Curcumin, an active ingredient in turmeric, has anti-inflammatory and antioxidant properties that may help relieve UC symptoms. However, more research is necessary to determine the optimal dose of curcumin.

Ulcerative colitis (UC) is a type of chronic inflammatory bowel disease (IBD) that can cause digestive symptoms such as diarrhea, abdominal pain and cramping, and urgent bowel movements.

While the precise cause of UC is unknown, experts believe it arises from overactive immune responses in the gut that cause inflammation in the large intestine. One of the goals of UC treatment is to reduce inflammation in the gut to help relieve symptoms and achieve remission.

Treatment options for UC include medications and surgery. People may also choose to try complementary therapies along with traditional treatments to help relieve their symptoms and improve their quality of life. Curcumin is one potential complementary therapy for UC.

Curcumin, one of the active components of the herb turmeric (Curcuma longa), has shown promising anti-inflammatory properties. Many people are interested in its potential use in the treatment of inflammatory diseases such as UC.

Here, experts share their perspectives on the role of turmeric and curcumin in the management of UC, including the available evidence and recommendations for its use.

Although people have long been interested in using turmeric and curcumin to relieve digestive symptoms in diseases such as UC, research on its use in these settings is relatively new and incomplete.

“There have been several clinical trials of curcumin for the treatment of UC, dating back over a decade, [but] these studies have tended to be small and limited in duration,” explained Jason Harper, MD, director of the Harborview Medical Center Inflammatory Bowel Disease program and clinical assistant professor at the University of Washington. “That’s fairly typical for trials of botanical agents.”

“In these studies, though, curcumin does seem to increase clinical response rates when added to other UC therapies such as mesalamine,” he noted.

Indeed, a 2020 review of 7 studies involving 380 people with mild to moderate UC found that those who received curcumin in addition to mesalamine were nearly three times more likely to achieve clinical remission compared with those who received mesalamine and a placebo. Clinical response rates were also higher for the curcumin-treated individuals.

“In more recently published trials, they have also demonstrated improvement in endoscopic assessments of inflammation [with curcumin], which is a very important endpoint in current-generation randomized controlled trials of agents for UC,” Harper added.

While she acknowledged recent observations of the potential implications of the endoscopic results, Brittany Rogers, MS, RDN, CPT, a California-based registered dietitian specializing in IBD, emphasized that more research on these effects is needed.

“We only have a few studies that look at whether curcumin supplementation could help with endoscopic inflammation, and therefore, we need more research before making any definitive statements around that,” she said. UC symptoms do not always correlate with the degree of inflammation in the gut, and Rogers emphasized that understanding how curcumin affects both could have important implications for UC care.

“Curcumin has demonstrated multiple pathways of potential anti-inflammatory effect in laboratory studies,” explained Harper. “In particular, it appears to be an inhibitor of a master regulator called NF-KB, which activates a number of downstream inflammatory pathways.”

“Curcumin also contains a potent antioxidant called polyphenol,” noted Rogers, “which may help to prevent pro-inflammatory cytokines from binding with their receptors, in turn potentially preventing or reducing inflammation.”

“Its ability to improve UC symptoms would be expected to be largely driven by these anti-inflammatory effects, though there is also some thought that curcumin may exert some positive effects through positive interactions with the gut microbiome,” Harper added.

“There have been both human- and animal-model studies that have shown changes in the gut microbiome with curcumin supplementation, but it’s hard to know to any significant extent what the practical significance of this would be.”

“Turmeric, the cooking spice that is the natural source of curcumin, is lovely to look at, and I personally love the flavor for cooking,” said Harper. “But the reality is that turmeric contains very little curcumin.”

“Turmeric usually contains around 2–5% curcumin by weight,” he explained. “So to get the equivalent doses studied in clinical trials would require upward of at least 2 tablespoons per day or more, which is really quite a lot when one considers that no more than 1 tablespoon might be used to season a large curry or other similar dish.”

Rogers added that knowing how much curcumin a person is getting from their turmeric can be challenging. “Curcumin content varies from one turmeric root to another due to a variety of factors, such as seasonality, temperature, and nutrient content in the soil,” she explained. “The section of the turmeric root utilized also has varying curcumin content.”

Both Rogers and Harper suggested that supplements may be necessary to achieve the potential benefits of curcumin observed in clinical trials.

Rogers noted that when considering the evidence on the benefits of curcumin, research on the optimal dose, formulation, and duration of supplementation is lacking.

“[Another] challenge is that the exact formulations used in various studies may vary quite a bit from each other in terms not just of dose, but also bioavailability [how much of the medication is absorbed],” added Harper.

“In fact, the thinking is that curcumin for UC may be most beneficial if it is actually not absorbed, but rather released in the colon, which requires different capsules to delay release,” he explained. “Most curcumin brands sold are designed to try to optimize absorption, which we may not want when we’re treating UC.”

“Working with a provider who is familiar with curcumin use medicinally is ideal to get suggestions about good brands for UC,” Harper added.

“In general, curcumin supplements appear to be safe, but like any medication — botanical or prescription — there are some things to be aware of,” noted Harper.

“Higher bioavailable forms of curcumin have been linked to liver toxicity,” Rogers explained. “This is particularly of concern for individuals with IBD on medications that are processed in the liver, such as biologics and small molecules.”

Both Rogers and Harper recommended periodic monitoring with liver function tests, particularly if someone is going to use curcumin supplements for longer periods, such as more than a month. A person may need to discontinue curcumin supplements before changing UC medications.

Other possible health concerns linked to higher doses of curcumin include:

  • mild anticoagulant (blood-thinning) effects
  • lowering of blood sugar
  • potential for pregnancy complications, including pregnancy loss

Rogers recommends discussing potential risks with a healthcare professional before starting curcumin supplements. Harper also emphasized the need for people to inform all members of the healthcare team of any supplements they are taking to avoid potential complications from interactions.

Turmeric and curcumin have long been used in traditional medicine to help relieve many ailments due to their potent anti-inflammatory and antioxidant properties. A growing body of research suggests curcumin may help relieve symptoms of mild to moderate UC, but the necessary doses and formulations to achieve these effects remain unclear.

Turmeric is a natural source of curcumin but is unlikely to contain the concentrations necessary to achieve the desired medicinal effects. Supplements may be a consideration, but experts recommend working with an experienced medical or dietary professional familiar with the use of curcumin for UC to avoid potential safety concerns and achieve the best results.