The researchers suggest that the findings may merit consideration in clinical practice.
An unprecedented study published in the journal BMJ Evidence-Based Medicine indicates that a natural compound in the culinary spice turmeric may have similar efficacy to omeprazole acid-reduction of drugs in controlling indigestion symptoms.
Extracted from the root of the Curcuma longa plant, turmeric has a compound called curcumin. Believed to exhibit anti-inflammatory and antimicrobial characteristics, curcumin has historically been used as a therapeutic agent in Southeast Asia, especially for problems related to indigestion.
Turmeric is derived from the root of the Curcuma longa plant. It contains a naturally active compound called curcumin, which is believed to have anti-inflammatory and antimicrobial properties, and has long been used as a medicinal remedy, including for treating indigestion, in Southeast Asia.
But it’s unclear how well it compares to conventional medicines for this indication, largely because there have been no head-to-head studies.
The researchers therefore randomly assigned 206 patients aged 18 to 70 years with recurrent stomach pain (functional dyspepsia) of unknown cause, recruited from hospitals in Thailand between 2019 and 2021, to one of three treatment groups for a period of 28 days.
These were: turmeric (two large capsules of 250 mg curcumin 4 times a day) and one small capsule (69 patients); omeprazole (one small 20 mg capsule per day and two large dummy capsules 4 times a day (68 patients); and saffron plus omeprazole (69 patients).
Omeprazole is a proton pump inhibitor, or PPI for short. PPIs are used to treat functional dyspepsia, whose symptoms include feeling excessively full after eating (postprandial fullness), feeling full after just a little food (premature satiety), and pain and/or burning sensation in the stomach and/or food tube (epigastric pain).
But long-term PPI use has been linked to an increased risk of fractures, micronutrient deficiencies and an increased risk of infections, researchers note.
Of the 206 patients enrolled, 151 completed the study, 20 in the curcumin group; 19 in the omeprazole group; and 16 in the combined treatment group dropping out.
Patients in the three groups had similar clinical characteristics and indigestion scores, as assessed by the dyspepsia severity assessment score, or SODA, at baseline. Patients were reevaluated after 28 days and again after 56 days.
SODA scores indicated significant reductions in symptom severity by day 28 for pain (4.83, 5.46, and 6.22) and other symptoms (2.22, 2.32, and 2.31) for those in the combined groups. , curcumin only and omeprazole only, respectively.
These improvements were even stronger after 56 days for pain (7.19, 8.07, and 8.85, respectively) and other symptoms (4.09, 4.12, and 3.71, respectively).
SODA also captures satisfaction scores: these have barely changed over time among curcumin users, which may be related to its taste and/or smell, the researchers suggest.
No serious side effects were reported, although liver function tests indicated some level of deterioration among overweight curcumin users, the researchers note.
They acknowledge the small size of the study, as well as several other limitations, including the short intervention period and the lack of long-term monitoring data. More larger, long-term studies are needed, they say.
However, they conclude: This multicenter randomized controlled trial provides highly reliable evidence for the treatment of functional dyspepsia, adding that the novel findings from our study may justify consideration of curcumin in clinical practice.
Reference: Curcumin and Proton Pump Inhibitors for Functional Dyspepsia: A Randomized, Double-Blind, Controlled Study Pochamana Phisalprapa, Thanwa Buamahakul, Sarawut Siwamogsatham, Jaenjira Angsusing, Pratchayanan Poonniam, Kulthanit Wanaratna, Monthaka Teerachaisakul and Krit Pongpirul, September 11, 2023, BMJ Evidence-Based Medicine.
The study was funded by the Thai Traditional and Alternative Medicine Fund.
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