Overview

Boswellia serrata has been investigated in small clinical trials involving individuals with inflammatory bowel disease (IBD), specifically ulcerative colitis (UC) and Crohn's disease. The evidence is graded Mixed / Limited because trials have produced inconsistent results, with some studies reporting statistically significant differences and others reporting no significant differences.

Important Context

IBD is a serious medical condition. The research summarized here should not be interpreted as establishing Boswellia serrata as a treatment for IBD. Management of IBD should be directed by a qualified gastroenterologist.

Ulcerative Colitis Trials

The most-cited study is a double-blind, randomized trial by Gupta et al. (1997) enrolling 30 participants with chronic colitis. Participants received either a Boswellia serrata gum resin preparation (900 mg/day) or sulfasalazine (3 g/day) for 6 weeks. Authors reported improvements in several outcome parameters in the Boswellia group. However, the study was small, had a short follow-up, and predates modern IBD trial methodology.

Crohn's Disease Trials

A study by Gupta et al. (2001) in Crohn's disease compared Boswellia extract to mesalazine over 8 weeks in 102 participants. Authors reported that changes in the Crohn's Disease Activity Index were similar between groups, with a numerical trend favoring Boswellia.

A subsequent larger, adequately powered randomized, double-blind, placebo-controlled trial (Holtmeier et al., 2011) in Crohn's disease patients in remission found no significant difference between Boswellia extract and placebo in maintaining remission over 52 weeks. This null finding is an important counterweight to earlier positive reports.

What Trials Have Reported
  • Small UC trial reported outcome improvements vs. sulfasalazine at 6 weeks
  • Small Crohn's trial reported similar CDAI changes to mesalazine
  • GI tolerability in reported trials was generally acceptable
What Remains Uncertain
  • Whether findings from small older trials would replicate in modern adequately powered trials
  • Efficacy in moderate-to-severe IBD with current standard-of-care comparators
  • Long-term safety and maintenance of effect
  • Whether null result in the 2011 Crohn's remission trial reflects true lack of effect

References

  1. 1Gupta I, et al. (1997). Effects of Boswellia serrata gum resin in patients with ulcerative colitis. European Journal of Medical Research. PubMed ↗
  2. 2Gupta I, et al. (2001). Effects of gum resin of Boswellia serrata in patients with Crohn's disease. Planta Medica. PubMed ↗
  3. 3Holtmeier W, et al. (2011). Randomized, placebo-controlled, double-blind trial of Boswellia serrata in maintaining remission of Crohn's disease. Inflammatory Bowel Diseases. PubMed ↗