Background/Aim: Irritable bowel syndrome (IBS) is a frequent gastrointestinal disorder, with only limited evidence regarding self-management approaches. This study tested the efficacy of caraway oil poultices (CarO) for treating IBS. Methods: This randomized controlled open-label cross-over trial included three treatment periods with hot CarO and hot olive oil poultice (OlivH) or nonheated poultices (OlivC) with olive oil as control interventions. Patients applied each intervention daily for 3 weeks. The primary outcome was symptom severity (IBS-SSS); secondary outcomes included responder rates (improvement ≥50 IBS-SSS), quality of life (EQ-5D, IBS-QOL), psychological distress (HADS), adequate relief, and safety. Results: 48 patients with IBS were included (40 females, 53.9 ± 14.4 years). A significant difference was found for symptom severity in favor of CarO compared to OlivC (difference -38.4, 95% CI -73.6, -3.1, p = 0.033), but not compared to OlivH (difference -24.3, 95% CI -56.5, 7.9, p = 0.139). Responder rates were highest for CarO compared to OlivH and OlivC (43.9, 20.0, 18.9%, respectively). Within the CarO, 51.8% reported adequate relief compared to 23.5% (OlivH) and 25.8% (OlivC). One adverse event (gastrointestinal infection) was reported during CarO. Conclusion: Hot caraway oil poultices appear effective and safe, although their effects may be a result of the heat application. Patients reported highest levels of subjective benefit from caraway oil poultices, making their use appropriate in the self-management of IBS.

Journal Section:
Original Paper
Keywords:
Irritable bowel syndrome, Herbal medicines, Topical heat, Self-care, Poultice, Clinical trial
1.
Lovell RM, Ford AC: Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol 2012;10:712-721.e4.
2.
Quigley EM, Abdel-Hamid H, Barbara G, Bhatia SJ, Boeckxstaens G, De Giorgio R, Delvaux M, Drossman DA, Foxx-Orenstein AE, Guarner F, Gwee KA, Harris LA, Hungin AP, Hunt RH, Kellow JE, Khalif IL, Kruis W, Lindberg G, Olano C, Moraes-Filho JP, Schiller LR, Schmulson M, Simrén M, Tzeuton C: A global perspective on irritable bowel syndrome: a consensus statement of the world gastroenterology organisation summit task force on irritable bowel syndrome. J Clin Gastroenterol 2012;46:356-366.
3.
Drossman DA, Dumitrascu DL: Rome III: new standard for functional gastrointestinal disorders. J Gastrointestin Liver Dis 2006;15:237-241.
4.
Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC: Functional bowel disorders. Gastroenterology 2006;130:1480-1491.
5.
van Tilburg MA, Palsson OS, Levy RL, Feld AD, Turner MJ, Drossman DA, Whitehead WE: Complementary and alternative medicine use and cost in functional bowel disorders: a six month prospective study in a large hmo. BMC Complement Altern Med 2008;8:46.
6.
Vlieger AM, Blink M, Tromp E, Benninga MA: Use of complementary and alternative medicine by pediatric patients with functional and organic gastrointestinal diseases: results from a multicenter survey. Pediatrics 2008;122:e446-e451.
7.
Wu JC: Complementary and alternative medicine modalities for the treatment of irritable bowel syndrome: facts or myths? Gastroenterol Hepatol (N Y) 2010;6:705-711.
8.
Comar KM, Kirby DF: Herbal remedies in gastroenterology. J Clin Gastroenterol 2005;39:457-468.
9.
Brenke R, Conradi E: Hydrotherapie; in Kraft K, Stange R (eds): Lehrbuch Naturheilverfahren. Stuttgart, Hippokrates, 2010, pp 181-208.
10.
Brenke R, Polonius D: Hydro- und Thermotherapie; in Melchart D, Brenke R, Dobos G, Gaisbauer M, Saller R (eds): Naturheilverfahren - Leitfaden für die ärztliche Aus-, Fort- und Weiterbildung. Stuttgart, Schattauer, 2002, pp 294-331.
11.
Adler M: Naturheilverfahren in der ärztlichen praxis; in Kraft K, Stange R (eds): Lehrbuch Naturheilverfahren. Stuttgart, Hippokrates, 2010, pp 72-81.
12.
Kalden M, Stange R: Onkologische erkrankungen; in Kraft K, Stange R (eds): Lehrbuch Naturheilverfahren. Stuttgart, Hippokrates, 2010, pp 659-672.
13.
Bundesinstitut für Arzneimittel und Medizinprodukte: Monographie carvi aetheroleum (kümmelöl). Bundesanzeiger 1990;22a:​A16AY.
14.
Bundesinstitut für Arzneimittel und Medizinprodukte: Monographie menthae piperitae aetheroleum (minzöl). Bundesanzeiger 1993;128:A16AY.
15.
Drossman DA: Rome III: the new criteria. Chin J Dig Dis 2006;7:181-185.
16.
Francis CY, Morris J, Whorwell PJ: The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther 1997;11:395-402.
17.
Drossman DA, Chang L, Bellamy N, Gallo-Torres HE, Lembo A, Mearin F, Norton NJ, Whorwell P: Severity in irritable bowel syndrome: a Rome foundation working team report. Am J Gastroenterol 2011;106:1749-1759; quiz 1760.
18.
Bushnell DM, Martin ML, Ricci JF, Bracco A: Performance of the EQ-5D in patients with irritable bowel syndrome. Value Health 2006;9:90-97.
19.
Wang HM, Patrick DL, Edwards TC, Skalicky AM, Zeng HY, Gu WW: Validation of the EQ-5D in a general population sample in urban china. Qual Life Res 2012;21:155-160.
20.
Drossman DA, Patrick DL, Whitehead WE, Toner BB, Diamant NE, Hu Y, Jia H, Bangdiwala SI: Further validation of the IBS-QOL: a disease-specific quality-of-life questionnaire. Am J Gastroenterol 2000;95:999-1007.
21.
Patrick DL, Drossman DA, Frederick IO, DiCesare J, Puder KL: Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Dig Dis Sci 1998;43:400-411.
22.
Herrmann-Lingen C, Buss U, Snaith RP: Hospital Anxiety and Depression Scale - Deutsche Version (HADS-D). Bern, Verlag Hans Huber, 1995.
23.
Ameen VZ, Health AT, McSorley D, Spiegel BM, Chang L: Global measure of adequate relief predicts clinically important difference in pain and is independent of baseline pain severity in irritable bowel syndrome. Gastroenterology 2007;132:A140.
24.
Mangel AW, Hahn BA, Heath AT, Northcutt AR, Kong S, Dukes GE, McSorley D: Adequate relief as an endpoint in clinical trials in irritable bowel syndrome. J Int Med Res 1998;26:76-81.
25.
Holtmann G, Adam B, Vinson B: Evidence-based medicine and phytotherapy for functional dyspepsia and irritable bowel syndrome: a systematic analysis of evidence for the herbal preparation iberogast. Wien Med Wochenschr 2004;154:528-534.
26.
Melzer J, Rösch W, Reichling J, Brignoli R, Saller R: Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation stw 5 (iberogast). Aliment Pharmacol Ther 2004;20:1279-1287.
27.
Saller R, Pfister-Hotz G, Iten F, Melzer J, Reichling J: [Iberogast: a modern phytotherapeutic combined herbal drug for the treatment of functional disorders of the gastrointestinal tract (dyspepsia, irritable bowel syndrome) - from phytomedicine to ‘evidence based phytotherapy.' A systematic review]. Forsch Komplementarmed Klass Naturheilkd 2002;9(suppl 1):1-20.
28.
Jailwala J, Imperiale TF, Kroenke K: Pharmacologic treatment of the irritable bowel syndrome: a systematic review of randomized, controlled trials. Ann Intern Med 2000;133:136-147.
29.
Liu JH, Chen GH, Yeh HZ, Huang CK, Poon SK: Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial. J Gastroenterol 1997;32:765-768.
30.
Pittler MH, Ernst E: Peppermint oil for irritable bowel syndrome: a critical review and metaanalysis. Am J Gastroenterol 1998;93:1131-1135.
31.
Kraft K: Phytotherapie; in Kraft K, Stange R (eds): Lehrbuch Naturheilverfahren. Stuttgart, Hippokrates, 2010, pp 145-180.
32.
Micklefield GH, Greving I, May B: Effects of peppermint oil and caraway oil on gastroduodenal motility. Phytother Res 2000;14:20-23.
33.
Goerg KJ, Spilker T: Effect of peppermint oil and caraway oil on gastrointestinal motility in healthy volunteers: a pharmacodynamic study using simultaneous determination of gastric and gall-bladder emptying and orocaecal transit time. Aliment Pharmacol Ther 2003;17:445-451.
34.
Madisch A, Holtmann G, Plein K, Hotz J: Treatment of irritable bowel syndrome with herbal preparations: results of a double-blind, randomized, placebo-controlled, multi-centre trial. Aliment Pharmacol Ther 2004;19:271-279.
35.
Sibaev A, Yuece B, Kelber O, Weiser D, Schirra J, Göke B, Allescher HD, Storr M: STW 5 (iberogast) and its individual herbal components modulate intestinal electrophysiology of mice. Phytomedicine 2006;13(suppl 5):80-89.
36.
Meyer F, Meyer E: Percutane resorption von ätherischen ölen und ihren inhaltsstoffen. Drug Res 1959;9:516-519.
37.
Cramer H, Baumgarten C, Choi KE, Lauche R, Saha F, Musial F, Dobos G: Thermotherapy self-treatment for neck pain relief - a randomized controlled trial. Eur J Integr Med 2012;4:e371-e378.
38.
Mulkern RV, McDannold NJ, Hynynen K, Fielding J, Panych LP, Jolesz FA, Weingand K: Temperature distribution changes in low back muscles during applied topical heat: a magnetic resonance thermometry study. Proc Int Soc Mag Res Med 1999:1054.
39.
Nadler SF, Weingand K, Kruse RJ: The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain Physician 2004;7:395-399.
40.
Azpiroz F, Malagelada JR: Abdominal bloating. Gastroenterology 2005;129:1060-1078.
41.
Barba E, Burri E, Accarino A, Cisternas D, Quiroga S, Monclus E, Navazo I, Malagelada JR, Azpiroz F: Abdominothoracic mechanisms of functional abdominal distension and correction by biofeedback. Gastroenterology 2014;148:732-739.
42.
Akin M, Price W, Rodriguez G Jr, Erasala G, Hurley G, Smith RP: Continuous, low-level, topical heat wrap therapy as compared to acetaminophen for primary dysmenorrhea. J Reprod Med 2004;49:739-745.
43.
Huber R, Weisser S, Luedtke R: Effects of abdominal hot compresses on indocyanine green elimination - a randomized cross over study in healthy subjects. BMC Gastroenterol 2007;7:27.
44.
Hishinuma M, Hiramatsu N, Kasuga M, Ooyoshi M, Kaharu C, Misao H, Kawashima M: [The effect on bowel sounds of very hot compresses applied to the lumbar region]. Nihon Kango Kagakkaishi 1997;17:32-39.
45.
Stasi C, Rosselli M, Bellini M, Laffi G, Milani S: Altered neuro-endocrine-immune pathways in the irritable bowel syndrome: the top-down and the bottom-up model. J Gastroenterol 2012;47:1177-1185.
46.
Whitehead WE, Crowell MD, Robinson JC, Heller BR, Schuster MM: Effects of stressful life events on bowel symptoms: subjects with irritable bowel syndrome compared with subjects without bowel dysfunction. Gut 1992;33:825-830.
47.
Design of Treatment Trials Committee, Irvine EJ, Whitehead WE, Chey WD, Matsueda K, Shaw M, Talley NJ, Veldhuyzen van Zanten SJ: Design of treatment trials for functional gastrointestinal disorders. Gastroenterology 2006;130:1538-1551.
48.
Ford AC, Bercik P, Morgan DG, Bolino C, Pintos-Sanchez MI, Moayyedi P: Characteristics of functional bowel disorder patients: a cross-sectional survey using the Rome III criteria. Aliment Pharmacol Ther 2014;39:312-321.
49.
Day SJ, Altman DG: Statistics notes: blinding in clinical trials and other studies. BMJ 2000;321:504.
50.
Fletcher PC, Schneider MA, Van Ravenswaay V, Leon Z: I am doing the best that I can!: living with inflammatory bowel disease and/or irritable bowel syndrome (part II). Clin Nurse Spec 2008;22:278-285.
51.
Ernst E: Complementary medicine in gastroenterology: more than a fad? J Clin Gastroenterol 2003;36:453-454.
52.
Schneider MA, Fletcher PC: ‘I feel as if my IBS is keeping me hostage!' Exploring the negative impact of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) upon university-aged women. Int J Nurs Pract 2008;14:135-148.
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