Boswellia for Colitis

Boswellia Serrata, also known as frankincense, has been used in traditional Ayurvedic medicine for centuries. Boswellia has been found to be quite helpful in addressing inflammation and pain, and it does this without causing ulcers like aspirin family medications. It has been shown in studies to be helpful for both rheumatoid arthritis and osteoarthritis.

Because of this, boswellia is combined with willow bark (salicin—a cousin to the Asacol medicine that helps ulcerative colitis) and cherry in an herbal pain-relief supplement (with boswellia and white willow bark; or Curcumin, boswellia, nattokinase, and DLPA).

Boswellia has been demonstrated to have significant anti-inflammatory properties. Boswellia inhibits leukotriene synthesis by inhibiting 5-lipooxygenase activity. It also decreases the activity of human leukocyte elastase (HLE). Unique to Boswellia is that it blocks two inflammatory chemicals that are increased simultaneously in a variety of human diseases. This results in its being helpful in asthma and colitis, as well as pain. In one study of asthmatics, 40 patients were given 300 mg 3 times day for 6 weeks. Seventy percent of the asthma patients showed improvement in symptoms and lung function and a decrease in allergic blood cells (eosinophils). Boswellia also helps in addressing ulcerative colitis. In one study of 20 patients in which boswellia, 300 mg 3 times a day, was given for 6 weeks, 14 went into remission, while with sulfasalazine (the standard prescription therapy), the remission rate was 4 out of 10.¹ Test tube studies suggest that boswellia also markedly inhibits cancer,^2,3 and this is helpful as the risk of colon cancer is higher in inflammatory colitis.

A recent study also showed that Boswellia was helpful in collagenous colitis, a rare form of colitis. That it helps several different kinds of colitis suggests that it is helpful in general for bowel inflammation.

In this study, 31 patients received either boswellia (an 80% extract at 300 mg 3x day) or placebo. No significant effect was seen at 3 weeks, but at 6 weeks 63.6 % of the boswellia patients were improved (vs. 26.7 % of the placebo group). Stool frequency dropped from 6.5 to 3 per day in the treatment group as well.⁴

I recommend those with colitis take boswellia (80% extract) 300-600 mg 3x a day. I would use an herbal pain-relief supplement that contains boswellia at the maximum dose for 6-8 weeks, and then the dose can be lowered.

The above study only had a small number of patients, leaving the results clinically very significant but of borderline statistical significance. This is also the case for studies using probiotics and even Pepto Bismol. This simply reflects the finances of studying cheap natural therapies vs. expensive patentable medications. That Pepto Bismol works (helped in 100% of the cases with none of the placebo group benefitting) raises the question of the role of Biofilm infections, in collagenous colitis. Biofilm infections respond poorly to antibiotics but are very sensitive to the Bismuth found in Pepto Bismol.

References

References for the above are in my book, Pain Free 1-2-3 (McGraw Hill, 2006). The ones specific to colitis are below:

¹Gupta, I., et al. "Effects of gum resin of Boswellia serrata in patients with chronic colitis." Planta Medica 2001 Jul;67(5): 391-5.

²Hostanska, K., et al. "Cytostatic and apoptosis-inducing activity of boswellic acids toward malignant cell lines in vitro." Anticancer Res, 2002 Sep-Oct;22(5): 2853-62.

³Huang, M.T., et al. "Anti-tumor and anti-carcinogenic activities of triterpenoid, beta-boswellic acid." Biofactors, 2000;13(1-4): 225-30.

⁴Madisch A, et al. "Boswellia Serrata extract for the treatment of Collagenous Colitis. A double-blind, randomized, placebo-controlled, multicenter trial." Int J of Colorectal Dis. Dec 2007; 22(12):1445-1451 (see study).