Tolerability of curcumin in pediatric inflammatory bowel disease:  a forced-dose titration study.
BACKGROUND
Inflammatory bowel disease (IBD) is characterized by chronic intestinal inflammation in the absence of a recognized etiology. The primary therapies are medications that possess anti-inflammatory or immunosuppressive effects. Given the high use of complementary alternative medicines in pediatric IBD, a prospective tolerability study of curcumin, an herbal therapy with known anti-inflammatory effects, was conducted to assess possible dosage in children with IBD.


METHODS
Prospectively, patients with Crohn disease or ulcerative colitis in remission or with mild disease (Pediatric Crohn's Disease Activity Index [PCDAI] <30 or Pediatric Ulcerative Colitis Activity Index [PUCAI] score <34) were enrolled in a tolerability study. All patients received curcumin in addition to their standard therapy. Patients initially received 500 mg twice per day for 3 weeks. Using the forced-dose titration design, doses were increased up to 1 g twice per day at week 3 for a total of 3 weeks and then titrated again to 2 g twice per day at week 6 for 3 weeks. Validated measures of disease activity, using the PUCAI and PCDAI, and the Monitoring of Side Effect System score were obtained at weeks 3, 6, and 9.


RESULTS
All patients tolerated curcumin well, with the only symptom that was consistently reported during all 3 visits being an increase in gassiness, which occurred in only 2 patients. Three patients saw improvement in PUCAI/PCDAI score.


CONCLUSIONS
This pilot study suggests that curcumin may be used as an adjunctive therapy for individuals seeking a combination of conventional medicine and alternative medicine.
Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, WA 98105, USA. David.Suskind@seattlechildrens.org
David L
DL
Suskind
Ghassan
G
Wahbeh
Tyler
T
Burpee
Morty
M
Cohen
Dennis
D
Christie
Wendy
W
Weber
D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D003093:Colitis, Ulcerative / Q000178:diet therapy* / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D003131:Combined Modality Therapy / Q000009:adverse effects; D003424:Crohn Disease / Q000178:diet therapy* / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D003474:Curcumin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D019587:Dietary Supplements / Q000009:adverse effects* / Q000032:analysis; D005260:Female; D005414:Flatulence / Q000209:etiology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000178:diet therapy / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D008297:Male; D008515:Medicine, Ayurvedic; D019804:Mesalamine / Q000627:therapeutic use; D010865:Pilot Projects; D012074:Remission Induction; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D014409:Tumor Necrosis Factor-alpha; D019804:Mesalamine; D003474:Curcumin