The effect of sorrel and lemongrass combination on clinical symptoms and quality of life in patients with irritable bowel syndrome with predominant constipation

Abstract

Irritable bowel syndrome (IBS) stands as one of the most prevalent functional disorders affecting the digestive system. It manifests as chronic and recurring abdominal pain, bloating, and alterations in bowel movements without any discernible structural abnormalities in the digestive tract. With a prevalence of approximately 10-20% among adults, it tends to affect women more frequently. Current conventional treatments for IBS often fall short, leaving medical professionals grappling with the challenge of effectively managing this syndrome. Furthermore, there exists a notable dearth of evidence concerning the efficacy of medicinal plants in alleviating symptoms associated with IBS. Given that IBS patients commonly experience abdominal pain, bloating, and constipation, and considering the purported properties of two specific plants, fenugreek and lemon balm, in ameliorating these symptoms, coupled with insufficient research exploring the combined effects of both plants, we embarked on this investigation to assess the impact of their consumption on IBS with constipation predominance. Materials and Methods: The present study adopts a double-blind randomized clinical trial approach involving patients diagnosed with irritable bowel syndrome according to the Rome IV criteria, attending gastroenterology clinics affiliated with Tabriz University of Medical Sciences. The majority of these patients exhibited symptoms indicative of constipation. Patients were randomly assigned to either the control (45 individuals) or drug (45 individuals) groups. The drug group received a daily dosage of 10 cc of combined syrup containing lemon balm leaf and fenugreek seed extracts, prepared by the Traditional Medicine Center. Conversely, the placebo group received a daily 10 cc dosage of multivitamin syrup, both administered over an 8-week period. Clinical manifestations of the patients were assessed by medical professionals, while pain intensity was evaluated using the visual analog scale. Clinical symptom questionnaires were administered before and after the 8-week treatment period. Results: Initial comparison of clinical symptoms between the two groups before intervention revealed no statistically significant difference (P=0.749). However, following the intervention, the number of patients exhibiting no or mild symptoms in the intervention group significantly exceeded that of the control group (P=0.014). Moreover, while there was no significant disparity in pain intensity between the groups before intervention (P=0.744), post-intervention analysis indicated a noteworthy reduction in pain intensity among patients in the intervention group compared to the control group (P=0.025). Prior to intervention, there was no statistically significant distinction in quality of life scores between the control (42.3±59.69) and intervention (41.3±55.34) groups (P=0.893). However, following intervention, quality of life scores substantially improved in the intervention group (89.6±33.37) compared to the control group (52.4±27.09) (P=0.893).