HIV-Associated Diarrhea Successfully Treated With Curcumin

Commentary by: Commentary by Steve Austin, ND

Reference: Conteas CN, Panossian AM, Tran TT, Singh H. Treatment of HIV-associated diarrhea with curcumin. Dig Dis Sci 2009;54:2188–91.

Design: Intervention trial

Participants: Subjects included 8 male patients suffering from HIV-related diarrhea with no identifiable cause.

Study Medication and Dosage: Subjects were instructed to take between 1 and 3 g per day (mean daily dosage was 1.9 g) curcumin. Most dosing was divided into t.i.d. administration. The interventions lasted for a mean of 41 weeks.

Primary Outcome Measures: Number of bowel movements per day, weight gain, and gastrointestinal (GI) symptoms

Key Findings: All 8 subjects had a complete resolution of diarrhea and normalization of stools in a mean of 13 days. The mean number of bowel movements per day decreased from 6.7 to 1.7 (P=0.006). Seven of 8 had weight gain averaging 10.8 pounds. Five of six with initial symptoms of bloating and abdominal pain also experienced resolution of those symptoms. On a one-to-ten scale, symptoms scores fell from a baseline of 7.8 to 1.6 (P=0.0001).

Practice Implications: Diarrhea is a common consequence of HIV disease. Though a bacterial agent is sometimes the cause, frequently no pathogen is found. No widely-accepted conventional treatment exists, and common anti-diarrheal medicines that have been used frequently trigger side effects. Studied actions of curcumin (e.g., anti-inflammatory activity, and inhibition of cyclooxygenase and lipoxygenase) are numerous, making it difficult for us to pinpoint why its use was so successful in this small trial. Although this was a small, uncontrolled trial, the safety profile of curcumin and the discomfort associated with HIV-associated diarrhea paired with the remarkable success reported here suggests that, at least until we have more evidence, a therapeutic trial should be considered for all such patients. “Such patients” might not include those who do have identifiable pathogens as causative agents, given that the subjects in the current trial had stool analyses run and all were free of identifiable pathogens at baseline. Curcumin is widely accepted as the primary therapeutic compound extracted from turmeric. No special form of curcumin extract was used in this trial. Indeed, all subjects were told to purchase curcumin themselves from health food stores. The principal investigator claimed that the various products used by subjects all appeared to produce equal efficacy (personal communication).

About Steve Austin, ND
Steve Austin, ND, is a naturopathic physician and co-author of the A-Z Guide to Drug-Herb-Vitamin Interactions; Breast Cancer: What You Should Know (But May Not Be Told) About Prevention, Diagnosis, and Treatment and The Natural Pharmacy, now in its second edition.  Dr. Austin was the founding Chief Science Officer for the Healthnotes team of writers. He is also former Professor of Nutrition at National College of Naturopathic Medicine, in Portland, Oregon. Previously, Dr. Austin headed the nutrition departments at Bastyr University in Seattle and Western States Chiropractic College in Portland, and has been on the faculties of four of the five naturopathic colleges in North America. He is a contributor to the Textbook of Natural Medicine, and was nutrition editor of the Quarterly Review of Natural Medicine and the Healthnotes Review of Natural Medicine. Dr. Austin is also an international lecturer on topics related to clinical nutrition.

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