{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:50:50Z","timestamp":1793321450502,"version":"4.5.0"},"reference-count":54,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Constipation-predominant irritable bowel syndrome (IBS-C) is a common gastrointestinal disorder characterized by abdominal pain and altered bowel habits. Conventional treatments for IBS-C often provide limited efficiency, leading to an increasing interest in exploring herbal remedies. This systematic review aims to evaluate the efficacy and safety of herbal remedies in the management of IBS-C. Materials and Methods: A comprehensive search of PubMed, MEDLINE, Embase, Scopus, and the Cochrane Library was conducted to identify relevant studies published up to July 2023 and data extraction was performed independently by two reviewers. Results: Overall, the included studies demonstrated some evidence of the beneficial effects of herbal remedies on IBS-C symptoms, including improvements in bowel frequency, stool consistency, abdominal pain, and quality of life. However, the heterogeneity of the interventions and outcome measures limited the ability to perform a meta-analysis. Conclusion: This systematic review suggests that herbal remedies may have potential benefits in the management of IBS-C. However, the quality of evidence is limited, and further well-designed, large-scale RCTs are needed to establish the efficacy and safety of specific herbal remedies for IBS-C. Clinicians should exercise caution when recommending herbal remedies and consider individual patient characteristics and preferences.<\/jats:p>","DOI":"10.3390\/nu15194216","type":"journal-article","created":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T04:28:08Z","timestamp":1696220888000},"page":"4216","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Herbal Remedies for Constipation-Predominant Irritable Bowel Syndrome: A Systematic Review of Randomized Controlled Trials"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9183-4750","authenticated-orcid":false,"given":"Giuseppe","family":"Chiarioni","sequence":"first","affiliation":[{"name":"Division of Gastroenterology B, AOUI Verona, 37126 Verona, Italy"},{"name":"Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7080, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5508-2598","authenticated-orcid":false,"given":"Stefan Lucian","family":"Popa","sequence":"additional","affiliation":[{"name":"2nd Medical Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7435-271X","authenticated-orcid":false,"given":"Abdulrahman","family":"Ismaiel","sequence":"additional","affiliation":[{"name":"2nd Medical Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9088-8589","authenticated-orcid":false,"given":"Cristina","family":"Pop","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Physiology, and Pathophysiology, Faculty of Pharmacy, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinu Iuliu","family":"Dumitrascu","sequence":"additional","affiliation":[{"name":"Department of Anatomy, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0007-8962","authenticated-orcid":false,"given":"Vlad Dumitru","family":"Brata","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5230-6680","authenticated-orcid":false,"given":"Traian Adrian","family":"Duse","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Incze","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora","family":"Surdea-Blaga","sequence":"additional","affiliation":[{"name":"2nd Medical Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1053\/j.gastro.2022.04.016","article-title":"AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome with Constipation","volume":"163","author":"Chang","year":"2022","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1111\/apt.16369","article-title":"Review article: Diagnosis, management and patient perspectives of the spectrum of constipation disorders","volume":"53","author":"Sharma","year":"2021","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.14309\/ajg.0000000000001708","article-title":"Burden of Constipation: Looking Beyond Bowel Movements","volume":"117","author":"Harris","year":"2022","journal-title":"Am. J. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"11362","DOI":"10.3748\/wjg.v21.i40.11362","article-title":"Irritable bowel syndrome and chronic constipation: Fact and fiction","volume":"21","author":"Bellini","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"835","DOI":"10.4065\/75.8.835","article-title":"Herbal therapy: What a clinician needs to know to counsel patients effectively","volume":"75","author":"Bauer","year":"2000","journal-title":"Mayo Clin. Proc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/S0165-6147(02)02059-X","article-title":"Herbal medicine: The dangers of drug interaction","volume":"23","author":"Izzo","year":"2002","journal-title":"Trends Pharmacol. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1002\/9780470319444.ch11","article-title":"Herbal medicines: Balancing benefits and risks","volume":"282","author":"Ernst","year":"2007","journal-title":"Novartis Found. Symp."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"91","DOI":"10.3810\/pgm.1998.07.535","article-title":"The dangers of using herbs. What your patients need to know","volume":"104","author":"Borins","year":"1998","journal-title":"Postgrad. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1177\/1090820X12438913","article-title":"Bleeding risks of herbal, homeopathic, and dietary supplements: A hidden nightmare for plastic surgeons?","volume":"32","author":"Wong","year":"2012","journal-title":"Aesthet. Surg. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1007\/s12291-016-0617-2","article-title":"Lead Poisoning Due to Herbal Medications","volume":"32","author":"Chambial","year":"2017","journal-title":"Indian J. Clin. Biochem."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1159\/000064936","article-title":"A novel treatment for constipation-predominant irritable bowel syndrome using Padma Lax, a Tibetan herbal formula","volume":"65","author":"Sallon","year":"2002","journal-title":"Digestion"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1016\/j.cgh.2015.06.022","article-title":"Efficacy of a Chinese Herbal Medicine in Providing Adequate Relief of Constipation-predominant Irritable Bowel Syndrome: A Randomized Controlled Trial","volume":"13","author":"Bensoussan","year":"2015","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1007\/s11655-020-3267-4","article-title":"Anti-irritable Bowel Syndrome Syrup Improves Constipation-Predominant Irritable Bowel Syndrome: A Randomized, Placebo-Controlled Trial","volume":"26","author":"Pazhouh","year":"2020","journal-title":"Chin. J. Integr. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.explore.2018.09.003","article-title":"Comparison and Assessment of Flixweed and Fig Effects on Irritable Bowel Syndrome with Predominant Constipation: A Single-Blind Randomized Clinical Trial","volume":"15","author":"Pourmasoumi","year":"2019","journal-title":"Explore"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.17554\/j.issn.2224-3992.2015.04.560","article-title":"Efficacy of a Quebracho, Conker Tree, and M. balsamea Willd Blended Extract in a Randomized Study in Patients with Irritable Bowel Syndrome with Constipation","volume":"4","author":"Brown","year":"2015","journal-title":"J. Gastroenterol. Hepatol. Res."},{"key":"ref_16","first-page":"451","article-title":"Kiwifruit improves bowel function in patients with irritable bowel syndrome with constipation","volume":"19","author":"Chang","year":"2010","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/BF02835744","article-title":"Effect of modified Sinisan on anorectal manometry of the constipation predominant type of irritable bowel syndrome","volume":"11","author":"Yu","year":"2005","journal-title":"Chin. J. Integr. Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Ricci, C., Rizzello, F., Valerii, M.C., Spisni, E., Gionchetti, P., Turroni, S., Candela, M., D\u2019Amico, F., Spigarelli, R., and Bellocchio, I. (2022). Geraniol Treatment for Irritable Bowel Syndrome: A Double-Blind Randomized Clinical Trial. Nutrients, 14.","DOI":"10.3390\/nu14194208"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s11130-019-00747-5","article-title":"Aloe vera (L.) Webb.: Natural Sources of Antioxidants\u2014A Review","volume":"74","author":"Dziedzic","year":"2019","journal-title":"Plant Foods Hum. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Kledecka, A., Siejak, P., Pratap-Singh, A., Kowalczewski, P.\u0141., Fathordoobady, F., Jarz\u0119bski, M., and Smu\u0142ek, W. (2022). Extracts from Frangula alnus Mill. and Their Effects on Environmental and Probiotic Bacteria. Plants, 11.","DOI":"10.3390\/plants11202719"},{"key":"ref_21","unstructured":"Mills, S., and Bone, K. (2013). Principles and Practice of Phytotherapy: Modern Herbal Medicine, Elsevier. [2nd ed.]."},{"key":"ref_22","first-page":"17","article-title":"Antioxidants and carbohydrate content in infusions and microwave extracts from eight medicinal plants","volume":"7","author":"Petkova","year":"2017","journal-title":"J. Appl. Pharm. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jtcme.2016.12.013","article-title":"Medicinal, biological and phytochemical properties of Gentiana species","volume":"7","author":"Mirzaee","year":"2017","journal-title":"J. Tradit. Complement. Med."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Batiha, G.E., Olatunde, A., El-Mleeh, A., Hetta, H.F., Al-Rejaie, S., Alghamdi, S., Zahoor, M., Magdy Beshbishy, A., Murata, T., and Zaragoza-Bastida, A. (2020). Bioactive Compounds, Pharmacological Actions, and Pharmacokinetics of Wormwood (Artemisia absinthium). Antibiotics, 9.","DOI":"10.3390\/antibiotics9060353"},{"key":"ref_25","first-page":"237","article-title":"Cuscuta campestris induces apoptosis by increasing reactive oxygen species generation in human leukemic cells","volume":"8","author":"Moradzadeh","year":"2018","journal-title":"Avicenna J. Phytomed."},{"key":"ref_26","first-page":"2125","article-title":"Cassia Fistula Linn: A review of phytochemical and pharmacological studies","volume":"5","author":"Ali","year":"2014","journal-title":"Int. J. Pharm. Sci. Res."},{"key":"ref_27","first-page":"1","article-title":"Bioactivity of Echium Amoenum: A Mini Review","volume":"20","author":"Patocka","year":"2019","journal-title":"Biomed. J. Sci. Tech. Res."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Petrisor, G., Motelica, L., Craciun, L.N., Oprea, O.C., Ficai, D., and Ficai, A. (2022). Melissa officinalis: Composition, Pharmacological Effects and Derived Release Systems-A Review. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23073591"},{"key":"ref_29","first-page":"266","article-title":"Phytochemical and pharmacological aspects of Descurainia sophia Webb ex Prantl: Modern and traditional applications","volume":"6","author":"Nimrouzi","year":"2016","journal-title":"Avicenna J. Phytomed."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ramadan, M.F. (2023). Production, Processing, and Properties, Springer.","DOI":"10.1007\/978-3-031-16493-4"},{"key":"ref_31","first-page":"268","article-title":"Inhibitory effects of Ficus carica and Olea europaea on pro-inflammatory cytokines: A review","volume":"25","author":"Rezagholizadeh","year":"2022","journal-title":"Iran. J. Basic Med. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Yang, F., Dong, X., Yin, X., Wang, W., You, L., and Ni, J. (2017). Radix Bupleuri: A Review of Traditional Uses, Botany, Phytochemistry, Pharmacology, and Toxicology. BioMed Res. Int., 2017.","DOI":"10.1155\/2017\/7597596"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.toxrep.2017.11.002","article-title":"Bitter orange (Citrus aurantium L.) extract subchronic 90-day safety study in rats","volume":"4","author":"Deshmukh","year":"2017","journal-title":"Toxicol. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Jo, H.G., Lee, G.Y., Baek, C.Y., Song, H.S., and Lee, D. (2020). Analgesic and Anti-Inflammatory Effects of Aucklandia lappa Root Extracts on Acetic Acid-Induced Writhing in Mice and Monosodium Iodoacetate-Induced Osteoarthritis in Rats. Plants, 10.","DOI":"10.3390\/plants10010042"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"113415","DOI":"10.1016\/j.jep.2020.113415","article-title":"Atractylodis Rhizoma: A review of its traditional uses, phytochemistry, pharmacology, toxicology and quality control","volume":"266","author":"Zhang","year":"2021","journal-title":"J. Ethnopharmacol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s11418-014-0857-5","article-title":"Genetic and chemical characterization of white and red peony root derived from Paeonia lactiflora","volume":"69","author":"Zhu","year":"2015","journal-title":"J. Nat. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"10614","DOI":"10.3390\/molecules170910614","article-title":"Advances in the chemical analysis and biological activities of chuanxiong","volume":"17","author":"Li","year":"2012","journal-title":"Molecules"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/1749-8546-6-29","article-title":"Bioactivities of major constituents isolated from Angelica sinensis (Danggui)","volume":"6","author":"Chao","year":"2011","journal-title":"Chin. Med."},{"key":"ref_39","first-page":"1","article-title":"Phytochemical Constituents and Pharmacological Effects of Licorice: A Review","volume":"3","author":"Mamedov","year":"2019","journal-title":"Plant Hum. Health"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1177\/1756283X17734809","article-title":"An update on prucalopride in the treatment of chronic constipation","volume":"10","author":"Omer","year":"2017","journal-title":"Therap. Adv. Gastroenterol."},{"key":"ref_41","unstructured":"National Institute of Child Health and Human Development (2006). Drugs and Lactation Database (LactMed\u00ae)."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1016\/j.bbrc.2016.08.140","article-title":"Cisapride, a selective serotonin 5-HT4-receptor agonist, inhibits voltage-dependent K(+) channels in rabbit coronary arterial smooth muscle cells","volume":"478","author":"Kim","year":"2016","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"M\u0105czka, W., Wi\u0144ska, K., and Grabarczyk, M. (2020). One Hundred Faces of Geraniol. Molecules, 25.","DOI":"10.3390\/molecules25143303"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1111\/bph.13632","article-title":"Probiotics, fibre and herbal medicinal products for functional and inflammatory bowel disorders","volume":"174","author":"Ianiro","year":"2017","journal-title":"Br. J. Pharmacol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Gemcioglu, E., Y\u0131lmaz Cakmak, N., Baser, S., Kocaoz, S., and Ersoy, O. (2022). Factors affecting the use of herbal products in patients with Irritable Bowel Syndrome and their results: Case-control study. BMC Gastroenterol., 22.","DOI":"10.1186\/s12876-022-02125-z"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/jcag\/gwy071","article-title":"Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS)","volume":"2","author":"Moayyedi","year":"2019","journal-title":"J. Can. Assoc. Gastroenterol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.nutres.2020.02.008","article-title":"Herbal formula improves upper and lower gastrointestinal symptoms and gut health in Australian adults with digestive disorders","volume":"76","author":"Ried","year":"2020","journal-title":"Nutr. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5507\/bp.2017.057","article-title":"Irritable bowel syndrome\u2014From etiopathogenesis to therapy","volume":"162","author":"Grgov","year":"2018","journal-title":"Biomed. Pap. Med. Fac. Univ. Palacky Olomouc Czech Repub."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"116672","DOI":"10.1016\/j.jep.2023.116672","article-title":"Different therapies of Chinese herbal medicine for diarrhea-predominant irritable bowel syndrome: A network meta-analysis of double-blinded, placebo-controlled trials","volume":"317","author":"Liu","year":"2023","journal-title":"J. Ethnopharmacol."},{"key":"ref_50","first-page":"5163","article-title":"The Efficacy and Potential Mechanisms of Chinese Herbal Medicine on Irritable Bowel Syndrome","volume":"23","author":"Bi","year":"2017","journal-title":"Curr. Pharm. Des."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1089\/acm.2009.0090","article-title":"Effects of two natural medicine formulations on irritable bowel syndrome symptoms: A pilot study","volume":"16","author":"Hawrelak","year":"2010","journal-title":"J. Altern. Complement. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"102233","DOI":"10.1016\/j.ctim.2019.102233","article-title":"Western herbal medicines in the treatment of irritable bowel syndrome: A systematic review and meta-analysis","volume":"48","author":"Hawrelak","year":"2020","journal-title":"Complement. Ther. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.14309\/ajg.0000000000001222","article-title":"Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review","volume":"116","author":"Rao","year":"2021","journal-title":"Am. J. Gastroenterol."},{"key":"ref_54","first-page":"685","article-title":"Efficacy of bio-optimized extracts of turmeric and essential fennel oil on the quality of life in patients with irritable bowel syndrome","volume":"31","author":"Portincasa","year":"2018","journal-title":"Ann. Gastroenterol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/19\/4216\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:02:20Z","timestamp":1760130140000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/19\/4216"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,29]]},"references-count":54,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["nu15194216"],"URL":"https:\/\/doi.org\/10.3390\/nu15194216","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,29]]}}}