Efficacy of Rose Oil Soft Capsules on Clinical Outcomes in Ulcerative Colitis: A Pilot Randomized, Double-Blinded, Placebo-Controlled Clinical Trial

The impact of Rosa dmascena Mill. on gastrointestinal disorders: a comprehensive analysis through clinical trials, systematic review, and meta-analysis

OBJECTIVES

Rosa damascena Mill. has been studied in clinical trials for the treatment of diverse gastrointestinal diseases. The aim of this study is to conduct a systematic review and meta-analysis of clinical trials using R. damascena in the management of gastrointestinal disorders.

EVIDENCE ACQUISITION

PubMed, Web of Science, Embase, Scopus, and Google Scholar were searched up to Jun 30, 2024. Clinical trials utilizing R. damascena for gastrointestinal disorders were included in the study. The study protocol was registered in PROSPERO (CRD42024519644). The main keywords for the search were R. damascena, gastrointestinal, digestive system, and clinical trials. The Cochrane RoB 2.0 tool was employed for quality assessment of randomized controlled trials. A summary of intervention effects for each study was provided by calculating standardized mean differences and accompanying 95% confidence intervals using a random-effects model. Weighted mean differences and heterogeneity between studies were assessed using Hedges's method and Cochran's Q test, respectively. Additionally, the risk ratio (RR) index was utilized to investigate the effect of R. damascena.

RESULTS

Thirteen studies were included for systematic review. The results showed that the use of R. damascena significantly improves the Quality of life (SMD: 0.84, CI95%: 0.03 to 1.65, P = 0.041) and mean defecation frequency per week (SMD: 0.86, CI95%:0.14 to 1.58, P = 0.018) in patients with constipation. However, no improvement was observed in the Bristol stool form scale in patients with constipation, and this relationship was not statistically significant either (SMD: -1.34, CI95%: -4.39 to 1.71, P = 0.388). Also, the rate of incomplete evacuation significantly improved in patients with constipation (RR: 0.78, CI95%: 0.63 to 0.94, P = 0.035).

CONCLUSION

Based on the results of this study, R. damascena could have promising effects on symptoms of patients with functional constipation and their quality of life. Future studies should focus on standardizing methodologies, exploring different dosage levels, and investigating its effects on a wider range of gastrointestinal conditions.

Clinical outcomes of flavonoids for immunomodulation in inflammatory bowel disease: a narrative review

Inflammatory bowel disease is a debilitating condition that undergoes a relapsing and remitting course. The pathogenesis of how this disease manifests remains to be elucidated; however, there is growing evidence that a synergism of familial predisposition and epigenetic alterations influenced by environmental factors all contribute to the development of the disease. The role of nutrition in improving the outcomes of the condition has garnered increasing interest, given the greater risks of neoplastic conversion and concerns about inappropriate remission with available pharmacotherapeutic treatments alone. Available reports, often anecdotal, have documented patient relief with employment of various dietary strategies. These have led to curiosity about nutritional assessments and nutrition therapies to ameliorate the morbidity and all-cause mortality of the disease. One group of such nutrition therapies, supported by a compendium of available articles, is flavonoids-although the greater abundance of in vitro experiments with relatively few clinical trials has limited their clinical use. Nonetheless, flavonoids have been shown to be functional foods with immunomodulatory capabilities. This article will thus delve into the role of flavonoids in altering the course of the immune response in inflammatory bowel disease, while assessing their clinical outcomes in human trials.

Herbal Medicines for the Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis

Herbal medicines are used by patients with IBD despite limited evidence. We present a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating treatment with herbal medicines in active ulcerative colitis (UC). A search query designed by a library informationist was used to identify potential articles for inclusion. Articles were screened and data were extracted by at least two investigators. Outcomes of interest included clinical response, clinical remission, endoscopic response, endoscopic remission, and safety. We identified 28 RCTs for 18 herbs. In pooled analyses, when compared with placebo, clinical response rates were significantly higher for Indigo naturalis (IN) (RR 3.70, 95% CI 1.97-6.95), but not for Curcuma longa (CL) (RR 1.60, 95% CI 0.99-2.58) or Andrographis paniculata (AP) (RR 0.95, 95% CI 0.71-1.26). There was a significantly higher rate of clinical remission for CL (RR 2.58, 95% CI 1.18-5.63), but not for AP (RR 1.31, 95% CI 0.86-2.01). Higher rates of endoscopic response (RR 1.56, 95% CI 1.08-2.26) and remission (RR 19.37, 95% CI 2.71-138.42) were significant for CL. CL has evidence supporting its use as an adjuvant therapy in active UC. Research with larger scale and well-designed RCTs, manufacturing regulations, and education are needed.

Effect of rose oil on Gastroesophageal Reflux Disease in comparison with omeprazole: A double-blind controlled trial

BACKGROUND AND OBJECTIVE

Gastroesophageal reflux disease (GERD) as one of the most common ailments of gastrointestinal system diminishes quality of life and impairs physical functioning and work productivity. Proton-pump inhibitors (PPIs), such as omeprazole play a more dominant role in amelioration of GERD symptoms; nonetheless, there is a growing concern about their side effects. According to traditional Persian medicine (TPM), the use of rose oil is recommended to alleviate GERD symptoms.

MATERIALS AND METHODS

Therefore, a randomized double-blind controlled trial was performed on 70 subjects who were randomly enrolled in two groups and received either rose oil softgel or omeprazole capsule combined with the placebo. Data were collected within 3 sessions of visit using the Mayo-gastroesophageal reflux questionnaire (GERQ).

RESULTS

Although, our findings showed that reflux symptoms were decreased in both groups after receiving medicine and the decrement was significant in treatment group, before and after the intervention, this decrease was not significant between two groups.

CONCLUSION

Given that the rose oil used in this study was produced according to the Iranian method and effective ingredients of Rosa damascena were preserved in sesame oil in production process, it seems that effectiveness of this product can be due to its tonic and enlivening properties. Consumption of rose oil soft capsule alleviates cardinal GERD symptoms similar to omeprazole. It seems that rose oil can have the same effects as PPIs in treatment of GERD but with no side effects due to its different mechanisms of action.