The Efficacy and Potential Mechanisms of Chinese Herbal Medicine on Irritable Bowel Syndrome

Abstract

Irritable bowel syndrome (IBS) is one of the most common functional bowel disorders (FBD), which is characterized by recurrent abdominal pain, abdominal bloating/distention associated with defecation or changed bowel habits. Currently, there is no evidence of obvious anatomic or physiologic abnormalities on the routine diagnostic examinations. There are multiple pathological factors involved in IBS responsible for its heterogeneous nature, although the exact etiology and pathology of IBS are not well known and it is disappointed to develop biomarkers for this disorder. These factors including low-grade inflammation, activation of immune system, changed intestinal microorganism, small intestinal bacterial overgrowth (SIBO), malabsorption of bile acid (BA), increased number of mast cells (MCs). Current pharmacologic treatment for IBS focuses on alleviation of its symptoms, but not on the elimination of its cause. Although there are a lot of conventional chemical medicines for IBS available, due to the limited clinical benefits, high medical expenses and severe side effects, many IBS patients have turned to alternative medicine, particularly Chinese herbal medicine (CHM). Chinese herbal therapies have been used for thousand years in eastern Asia and have been provided that they are effective in relieving symptoms among IBS patients. Generally, traditional Chinese herbal formulae (CHF) consisting of CHM can be easily adjusted in accordance with concrete conditions, which means the treatment is based on syndrome differentiation and varied from individual to individual. Meanwhile, CHF/CHM containing many different ingredients may act on multiple sites/pathways with potential synergistic effects and chemical reactions.

Synergistic Effect of Berberine-Based Chinese Medicine Assembled Nanostructures on Diarrhea-Predominant Irritable Bowel Syndrome In Vivo

“…However, Chinese herbal therapies have been used to treat diarrhea for thousands years in eastern Asia ( Chen et al, 2015 ). Generally, Chinese herbal medicine (CHM) including several herbals from traditional Chinese herbal formulae (CHF), which containing many different ingredients may act on multiple sites/pathways with potential synergistic effects and chemical reactions ( Bi et al, 2017 ). Nowadays, it has been shown that CHM are effective in relieving symptoms among patients and rats with IBS-D ( Mao et al, 2017 ; Fan et al, 2020 ).…”

Chinese herbal medicine versus antispasmodics in the treatment of irritable bowel syndrome: A network meta‐analysis

“…Among the large number of alternative treatment options, Chinese herbal medicine (CHM) is one of the most popular 6 . Accumulating evidence shows that CHM has benefit in relieving IBS symptoms and improving quality of life 7–11 . In the trials and meta‐analyses that examined the effect of CHM on IBS, most of them compared CHM with placebo; few of them compared CHM directly with conventional treatments 8,10,12‐16 .…”

“…6 Accumulating evidence shows that CHM has benefit in relieving IBS symptoms and improving quality of life. [7][8][9][10][11] In the trials and meta-analyses that examined the effect of CHM on IBS, most of them compared CHM with placebo; few of them compared CHM directly with conventional treatments. 8,10,[12][13][14][15][16] Two recent trials comparing CHM with pinaverium showed that CHM was as effective as pinaverium 7,17 ; one trial showed that CHM was equivalent to pinaverium in relieving abdominal pain, 7 another trial showed that CHM was superior over pinaverium in relieving gastrointestinal symptoms.…”

Herbal medicine for irritable bowel syndrome

“…[ 5 ] HMs contain various ingredients, and these can act on multiple targets with potential synergistic effects; HMs that have been used to treat IBS-related symptoms for centuries with satisfactory effects will be the optimal choice. [ 6 ]…”