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Is ginger effective for the treatment of irritable bowel syndrome? A double blind randomized controlled pilot trial
Open accessAbstract
Objectives Ginger is one of the most commonly used herbal medicines for irritable bowel syndrome (IBS) but no data exists about its effectiveness. Design Double blind randomized controlled trial. Setting University of North Carolina, Chapel Hill, North Carolina, USA. Intervention Forty-five IBS patients were randomly assigned to three groups: placebo, 1g of ginger, and 2g of ginger daily for 28 days. Main outcome measures The IBS severity scale (IBS-SS) was administered, as well as adequate relief of symptoms scale. A responder was defined as having at least 25% reduction in IBS-SS post-treatment. Results There were 57.1% responders to placebo, 46.7% to 1g and 33.3% to 2g of ginger. Adequate relief was reported by 53.3% on placebo and 53.3% in both ginger groups combined. Side effects were mild and reported by 35.7% in the placebo and 16.7% in the ginger groups. Conclusions This double blind randomized controlled pilot study suggests ginger is well tolerated but did not perform better than placebo. Larger trials are needed before any definitive conclusions can be drawn.
Overview
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TL;DR
In this double-blind randomized pilot trial, ginger (1 g or 2 g daily for 28 days) was well tolerated but did not outperform placebo for IBS symptom relief. The authors conclude larger trials are needed before definitive conclusions.
Key findings
- Treatment responders (≥25% reduction in IBS-SS) were 57.1% on placebo, 46.7% on 1 g ginger, and 33.3% on 2 g ginger; differences were not significant (p > .05).
- Adequate relief was reported by 53.3% on placebo and 53.3% in both ginger groups combined (p > .05).
- IBS severity scores fell significantly in the placebo (34.8%) and 1 g ginger (26.4%) groups; the discussion notes a 26% symptom decrease with 1 g versus 12% with 2 g of ginger.
- Side effects were mild and reported by 35.7% of the placebo group versus 16.7% of the ginger groups; most were gastrointestinal (heartburn, nausea, stool changes, bloating, hunger suppression), with two subjects reporting headaches and tiredness.
Methods
- Double-blind, randomized, controlled, parallel-group pilot trial at the University of North Carolina, Chapel Hill; 45 adults (age 18+) with physician-diagnosed IBS verified by Rome III criteria, recruited by mass e-mail to students, staff, and faculty, with 15 subjects randomly assigned to each of three arms (placebo, 1 g ginger, 2 g ginger daily) for 28 days.
- Pharmaceutical-grade ginger (2.29 mg/g gingerols and 6-shogaols) and brown-sugar placebo were blister packed by a compounding pharmacy for blinding; compliance was 97.3% (placebo), 98.5% (1 g), and 85.2% (2 g).
- Outcomes were the IBS Severity Scale (IBS-SS) and the Adequate Relief Rating Scale (ARRS); paired t-tests compared pre/post IBS severity scores and Chi-square tests compared responder percentages and ARRS across arms.
Limitations
- Stated by the authors: small sample size, short treatment duration, recruitment among university employees and students, and absence of investigator blinding during the analysis phase, all limiting generalizability and definitive conclusions.
- Stated by the authors: as a pilot study it may not be powered to detect significant results, and the placebo response (57%) was considerably higher than the ~40% average reported in IBS trials.
- Evident from the text: the trial enrolled only the first 45 of 181 interested and screened patients, and the authors note that consent-form information about ginger's potential benefits may itself have raised treatment expectancies and inflated the placebo response.
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Claims the paper makes
0 Valid · 0 Not valid · 10 Not checked · 31 Own results and interpretations
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The placebo group also reported twice as many side effects as the ginger group, corroborating the placebo effect.”
§ Is ginger effective for the treatment of Irritable Bowel Syndrome? A double blind randomized controlled pilot trial > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Except for two subjects who reported headaches and tiredness, all side effects were gastrointestinal symptoms including heart-burn, nausea, difficulty passing stool, more frequent stools, loose stools, bloating and hunger suppression.”
§ Is ginger effective for the treatment of Irritable Bowel Syndrome? A double blind randomized controlled pilot trial > Results
plainn = 2- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No differences between the 3 treatment arms were found in gender, age and IBS-SS scores at baseline.”
§ Is ginger effective for the treatment of Irritable Bowel Syndrome? A double blind randomized controlled pilot trial > Results
plainn = 45- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We observed a 26% decrease in symptoms with 1 gram versus 12% decrease in symptoms with 2 grams of ginger.”
§ Is ginger effective for the treatment of Irritable Bowel Syndrome? A double blind randomized controlled pilot trial > Discussion
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This double blind randomized controlled pilot study suggests ginger is well tolerated but did not perform better than placebo.”
§ Is ginger effective for the treatment of Irritable Bowel Syndrome? A double blind randomized controlled pilot trial > Abstract > Conclusions
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
19 more claims
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Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“At variance, a pilot double-blind randomized controlled trial enrolling 45 IBS patients failed to observe any difference between the group treated with ginger (1 g or 2 g daily for 28 days) and placebo group in reducing IBS symptoms or providing adequate relief [87].”
From Natural Remedies for Irritable Bowel Syndrome: A Comprehensive Review of Herbal-Based Therapies (2025) · cites this paper as [87]
In the citing paper
“In contrast, a pilot double blind randomized controlled trial enrolling 45 IBS patients found no statistically significant improvement in IBS symptoms with ginger alone (p > 0.05), although reductions in anxiety and depression were observed [85].”
From Plant-Derived Treatments for IBS: Clinical Outcomes, Mechanistic Insights, and Their Position in International Guidelines (2026) · cites this paper as [85]
In the citing paper
“Ginger was well tolerated but it did not show better effects in comparison with placebo.”
From Ginger in gastrointestinal disorders: A systematic review of clinical trials (2019) · cites this paper as Van Tilburg et al. (2014)
In the citing paper
“Van Tilburg et al. (2014) evaluated ginger for IBS treatment in a pilot study of 45 IBS patients, who were randomly consumed placebo, or 1 g of ginger, or 2 g of ginger daily for 28 days.”
From Ginger in gastrointestinal disorders: A systematic review of clinical trials (2019) · cites this paper as Van Tilburg et al. (2014)
In the citing paper
“The investigators also examined trends of these effects, and they found a trend of more improvement of IBS symptoms with placebo (brown sugar) than ginger.”
From Ginger in gastrointestinal disorders: A systematic review of clinical trials (2019) · cites this paper as Van Tilburg et al. (2014)
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Citations
Cites
FRANCIS, C. Y., MORRIS, J., & WHORWELL, P. J. (1997) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.1997.142318000.x · Cited by 1,708
Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome
Kaptchuk, T. J., Friedlander, E., Kelley, J. M., Sanchez, M. N., Kokkotou, E., Singer, J. P., Kowalczykowski, M., Miller, F. G., Kirsch, I., & Lembo, A. J. (2010) · PLoS ONE · doi:10.1371/journal.pone.0015591 · Cited by 900
Ginger—An Herbal Medicinal Product with Broad Anti-Inflammatory Actions
Grzanna, R., Lindmark, L., & Frondoza, C. G. (2005) · Journal of Medicinal Food · doi:10.1089/jmf.2005.8.125 · Cited by 826
(2006) · Cited by 534
ROME III: The Functional Gastrointestinal Disorders
Sheth, A. A. (2007) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0b013e31804bbe26 · Cited by 489
The placebo effect in irritable bowel syndrome trials: a meta‐analysis1
Patel, S. M., Stason, W. B., Legedza, A., Ock, S. M., Kaptchuk, T. J., Conboy, L., Canenguez, K., Park, J. K., Kelly, E., Jacobson, E., et al. (2005) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2005.00650.x · Cited by 285
Placebo analgesia: Psychological and neurobiological mechanisms
Colloca, L., Klinger, R., Flor, H., & Bingel, U. (2013) · Pain · doi:10.1016/j.pain.2013.02.002 · Cited by 263
The efficacy of ginger for the prevention of postoperative nausea and vomiting: A meta-analysis
Chaiyakunapruk, N., Kitikannakorn, N., Nathisuwan, S., Leeprakobboon, K., & Leelasettagool, C. (2006) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2005.06.046 · Cited by 220
Effectiveness and Safety of Ginger in the Treatment of Pregnancy-Induced Nausea and Vomiting
Borrelli, F., Capasso, R., Aviello, G., Pittler, M. H., & Izzo, A. A. (2005) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000154890.47642.23 · Cited by 202
Pharmacological Basis for the Medicinal Use of Ginger in Gastrointestinal Disorders
Ghayur, M. N., & Gilani, A. H. (2005) · Digestive Diseases and Sciences · doi:10.1007/s10620-005-2957-2 · Cited by 183
Cited by
Serra, J., Pohl, D., Azpiroz, F., Chiarioni, G., Ducrotté, P., Gourcerol, G., Hungin, A. P. S., Layer, P., Mendive, J., Pfeifer, J., et al. (2020) · Neurogastroenterology & Motility · doi:10.1111/nmo.13762 · Cited by 244
Ginger on Human Health: A Comprehensive Systematic Review of 109 Randomized Controlled Trials
Anh, N. H., Kim, S. J., Long, N. P., Min, J. E., Yoon, Y. C., Lee, E. G., Kim, M., Kim, T. J., Yang, Y. Y., Son, E. Y., et al. (2020) · Nutrients · doi:10.3390/nu12010157 · Cited by 227
Ginger in gastrointestinal disorders: A systematic review of clinical trials
Nikkhah Bodagh, M., Maleki, I., & Hekmatdoost, A. (2019) · Food Science & Nutrition · doi:10.1002/fsn3.807 · Cited by 221
Layer, P., Andresen, V., Allescher, H., Bischoff, S. C., Claßen, M., Elsenbruch, S., Freitag, M., Frieling, T., Gebhard, M., Goebel-Stengel, M., et al. (2021) · Zeitschrift für Gastroenterologie · doi:10.1055/a-1591-4794 · Cited by 76
Fifi, A. C., Axelrod, C. H., Chakraborty, P., & Saps, M. (2018) · Nutrients · doi:10.3390/nu10111715 · Cited by 72
Metadata
- Authors
- van Tilburg, M. A. L., Palsson, O. S., Ringel, Y., & Whitehead, W. E.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- van Tilburg, Miranda A.L.
- Venue
- Complementary Therapies in Medicine
- Publisher
- Elsevier BV
- Published
- 2014-02
- Volume
- 22
- Issue
- 1
- Pages
- 17-20
- ISSN
- 0965-2299 (ISSN-L)
- PMC
- PMC3958926
- OpenAlex
- W2135013258
- Semantic Scholar
- 43284d3308d395cf28cf4510c1e66890ebb16525
- Cited by
- 64
- References
- 14
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 11 · 2023: 6 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 8 · 2018: 3 · 2017: 2 · 2016: 3 · 2015: 1 · 2014: 1
- FWCI
- 1.93
- Type
- journal article
- Language
- en
- Open access
- green
- pmc.ncbi.nlm.nih.gov
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- Locations
- Complementary Therapies in Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R24DK067674)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Ginger and Zingiberaceae research
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Keywords
- ginger, irritable bowel syndrome, herbal medicine, symptom relief, placebo comparison, tolerability, dose comparison
- MeSH terms
- Adult, Double-Blind Method, Humans, North Carolina, Plant Extracts, Severity of Illness Index, Placebo Effect, Chi-Square Distribution, Zingiber officinale, Irritable Bowel Syndrome
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