Propolis May Reduce Severity and Frequency of Abdominal Pain in Subjects with IBS-C and IBS-M

by | May 9, 2023 | 2022, Digestive Health, Irritable Bowel Syndrome, Propolis

Written by Taylor Woosley, Staff Writer. Results of 6-week supplementation of 900 mg/day shows that participants in the propolis group were 6.22 times more likely to experience improvements in IBS symptoms compared to placebo. 

stomach painIrritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder which presents with abdominal pain associated with alteration of bowel habits1. IBS is characterized by several GI symptoms like bloating, urgency, a sensation of incomplete evacuation and altered bowel habits without any organic and biochemical abnormalities2. IBS can be further categorized into subtypes based on fecal condition and bowel movements and is termed diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), mixed (IBS-M), and unclassified (IBS-U)3.

Several factors are expected to play a role in IBS etiology, including microscopic inflammation, enhancement of GI tract permeability, alterations of the nervous system, changes in brain-gut axis, and alterations of gut flora4. Propolis, the resinous substance accumulated by bees from different types of plants, has numerous applications owing to their anti-inflammatory and antioxidant properties5. Recent studies have shown that propolis can modulate inflammatory pathways, immune system function, gut microbiota, and GI permeability6.

Miryan et al. conducted a randomized, double-blind clinical trial to assess the efficacy of propolis supplementation on the severity of IBS symptoms. Subject inclusion consisted of being diagnosed with IBS by a gastroenterologist according to the Rome IV criteria, who were between the ages of 18-65 years, who have IBS-C or IBS-M based on the Bristol stool form scale (BSFS) and have no allergy to bee products. Subjects were randomly allocated to receive propolis or placebo tablets. Propolis tablets contained 450 mg of propolis extract containing 90 mg of polyphenols and 67 mg of flavonoids. The placebo tablets contained microcrystalline cellulose and various edible colors. Tablets were administered before lunch and dinner for 6 weeks.

The primary outcome of the study was the percentage of patients with an improvement of at least one grade of IBS disease from baseline to the sixth week of intervention. The IBS symptom severity scale (IBS-SSS) was used to assess IBS severity. Subjects completed the IBS-SSS pre- and post-intervention. Secondary outcomes included changes in body mass index (BMI) and waist circumference (WC) from baseline to the end of the sixth week. Dietary intake was measured using three-day food records before, during, and after the study. The anxiety state of participants was measured as a confounding factor using the Beck anxiety inventory (BAI) before and after the study. Independent samples t-test and Mann-Whitney U test were utilized for evaluating the differences between the two groups at baseline. Paired-samples t-test and Wilcoxon’s signed-rank test were utilized to assess within-group changes.

A total of 51 subjects completed the study and there were no statistically significant differences between the two groups regarding gender, education levels, IBS sub-types, and anxiety state at baseline. Significant findings of the study are as follows:

  • At the end of the study, the mean standard deviation (SD) of anxiety score was 16.72 (8.46) in the placebo group and 11.19 (8.37) in the propolis group. The anxiety score significantly decreased in the propolis group compared with placebo (-5.69 ±22 versus -0.96 ± 7.81; p-value = 0.40).
  • Overall scores of IBS symptoms and scores of all their components were significantly reduced in the propolis group at the end of the trial (p < 0.05). After adjustment of anxiety scores as a covariate, there were significant between-group differences for the mean changes in overall scores of IBS symptoms, the severity of abdominal pain, and frequency of abdominal pain (p-value < 0.05).
  • The percentage of participants achieving at least one grade reduction in IBS symptoms was significantly higher in the propolis group than in the placebo group (80.7% versus 52%; p = 0.015).

Results of the study suggest that supplementation of 900 mg/day of propolis for 6 weeks can improve IBS symptom severity. The main symptom improvement was related to the severity and frequency of abdominal pain. Study limitations include the self-reporting nature of physical activity and food intake which may not be accurate and the lack of markers or laboratory parameters that are accessible to diagnose the disease.

Source: Miryan, Mahsa, Davood Soleimani, Pejman Alavinejad, Mohammadreza Abbaspour, and Alireza Ostadrahimi. “Effects of propolis supplementation on irritable bowel syndrome with constipation (IBS‐C) and mixed (IBS‐M) stool pattern: A randomized, double‐blind clinical trial.” Food Science & Nutrition 10, no. 6 (2022): 1899-1907.

© 2022 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC

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Posted May 9, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Adriani A, Ribaldone DG, Astegiano M, Durazzo M, Saracco GM, Pellicano R. Irritable bowel syndrome: the clinical approach. Panminerva Med. Dec 2018;60(4):213-222. doi:10.23736/s0031-0808.18.03541-3
  2. Altomare A, Di Rosa C, Imperia E, Emerenziani S, Cicala M, Guarino MPL. Diarrhea Predominant-Irritable Bowel Syndrome (IBS-D): Effects of Different Nutritional Patterns on Intestinal Dysbiosis and Symptoms. Nutrients. Apr 29 2021;13(5)doi:10.3390/nu13051506
  3. Mishima Y, Ishihara S. Molecular Mechanisms of Microbiota-Mediated Pathology in Irritable Bowel Syndrome. Int J Mol Sci. Nov 17 2020;21(22)doi:10.3390/ijms21228664
  4. Miryan M, Alavinejad P, Abbaspour M, Soleimani D, Ostadrahimi A. Does propolis affect the quality of life and complications in subjects with irritable bowel syndrome (diagnosed with Rome IV criteria)? A study protocol of the randomized, double-blinded, placebo-controlled clinical trial. Trials. Aug 5 2020;21(1):698. doi:10.1186/s13063-020-04615-5
  5. Okamura T, Hamaguchi M, Bamba R, et al. Brazilian green propolis improves gut microbiota dysbiosis and protects against sarcopenic obesity. J Cachexia Sarcopenia Muscle. Dec 2022;13(6):3028-3047. doi:10.1002/jcsm.13076
  6. Miryan M, Soleimani D, Alavinejad P, Abbaspour M, Ostadrahimi A. Effects of propolis supplementation on irritable bowel syndrome with constipation (IBS-C) and mixed (IBS-M) stool pattern: A randomized, double-blind clinical trial. Food Sci Nutr. Jun 2022;10(6):1899-1907. doi:10.1002/fsn3.2806