generated in Comprehensive Meta-Analysis using standardized mean differences.

Limitations

  • The paper states that the evidence base was limited by high risk of bias (14/26 high, 12 unclear), clinical and methodological heterogeneity, small sample sizes, poor reporting, variation in turmeric preparations, and concurrent standard therapy in IBD/IBS that makes isolating turmeric’s effects difficult.
  • The paper also states that not all studies reported between-group comparisons, several used per-protocol rather than intention-to-treat analyses, adverse-event reporting was inadequate, some statistical methods were inappropriate, and zero cells limited precision.
  • Evident from the text: because meta-analysis was not performed, no pooled effect estimates are available, and outcome definitions varied widely with minimal overlap across studies.

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Integrity signals

Registry

Crossref · 10.1002/ptr.8189

Cites

52 of 52 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

FIGURE 1 Evidence flow diagram.
FIGURE 1 Evidence flow diagram.CC-BY-NC-ND · From the PDF
FIGURE 2 Risk of bias summary by domain inflammatory bowel disease (ulcerative colitis and Crohn's disease).
FIGURE 2 Risk of bias summary by domain inflammatory bowel disease (ulcerative colitis and Crohn's disease).CC-BY-NC-ND · From the PDF
FIGURE 3 Forest plot of the response to treatment with curcumin versus placebo in people with inflammatory bowel disease (ulcerative colitis or Crohn's disease). Effect estimates in forest plots (risk ratios, differences of differences, and standardized differences of differences) may not match those reported in the text due to the use of raw data to generate plots and standardization of some estimates. ASA, acetylsalicylic acid; Bio-en, bio-enhanced; CDAI, Crohn's Disease Activity Index; CI, confidence interval; CS, corticosteroid; Diff, difference; IM, immunomodulator; MES, mesalamine; SCCAI, Simple Clinical Colitis Activity Index; SE, standard error; SESCD, Simple Endoscopic Score for Crohn's Disease; Std diff, standardized difference; tx, treatment; UCDAI, Ulcerative Colitis Activity Index.
FIGURE 3 Forest plot of the response to treatment with curcumin versus placebo in people with inflammatory bowel disease (ulcerative colitis or Crohn's disease). Effect estimates in forest plots (risk ratios, differences of differences, and standardized differences of differences) may not match those reported in the text due to the use of raw data to generate plots and standardization of some estimates. ASA, acetylsalicylic acid; Bio-en, bio-enhanced; CDAI, Crohn's Disease Activity Index; CI, confidence interval; CS, corticosteroid; Diff, difference; IM, immunomodulator; MES, mesalamine; SCCAI, Simple Clinical Colitis Activity Index; SE, standard error; SESCD, Simple Endoscopic Score for Crohn's Disease; Std diff, standardized difference; tx, treatment; UCDAI, Ulcerative Colitis Activity Index.CC-BY-NC-ND · From the PDF
Image 4
CC-BY-NC-ND · From the PDF
FIGURE 4 Forest plot of the effects of curcumin versus placebo on relapse of ulcerative colitis or Crohn's disease. Effect estimates in forest plots (risk ratios, differences of differences, and standardized differences of differences) may not match those reported in the text due to the use of raw data to generate plots and standardization of some estimates. AZA, azathioprine; CAI, Clinical Activity Index; CDAI, Crohn's Disease Activity Index; CI, confidence interval; Diff, difference; EI, Endoscopic Index; MES, mesalamine; SE, standard error; Std diff, standardized difference; SZ, sulfasalazine; tx, treatment.
FIGURE 4 Forest plot of the effects of curcumin versus placebo on relapse of ulcerative colitis or Crohn's disease. Effect estimates in forest plots (risk ratios, differences of differences, and standardized differences of differences) may not match those reported in the text due to the use of raw data to generate plots and standardization of some estimates. AZA, azathioprine; CAI, Clinical Activity Index; CDAI, Crohn's Disease Activity Index; CI, confidence interval; Diff, difference; EI, Endoscopic Index; MES, mesalamine; SE, standard error; Std diff, standardized difference; SZ, sulfasalazine; tx, treatment.CC-BY-NC-ND · From the PDF
Image 6
CC-BY-NC-ND · From the PDF
Image 7
CC-BY-NC-ND · From the PDF
FIGURE 5 Forest plot of response to treatment for patients with IBS, curcumin versus placebo. Effect estimates in forest plots (risk ratios, differences of differences, and standardized differences of differences) may not match those reported in the text due to the use of raw data to generate plots and the standardization of some estimates. CI, confidence interval; Diff, difference; IBS, irritable bowel syndrome; IBS-GIS, IBS Global Improvement Scale; IBS-SSS, IBS Symptom Severity Scale; SE, standard error; Std diff, standardized difference; tx, treatment; VAS, Visual analog scale.
FIGURE 5 Forest plot of response to treatment for patients with IBS, curcumin versus placebo. Effect estimates in forest plots (risk ratios, differences of differences, and standardized differences of differences) may not match those reported in the text due to the use of raw data to generate plots and the standardization of some estimates. CI, confidence interval; Diff, difference; IBS, irritable bowel syndrome; IBS-GIS, IBS Global Improvement Scale; IBS-SSS, IBS Symptom Severity Scale; SE, standard error; Std diff, standardized difference; tx, treatment; VAS, Visual analog scale.CC-BY-NC-ND · From the PDF
FIGURE 6 Forest plot of the effects of curcumin versus placebo on the quality of life of people with IBS. Effect estimates in forest plots (differences of differences and standardized differences of differences) may not match those reported in the text due to the use of raw data to generate plots and standardization of some estimates. CI, confidence interval; Diff, difference; EQ-5D, EuroQol- 5 Dimension; IBS, irritable bowel syndrome; IBS-QoL, IBS Quality of Life; IBS-SSS, IBS Symptom Severity Scale; QoL, quality of life; SE, standard error; Std diff, standardized difference; tx, treatment; VAS, Visual analog scale.
FIGURE 6 Forest plot of the effects of curcumin versus placebo on the quality of life of people with IBS. Effect estimates in forest plots (differences of differences and standardized differences of differences) may not match those reported in the text due to the use of raw data to generate plots and standardization of some estimates. CI, confidence interval; Diff, difference; EQ-5D, EuroQol- 5 Dimension; IBS, irritable bowel syndrome; IBS-QoL, IBS Quality of Life; IBS-SSS, IBS Symptom Severity Scale; QoL, quality of life; SE, standard error; Std diff, standardized difference; tx, treatment; VAS, Visual analog scale.CC-BY-NC-ND · From the PDF
Image 10
CC-BY-NC-ND · From the PDF

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Citations

Cites

Research works printed but not linked: 3

  1. Oxford Centre for Evidence‐based Medicine. (2009).Levels of Evidence.https://www.cebm.net/2009/06/oxford‐centre‐evidence‐based‐medicine‐levels‐evidence‐march‐2009/accessed 2024/01/10.
  2. Shivakumar V., 2011, A double blind randomised controlled trial to study the effect of oral Curcumina longa versus placebo in patients with active ulcerative colitis, Indian Journal of Gastroenterology, 30, A1
  3. Sirijarugul S., 2007, Efficacy and side effects of Curcuma longa and ranitidine in patients with uninvestigated dyspepsia

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Metadata

Authors
Thavorn, K., Wolfe, D., Faust, L., Shorr, R., Akkawi, M., Isaranuwatchai, W., Klinger, C., Chai‐Adisaksopa, C., Tanvejsilp, P., Nochaiwong, S., Straus, S. E., & Hutton, B.
Affiliations
  • University of Ottawa (CA)
  • Ottawa Hospital Research Institute (CA)
  • McGill University (CA)
  • Ministry of Public Health (TH)
  • University of Toronto (CA)
  • Department of Internal Medicine Chiang Mai University Chiang Mai Thailand
  • Prince of Songkla University (TH)
  • Chiang Mai University (TH)
  • St. Michael's Hospital (CA)
Corresponding author
Thavorn, Kednapa
Venue
Phytotherapy Research
Publisher
Wiley
Published
2024-03-19
Volume
38
Issue
6
Pages
2687-2706
ISSN
  • 0951-418X (ISSN-L)
  • 1099-1573
OpenAlex
W4394740489
Cited by
11
References
52
Citations by year
2026: 4 · 2025: 5 · 2024: 2
FWCI
0.38
Type
journal article
Language
en
Open access
Locations
  • Phytotherapy Research (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Center for Complementary and Integrative Health (R24AT001293)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Curcumin's Biomedical Applications
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Saffron Plant Research Studies
  • Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
Keywords
turmeric, gastrointestinal diseases, inflammatory bowel disease, irritable bowel syndrome, dyspepsia, gastroesophageal reflux disease, peptic ulcer, herbal intervention, efficacy, safety, risk of bias
MeSH terms
Digestive System Diseases, Humans, Plant Extracts, Inflammatory Bowel Diseases, Randomized Controlled Trials as Topic, Curcuma, Irritable Bowel Syndrome

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