On the Use of Herbal Medicines in Management of Inflammatory Bowel Diseases: A Systematic Review of Animal and Human Studies

Abstract

Because of potential adverse events and lack of effectiveness of standard therapies, the use of complementary and alternative medicines (CAM), particularly of herbal therapies, for inflammatory bowel disease (IBD) is increasing. Results from the use of herbal therapies for managing IBD are promising, and no serious adverse events have been reported from them. Herbal therapies show their benefit in managing IBD by different mechanisms such as immune system regulation, antioxidant activity, inhibition of leukotriene B4, inhibition of nuclear factor-kappa B (NF-kappaB), and antiplatelet activity. In this paper, all reported herbal therapies established in animal IBD models or used for managing human IBD are systematically reviewed and their possible mechanisms of action discussed. Conducting clinical trials with high quality and validity (randomized, double blinded, controlled, on a large number of patients) to obtain more conclusive results about the use of herbal therapies in IBD is recommended.

Benefit of nicorandil using an immunologic murine model of experimental colitis

“…TNF-α is widely secreted during inflammation from monocytes and macrophages, T cells, B cells, NK cells, and mast cells [40]. This cytokine is able to trigger a cascade of pro-inflammatory cytokine production [10]. Attempts to block TNF-α or reduce its levels have been successful in the treatment of IBD.…”

“…Currently, the use of complementary and alternative therapies is also common in 50% of patients suffering from IBD [6]. Moreover, various herbal extracts [7][8][9][10], N-acetylcysteine (NAC) [11] and probiotics [12][13][14][15] have been suggested for the treatment of IBD, and the effectiveness of antibiotic therapy in IBD has been investigated [16,17]. Unfortunately, it is very difficult to reach maximum efficacy and quality of life because of the side effects [18] associated with the treatments described above.…”

Effect of hydroalcoholic extract of Hibiscus rosa sinensis Linn. leaves in experimental colitis in rats

“…Hibiscus rosa sinensis (HRS) has been evaluated for an array of diseases like heart disorders, tumors, convulsion, diabetes, inflammation, oxidative stress, diarrhoea, ulcer by various authors [4][5][6][7][8] . In the Indian traditional system of medicine, it is claimed to possess therapeutic utility in IBD.…”

On the benefits of silymarin in murine colitis by improving balance of destructive cytokines and reduction of toxic stress in the bowel cells

“…Recently, the effectiveness of many pharmacotherapeutic agents including antibiotics [12][13][14][15], probiotics [16,17] and 5-aminosalicylates [18][19][20] has been meta-analyzed. In addition, using herbal extracts as a new strategy for management of IBD is currently in the center of attention [21][22][23][24].…”