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Inflammatory Bowel Disease (IBD)

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Inflammatory bowel disease (IBD) is inflammation in the lining and sometimes the wall of the intestine. It includes ulcerative colitis and crohns disease. It can cause diarrhea, belly pain, and rectal bleeding.

It is managed with medicine and healthy habits. Some people may need surgery. Natural therapies have been used to ease digestive upset. They should not be used in place of standard care.

Natural Therapies

Likely Effective

  • Kangfuxin liquid is likely to improve symptoms of ulcerative colitis and lower the risk of flare ups when used with standard medicine.A19

May Be Effective

  • Acupuncture uses needles and trigger points. It may improve quality of life.A6
  • Andrographis is a plant that can be taken as a supplement. It may improve symptoms and ease pain. (Note: It should not be taken by people who have problems with their immune system.)A8, A11
  • Curcumin is a bright yellow chemical made by a plant. It may help maintain ulcerative colitis remission.A2, A17
  • Green tea may ease symptoms in people with IBD.A15
  • Probiotics are healthy bacteria that can be taken as a supplement. They may prevent flare ups.A3, A7, A13, A16
  • Vitamin B 12 may ease symptoms in people with IBD.A15
  • Vitamin D may lower the risk of flare ups.A9, A21

Mindfulness practices may improve quality of life in people who are very stressed.B2

Unlikely to Be Effective

  • Fish Oil can be taken as a supplement. It is unlikely to ease symptoms.A5
  • Omega-3 fatty acids are unlikely to maintain remission in people with Crohn disease.A4, A10, A12

Not Enough Data to Assess

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some may get in the way of treatment. They can also make illness worse or cause new problems. Examples include:

  • Andrographis may make the immune system more active. Talk to your doctor before taking it if you have problems with your immune system.
 

References►

Herbs and Supplements

A1. Gerhardt H, Seifert F, et al. [Therapy of active Crohn disease with Boswellia serrata extract H 15]. Z Gastroenterol. 2001;39(1):11-17.

A2. Hanai H, Iida T, et al. Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial. Clin Gastroenterol Hepatol. 2006;4(12):1502-1506.

A3. Mallon P, McKay D, et al. Probiotics for induction of remission in ulcerative colitis. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005573.

A4. Turner D, Zlotkin SH, et al. Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev. 2007;(2):CD006320.

A5. De Ley M, de Vos R, et al. Fish oil for induction of remission in ulcerative colitis. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005986.

A6. Schneider A, Streitberger K, et al. Acupuncture treatment in gastrointestinal diseases: a systematic review. World J Gastroenterol. 2007 Jul 7;13(25):3417-3424.

A7. Doherty GA, Bennett GC, et al. Meta-analysis: targeting the intestinal microbiota in prophylaxis for post-operative Crohn’s disease. Aliment Pharmacol Ther. 2010;31(8):802-809.

A8. Tang T, Targan SR, et al. Randomized clinical trial: herbal extract HMPL-004 in active ulcerative colitis – a double-blind comparison with sustained release mesalazine. Aliment Pharmacol Ther. 2011;33(2):194-202.

A9. Nicholson I, Dalzell AM, et al. Vitamin D as a therapy for colitis: a systematic review. J Crohns Colitis. 2012 May;6(4):405-411.

A10. Cabré E, Mañosa M, et al. Omega-3 fatty acids and inflammatory bowel diseases - a systematic review. Br J Nutr. 2012 Jun;107 Suppl 2:S240-52.

A11. Sandborn WJ, Targan SR, et al. Andrographis paniculate extract (HMPL-004) for active ulcerative colitis. Am J Gastroenterol. 2013;108(1):90-98.

A12. Swan K, Allen PJ. Omega-3 fatty acid for the treatment and remission of Crohn's disease. J Complement Integr Med. 2013 May 7;10.

A13. Shen J, Zuo ZX, et al. Effects of probiotics on inducing remission and maintain therapy in ulcerative colitis, Crohn’s disease, and pouchitis: meta-analysis of randomized controlled trials. Inflamm Bowel Dis. 2014;20(1):21-35.

A14. Akobeng AK, Elawad M, et al. Glutamine for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2016 Feb 8;2:CD007348.

A15. Rossi RE, Whyand T, et al. The role of dietary supplements in inflammatory bowel disease: a systematic review. Eur J Gastroenterol Hepatol. 2016 Dec;28(12):1357-1364.

A16. Derwa Y, Gracie DJ, et al. Systematic review with meta-analysis: the efficacy of probiotics in inflammatory bowel disease. Aliment Pharmacol Ther. 2017;46(4):389-400.

A17. Schneider A, Hossain I, et al. Comparison of remicade to curcumin for the treatment of Crohn's disease: A systematic review. Complement Ther Med. 2017 Aug;33:32-38.

A18. Kafil TS, Nguyen TM, et al. Cannabis for the treatment of Crohn’s disease. Cochrane Database Syst Rev. 2018;11:CD012853.

A19. Li HB, Chen MY, et al. Efficacy and safety of Kangfuxin liquid combined with aminosalicylic acid for the treatment of ulcerative colitis: A systematic review and meta-analysis. Medicine (Baltimore). 2018 May;97(21):e10807.

A20. Kafil TS, Nguyen TM, et al. Cannabis for the treatment of ulcerative colitis. Cochrane Database Syst Rev. 2018 Nov 8;11:CD012954.

A21. Li J, Chen N, et al. Efficacy of vitamin D in treatment of inflammatory bowel disease: A meta-analysis. Medicine (Baltimore). 2018 Nov;97(46):e12662.

B. Other Therapies

B1. Lee DH, Kim JI, et al. Moxibustion for ulcerative colitis: a systematic review and meta-analysis. BMC Gastroenterol. 2010 Apr 7;10:36.

B2. Jewell S, Hoffman A, et al. A randomized controlled trial of mindfulness-based stress reduction to prevent flare-up in patients with inactive ulcerative colitis. Digestion. 2014;89(2):142-155.

C. Foods

C1. Wedlake L, Slack N, et al. Fiber in the treatment and maintenance of inflammatory bowel disease: a systematic review of randomized controlled trials. Inflamm Bowel Dis. 2014 Mar;20(3):576-586.

C2. Thies F, Masson LF, et al. Oats and bowel disease: a systematic literature review. Br J Nutr. 2014 Oct;112 Suppl 2:S31-43.

C3. Limketkai BN, Iheozor-Ejiofor Z, et al. Dietary interventions for induction and maintenance of remission in inflammatory bowel disease. Cochrane Database Syst Rev. 2019 Feb 8;2:CD012839.

Last reviewed February 2020 by EBSCO NAT Review Board Eric Hurwitz, DC  Last Updated: 5/26/2020