Investigating herbal medicines to reduce chemotherapy related digestive side effects in patients with colorectal cancer

The aim of this study was to evaluate herbal medicines to treat gastrointestinal (GI) side effects in patients with colorectal cancer (CRC) treated with chemotherapy. The study found that herbal medicines reduced some GI side effects in these patients.

CRC can be treated with surgery to remove the tumor. In general, patients are given chemotherapy (CT) before and/or after surgery. However, CT can cause GI side effects in patients with CRC. These side effects include nausea, vomiting, diarrhea, constipation, abdominal pain or swelling, and anorexia (loss of appetite). Some of these side effects can be managed by lowering the dose of CT. However, this could result in the CT not being as effective.

Herbal medicines (HM) can be used to reduce GI side effects. HMs with different ingredients have been investigated. However, it is currently unclear how beneficial HMs are for patients with CRC treated with chemotherapy.

This study evaluated data from 1,995 patients with CRC from 22 studies. Each trial compared the use of HM with CT to CT alone. 

Overall, HMs in combination with CT reduced the risk of GI side effects by 22%. HMs significantly reduced the risk of nausea and vomiting by 26%, diarrhea by 36%, abdominal swelling by 64%, and lesions in the mouth by 35%. 

The most commonly used plants in the HM supplements were Glycyrrhiza uralensis (gan cao), Atractylodes macrocephala (bai zhu), Astragalus membranaceus (huang qi), Codonopsis pilosula (dang shen), and the pericarp of Citrus reticulata (chen pi).

The study concluded that HMs improved GI side effects in patients with CRC treated with chemotherapy.

The study evaluated existing data. The clinical trials had different protocols. In the trials where neither the participants nor the doctors knew if patients were taking HMs or placebos, the effects were not considered significant. Randomized, placebo-controlled trials need to be carried out to understand if HMs can significantly improve GI side effects.