Punica granatum peel extract on irritable bowel syndrome patients with predominant diarrhea: A randomized double‐blinded placebo‐controlled trial study

Abstract Background IBS is a chronic functional gastrointestinal disorder, with IBS‐D being the most common subtype. Patients with IBS‐D experience a lower quality of life than other patients with IBS, and current treatments do not provide relief for all individuals. Given the potential benefits of Punica granatum (Pg), also known as pomegranate, this trial aimed to evaluate the effects of its peel extract as a supplement on patients with IBS‐D. Methods In this trial, patients with a diagnosis of IBS‐D based on ROME IV criteria, fecal calprotectin levels >50 μg/mg, and normal colonoscopy findings were enrolled and then randomized in a 1:1 ratio to receive capsules (250 mg) of Pg peel extract or placebo (one capsule every 12 h) for 8 weeks. Patients were evaluated regarding the severity of abdominal pain, abdominal bloating, diarrhea, quality of life, and fecal calprotectin levels. Results In total, 62 patients with IBS‐D divided into two groups of 31 receiving supplement or placebo were analyzed. The results showed significant improvements in the severity of abdominal pain, diarrhea, and quality of life compared with the beginning of the trial and placebo group ( p < 0.05). In addition, the severity of abdominal bloating and fecal calprotectin levels improved compared with the beginning of the trial but not compared with the placebo group. Supplements were tolerated well, with no complications or allergic reactions reported, even at mild intensities. Conclusions Pg peel extract may be helpful for patients with IBS‐D as a therapeutic supplement by improving their clinical symptoms and quality of life.