Food as Medicine; Turmeric for Ulcerative Colitis

Ulcerative colitis or inflammatory bowel disease (IBD), is a chronic gastrointestinal disorder that affects people at all stages of life. Australia currently has one of the largest numbers of patients suffering from IBD, more than 80,000 patients are experiencing this illness (Crohn’s & Colitis Australia, 2019). The symptoms of ulcerative colitis include abdominal cramping, pain, frequent diarrhoea and tiredness and fatigue. The disease is chronic; however, patients may suffer from symptoms that come and go due to the level of inflammation in the gastrointestinal tract.
 
The use of turmeric (Curcuma longa), part of the Zingiberacaeae family, for patients who have ulcerative colitis is known to have a long historical therapeutic use (American Botanical Council, 2018). Ayurvedic practises have continuously used turmeric to relieve inflammation of the bowels (Botanical Adulterants Prevention Program, 2018). Turmeric contains a polyphonic compound known as curcuminoids and curcumin is the principal curcuminoid in turmeric.
 
During recent clinical studies, experimental models of the use of curcumin to relieve ulcerative colitis symptoms has increased significantly. It has been effective in facilitating the inhibitory effects by scavenging free radicals, influencing signalling pathways, inhibiting myeloperoxidase and even transcription factor NF-κB. Studies have also shown that simultaneous use of curcumin and conventional drugs is successful and well-tolerated, thus not creating contraindications with other medications (Baliga et al, 2012).
 
Further research has shown that turmeric and thus curcumin has a significantly low bioavailability when it is orally administered. The addition of black pepper into the consumption of curcumin considerably increases absorption due to the natural compound piperine. Studies have shown it to increase the bioavailability by 2,000% 45 minutes after co-administering curcumin orally with piperine (Prasad et al, 2014). It is recommended that the consumption of 4000-8000mg of fresh turmeric as juice or a paste per day to receive full therapeutic effects (Gupta et al, 2013).  Turmeric should be consumed with black pepper to increase the bioavailability of the polyphonic compounds and receive the full benefits. Curcumin can then accumulate within the gastrointestinal networks, thus providing local anti-inflammatory properties, neutralise free radicals and reduce oxidative strain which will prevent relapses of ulcerative colitis (Lee et al, 2013). The overconsumption of turmeric and its constituents can result in illnesses such as nausea and headaches, thus no more than 3.6 grams/day should be consumed (Hewlings et al, 2017).