Current approaches for managing gut-pouch episodes involves a modified diet, bowel rest, antibiotics, and/or pain management. However, individuals who have suffered 3 or more earlier cases have about an 80% chance of another recurrence, raising the chance of complications. 15-25% of people with a first episode of acute abdominal pain require surgery, and 22% of those are likely to suffer a future attack post-surgery.Â
As episodes involving structural pockets in the colon are often underlooked with limited research regarding management options, researchers are investigating compounds with direct anti-microbial action, and modulation of the intestinal microbiome to potentially improve outcomes and help reduce the likelihood of future episodes
Currently under investigation are the natural herbal compounds, curcumin and coptis. These compounds both show potent balancing effects on the body’s natural response activities and have both been found to improve microbial health and gut immunity with the potential to promote a sense of internal resilience.
Coptis Chinensis for Abdominal tenderness
Coptis chinensis is one of the rare sacred herbs for ‘damp heat’ conditions in Traditional Chinese Medicine. Used widely to drain fire and relieve toxicity associated with structural pockets in the colon, Coptis promotes balance in the microbiome, boosts gut immunity, and encourages overall digestive well-being.Â
Coptis is a natural anti-microbial herb containing several bioactive compounds reported to be overall gut resilience and internal balance including the alkaloids berberine, palmatine, and jatrorrhizine.Â
Berberine for Abdominal tenderness
Berberine is the main biologically active compound found in coptis. The compound has been found to support a healthy digestive environment by interacting with microbial activity and fortifying the intestinal mucosa.
Berberine exerts broad-spectrum antibiotic activity and increases the production of butyrate, a vital short-chain fatty acid that regulates the intestinal environment, helps maintain mucosal balance, and has been found to lower the recurrence of intestinal discomfort.
Berberine may influence key biological pathways by reducing the expression of TNF-α. TNFα is a cytokine associated with gut-related sensitivity and internal stress responses, with mucosal TNFα levels decreasing during periods of improved well-being. Individuals with visceral hypersensitivity may also benefit from berberine, as it alleviates visceral hypersensitivity, helping promote a more balanced digestive experience.
Berberine additionally inhibits the activation of the NF-κB-MLCK pathway, increasing the expression of tight junction proteins and repairing epithelial barrier damage. This may benefit individuals as it is theorized that the prolonged immune activation driving progression may be caused by the translocation of intestinal microbes and products from the gut lumen through the mucosa.Â
Palmatine & Jatrorrhizine
Two other main active components of Coptis are palmatine and jatrorrhizine, which both contribute to the anti-bacterial and anti-viral properties of Coptis.Â
Palmatine has been explored for its supportive effects on cellular balance and resilience as well as its interactions with microbial activity. Likewise, jatrorrhizine has been studies for its role in supporting healthy biological responses and maintaining microbial harmony, and has been observed to promote gut bacteria balance.Â
Curcumin for Abdominal tendernessÂ
Curcumin is a potent curative compound extracted from turmeric currently used to manage a wide range of conditions due to its beneficial balancing, antioxidant, and neuroprotective properties.Â
Curcumin can benefit those with acute abdominal discomfort, as these individuals show significant signs of mucosal unrest due to immune system activation. One of the markers is an increased expression of TNFα in acute episodes of digestive discomfort, with levels easing during periods when the gut settles. Studies have shown curcumin can inhibit tumor necrosis factor-alpha, one of the chemical messengers associated with heightened digestive discomfort and internal stress responses
Moreover, curcumin has been observed to help support microbial harmony in the gut, addressing what is known as dysbiosis, or an imbalance of the gut microbiome. Research indicated that structural pockets in the colon may influence shifts in microbial communities, which can contribute to heightened digestive discomfort and internal stress responses. Therefore, it has been suggested that curcumin may help support long-term digestive balance by promoting a healthier microbial environment.
Curcumin supplementation has also been found to neutralize the decrease of butyric acid-producing bacteria. This has a beneficial impact on those with abdominal discomfort as butyrate is a short-chain fatty acid that improves tight junction expression, which, as mentioned above, plays an important role. Whether by preventing low levels of butyrate or by other mechanisms, curcumin has the ability to restore impaired intestinal permeability by preventing tight junction protein disruption.Â
Additionally, curcumin can enrich beneficial bacteria such as Bifidobacteria and Lactobacilli and reduce pathogenic bacteria associated with helping support a more balanced gut ecosystem..Â
Butyrate and Its Role in Supporting Long-Term Digestive Balance — A Randomized Study
A prospective randomized study investigated the preventative effect of butyrate in individuals with episodes of pockets in the colon, with at least one episode of mild or moderate episode requiring treatment. During the 12-month course, there was a decrease in the number of episodes, acute pain, fever, hospitalization, and surgery in comparison to the control group, as well as reports of improved quality of life. Â
The study demonstrated that a butyrate regimen can result in a significant reduction of clinical incidence.Â