Indigo Naturalis for Ulcerative Colitis
Ulcerative colitis can be a painful and lasting inflammatory bowel disease. The condition affects the colon and sometimes the rectum. The inner lining (the mucosa) of the colon is most affected. It is called ulcerative because ulcers or sores develop in the colon lining. They can also bleed.
The image above illustrates this. The endoscopy image on the right side is of a healthy rectal colon. The image on the left shows the results of ulcerative colitis.
Periods of relapse will often be evidenced by blood in the stools. Anemia can also occur as a result of blood loss.
Those who have it will experience alternating remission and relapse. Relatively pain-free periods will be replaced by periods lasting days, weeks or months of gripping abdominal pain and diarrhea. Remission periods can last days, weeks or sometimes longer.
Ulcerative colitis and Crohn’s disease are very similar. Their symptoms are practically the same. They are also both considered autoimmune disorders. The primary difference is that Crohn’s will affect the entire digestive tract. Ulcerative colitis is restricted to the colon and rectum.
Nearly a million Americans have ulcerative colitis. It often develops between the teenage years and early adulthood. But really it can develop anytime. Some suggest there is a genetic component because it tends to run in families. But there is no reason to think it is not associated with a family tradition of diet or lifestyle factors.
In this article
Conventional treatments for ulcerative colitis
There is currently no conventional cure for ulcerative colitis. Most conventional treatments seek to reduce the symptoms. These include medications such as corticosteroids like Prednisolone; aminosalicylates like mesalamine (Pentasa, Rowasa and others) and sulfasalazine (Azufidine); and thiopurines (such as azathioprine (Imuran), mercaptopurine and others).
Each of the above provides some temporary relief of symptoms. Some come with significant adverse effects too. And none provide a cure.
Surgical treatments for ulcerative colitis include the removal of diseased sections of colon. As many as a third of ulcerative colitis patients are operated on to remove parts of the colon. Sometimes the entire colon will be removed in urgent cases.
Herbal medicine for ulcerative colitis
It is not as if ulcerative colitis and similar intestinal conditions are new. Ayurveda and Chinese Medicine utilized herbs for thousands of years to treat conditions symptomized by abdominal pain. They might not have employed endoscopy. Nor specified ulcerative colitis. But indeed they did treat this and similar conditions quite successfully using natural herbal medicines.
This has been proven out recently in the use of a Traditional Chinese Medicine herbal extract called Qing-Dai. It is also called Indigo Naturalis. The extract is derived from Indigofera tinctoria or other indigo related plants. These include Baphicacanthus cusia, Isatis tinctoria, and Polygonum tinctorium.
The result is a dark blue or blackish powder – an indole powder – that has been used to treat mouth ulcers, abscesses, carbuncles and inflammation of many types. It is said to remove or pull out toxins and thus allow the sore to heal more quickly.
The Chinese consider Indigo Naturalis’ action to be heat-clearing and toxin-reducing. These two actions have been considered to be the cause of inflammatory relief for thousands of years. More below on how Indigo Naturalis works to treat colon ulcers.
Clinical evidence: Indigo Naturalis and ulcerative colitis
Researchers from Japan’s Keio University School of Medicine in Tokyo have recently put Indigo Naturalis to the test.
The medical doctors enrolled 20 patients with a history of ulcerative colitis. Their medications were discontinued between two and four weeks from the beginning of the study. The only treatment that was allowed to continue was thiopurine. And this was only allowed if the medication was started more than three months before the study – and only if the current response was stable.
The researchers then proceeded to treat each patient with 1,000 milligrams of Indigo Naturalis (Qing Dai) in capsules twice a day for two months. (Powdered Qing-Dai was imported from Fujian, China to the University Hospital.)
Before and after the treatment period, the researchers carefully examined each patient. This included endoscopy. After the eight week period, the researchers found the Indigo Naturalis had resulted in a 72 percent improvement (clinical response) among the patients.
They also found that the Indigo Naturalis resulted in a 61 percent increase in mucosal healing. And the Indigo Naturalis increased remission rates by 33 percent after only two months of treatment.
In addition, the researchers found that the Indigo Naturalis treatment reduced fecal blood release levels. It also improved C-reactive protein (CRP) levels. This indicates a reduction of inflammation.
In addition, the researchers found that endoscopic examination scores significantly improved.
The net results of the study found that the Qing Dai treatment resulted in the full remission of 30 percent of the patients, while another 35 percent had significant symptom improvement. The treatment did not seem to help 25 percent of those treated, and 10 percent of the patients discontinued the treatment before the end of the study.
Using Mayo scores, the researchers found the group has a whole improved from an average score of 5.7 to 1.4. The net clinical activity index (CAI) scores went from an average of 9.4 to 3.5 at the end of the two months.
The below image is representative of the endoscopies of the entire group. The left side is prior to treatment with Qing Dai. The right side is after two months of treatment. Most of these show a complete or nearly complete elimination of ulcers and mucosal damage.
The researchers concluded in their discussion:
“In this study, we demonstrated that a traditional Chinese medicine Qing-Dai is overall safe and effective for the induction of remission in ulcerative colitis patients.”
Not the first study to show Qing Dai treats UC
In 2013, researchers from the Institute of Clinical Medicine at Japan’s University of Tsukuba Graduate School also studied Indigo Naturalis treatment for ulcerative colitis.
The researchers studied nine patients with a history of ulcerative colitis. They had all been taking conventional medication but volunteered to be treated alternatively. The doctors gave each two grams per day (2,000 milligrams) of the Qing Dai powder for four months.
The researchers found the treatment resulted in a significant improvement among the patients. Utilizing the clinical activity index (CAI), the researchers scored the activity of the condition among the patients.
In the beginning of the study, the average CAI scores were 8.3. After the four months, the researchers found the Indigo Naturalis reduced the CAI scores to an average of 2.4. This means they had nearly a quarter of the condition activity (pain, inflammation and other symptoms) as they had before they began taking the Indigo Naturalis.
Furthermore, six of the seven patients that were taking prednisolone discontinued the use of the corticosteroid. Those who know this condition know how significant this is.
The researchers also found significant improvements in the patients’ endoscopic examinations. The photograph at the very top of this article shows the results of one of the patient’s endoscopic exam. The image on the left is the patient’s rectal colon before treatment with Indigo Naturalis began. The image on the right is after three months of treatment with the Qing Dai. As you can see clearly, the ulcers and mucosal damage have completely disappeared. Other patients showed similar results.
The researchers also reported no serious side effects among the patients.
Prior to this research, a 2009 paper published in the Chinese-German Journal of Clinical Oncology describes a study of seven patients with chronic hemorrhagic radiation proctitis. This might also be called inflammatory rectal bleeding. It is similar to and quite possibly a type of ulcerative colitis.
At any rate, the patients treated the patients in two-week long courses. Each course consisted of five days of 1.5 grams twice a day for five straight days every two weeks.
After one course, six of the seven patients showed significant improvement. After two courses, four patients had little or no rectal bleeding. After a follow-up period that averaged 10 months, the researchers found that only one patient had a relapse of bleeding. The others went into remission.
How does Qing Dai work?
The University of Tsukuba researchers tried to figure out why the Indigo Naturalis was so successful. They conducted electron spin resonance testing and determined that the indole compound was a hydroxyl radical scavenger.
The researchers also established that Qing Dai coats the mucosal membrane. This allows the mucosa to heal without becoming irritated. In addition, the Qing Dai seems to be anti-inflammatory in that it suppresses superoxide production. It also appears to affect neutrophil expression.
Research from Japan’s Keio University School of Medicine studied the indole compounds found in Qing Dai and found they also promoted healthy tight junctions in the intestinal mucosa. This is one of the mechanical elements of leaky gut syndrome.
The research has shown that Qing Dai suppresses the production of inflammatory cytokines such as interferon-alpha, interleukin-6 and nuclear factor kB (NF-kB). Decreased expression of tumor necrosis factor-alpha has also been seen.
The bottom line is this ancient herbal extract therapy deserves the attention of the medical community. Clinical research is confirming Indigo Naturalis’ efficacy and safety. Doctors that want to help their patients should consider this treatment.
Will Indigo Naturalis help similar conditions such as Crohn’s disease? It successfully and safely treated a number of chronic hemorrhagic radiation proctitis. But this could only be answered by further testing.
Discover: Qing Dai
Sugimoto S, Naganuma M, Kiyohara H, Arai M, Ono K, Mori K, Saigusa K, Nanki K, Takeshita K, Takeshita T, Mutaguchi M, Mizuno S, Bessho R, Nakazato Y, Hisamatsu T, Inoue N, Ogata H, Iwao Y, Kanai T. Clinical Efficacy and Safety of Oral Qing-Dai in Patients with Ulcerative Colitis: A Single-Center Open-Label Prospective Study. Digestion. 2016;93(3):193-201. doi: 10.1159/000444217.
Suzuki H, Kaneko T, Mizokami Y, Narasaka T, Endo S, Matsui H, Yanaka A, Hirayama A, Hyodo I. Therapeutic efficacy of the Qing Dai in patients with intractable ulcerative colitis. World J Gastroenterol. 2013 May 7;19(17):2718-22. doi: 10.3748/wjg.v19.i17.2718.
Yuan G, Ke Q, Su X, Yang J, Xu X. Qing Dai, a traditional Chinese medicine for the treatment of chronic hemorrhagic radiation proctitis. Chin-Germ Journal of Clinical Oncology. Feb. 2009, 8:114.
Sugimoto S, Naganuma M, Kanai T. Indole compounds may be promising medicines for ulcerative colitis. J Gastroenterol. 2016 May 9.