Impact of curcumin on gut microbiome

Table 4 Implications of gut microbiome in gastrointestinal disorders

Gastrointestinal disorder	Curcumin's effects	Mechanisms of action	Clinical implications
Inflammatory bowel disease	Ulcerative colitis. Reduces disease activity index and endoscopic scores. Increases beneficial bacteria (Lactobacillus, Bifidobacterium). Decreases pro-inflammatory bacterial species	NF-κB pathway inhibition; Modulates Th17/Treg balance through microbiota alterations; Improves barrier function	Efficacious as adjunct therapy with mesalamine
	Crohn's disease. Reduces inflammatory markers (TNF-α, IL-1β, IL-6). Strengthens epithelial barrier integrity	Modifies intestinal microbiota composition. Influences bacterial metabolite production	Shows promise in maintaining remission
Colorectal cancer	Suppresses growth of pro-carcinogenic bacteria. Enhances production of beneficial metabolites	Alters microbial diversity in colorectal cancer microenvironment; modulates bacterial enzyme activities related to carcinogenesis	Synergistic effects with conventional chemotherapy
IBS	Reduces abdominal pain and bloating. Normalizes bowel habits	Modifies gut microbiota composition. Improves gut-brain axis signaling	Effects vary across IBS subtypes (IBS-D vs IBS-C)
Celiac disease	Reduces intestinal inflammation	Modifies intestinal permeability. Influences microbiota adaptation to gluten-free diet	Potential role in managing non-responsive celiac disease
Gastric Disorders	Helicobacter pylori infection. Modification of gastric microbiota	Direct antimicrobial effects. Enhancement of mucosal defense	Synergistic effects with standard triple therapy
	Gastric cancer. Influences Helicobacter pylori-associated dysbiosis. Affects cancer stem cell populations	Modulates inflammatory responses	Potential role in prevention and therapy
Small intestinal bacterial overgrowth	Reduces bacterial overgrowth	Modifies small intestinal microbiota composition. Improves intestinal motility	Alleviates small intestinal bacterial overgrowth-associated symptoms
Radiation-induced enteritis	Reduces oxidative stress	Preserves beneficial microbiota. Modulates inflammatory response	Maintains intestinal barrier function
Drug-induced gastrointestinal injury	Non-steroidal anti-inflammatory drugs-induced damage. Maintains microbial homeostasis	Protects against mucosal injury; Reduces oxidative stress	Enhances mucosal recovery
	Chemotherapy-induced mucositis. Preserves microbiota diversity. Reduces inflammatory damage	Supports mucosal healing	Improves treatment tolerance

IBS: Irritable bowel syndrome; TNF-α: Tumor necrosis factor-alpha; IL: Interleukin.