The Possible Synergistic Pharmacological Effect of an Oral Berberine (BBR) and Curcumin (CUR) Complementary Therapy Alleviates Symptoms of Irritable Bowel Syndrome (IBS): Results from a Real-Life, Routine Clinical Practice Settings-Based Study

Author:

Wade Ursula1,Pascual-Figal Domingo A.2ORCID,Rabbani Fazale3,Ernst Marie4ORCID,Albert Adelin4ORCID,Janssens Isabelle5,Dierckxsens Yvan5,Iqtadar Somia6ORCID,Khokhar Nisar A.7,Kanwal Ayesha3,Khan Amjad89ORCID

Affiliation:

1. Department of Basic and Clinical Neuroscience, Kings College London, London SE5 9RT, UK

2. Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Universidad de Murcia, 30120 Murcia, Spain

3. Lady Reading Hospital, Peshawar 25000, Pakistan

4. Biostatistics and Research Methods Center (B-STAT), CHU of Liège and University of Liège, 4000 Liège, Belgium

5. Laboratoire Tilman, 5377 Baillonville, Belgium

6. Department of Medicine, King Edward Medical University, Lahore 54000, Pakistan

7. Department of Medicine, Bilawal Medical College, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Pakistan

8. Department of Biochemistry, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Pakistan

9. Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK

Abstract

Irritable bowel syndrome (IBS) is a prevalent chronic functional gastrointestinal disorder, characterised by recurrent abdominal discomfort and altered bowel movements. IBS cause a significantly negative impact on quality of life (QoL). Growing pharmacological evidence suggests that berberine (BBR) and curcumin (CUR) may mitigate IBS symptoms through multiple complementary synergistic mechanisms, resulting in the attenuation of intestinal inflammation and regulation of bowel motility and gut functions. In the present observational study conducted under real-life routine clinical practice settings, 146 patients diagnosed with IBS were enrolled by general practitioner clinics and pharmacies in Belgium. For the first time, this study assessed the potential synergistic pharmacological effect of a combined oral BBR/CUR supplement (Enterofytol® PLUS, containing 200 mg BBR and 49 mg CUR) (two tablets daily for 2 months), serving as complementary therapy in the management of IBS. Following the 2-month supplementation, significant improvements were observed in the patients’ IBS severity index (IBSSI) (47.5%) and all the primary IBS symptoms, such as abdominal discomfort (47.2%), distension (48.0%), intestinal transit (46.8%), and QoL (48.1%) (all p < 0.0001). The improvement in the patients’ IBSSI was independent of age, sex, and IBS sub-types. The patients’ weekly maximum stool passage frequency decreased significantly (p < 0.0001), and the stool status normalized (p < 0.0001). The patients’ need for concomitant conventional IBS treatment decreased notably: antispasmodics by 64.0% and antidiarrhoeals by 64.6%. Minor adverse effects were reported by a small proportion (7.1%) of patients, mostly gastrointestinal. The majority (93.1%) experienced symptom improvement or resolution, with a high satisfaction rate (82.6%) and willingness to continue the supplementation (79.0%). These findings support the potential synergistic pharmacological role of BBR and CUR in IBS, and their co-supplementation may alleviate IBS symptoms and improve QoL.

Publisher

MDPI AG

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