Comparative Study on The Effectiveness And Safety of Cinnamon Stomachic Mixture And Turmeric Capsules in Patients With Flatulence

Abstract

Introduction and objective: Flatulence is a prevalent symptom, accounting for up to 50 percent of gastrointestinal disorders among patients receiving medical attention. Cinnamon stomachic mixture and turmeric capsules are included in the National List of Essential Herbal Medicines (NLEHM) for the alleviation of flatulence and bloating. The two herbal medicines are categorized as basic medicinal items of NLEHM; thereby can generally be prescribed by healthcare practitioners. This study aimed to compare the effectiveness in relieving flatulence, safety, and patient satisfaction of the cinnamon stomachic mixture (CM) against turmeric capsule (TC) in patients with flatulence.

Methods: This study was a quasi–experimental design with a pretest–posttest two–group method in patients with flatulence who sought medical attention at Tha Rong Chang Hospital in Surat Thani province. Sixty patients were randomly divided into two groups: the test group (CM group), and the comparison group (TC group). The patients were given CM (15 ml) or TC (2 capsules) three times daily after breakfast, lunch, and dinner for one week. The assessment of the study outcomes was based on patients’ characteristics, the severity of dyspeptic symptoms utilizing the Severity of Dyspepsia Assessment (SODA) scale, adverse events experienced after using medications, and a validated 10–item questionnaire to evaluate satisfaction with service provision and medication use.

Results: 1) The severity of symptoms. Comparison of mean severity scores of abdominal pain, flatulence, and other non–pain related symptoms within test group and comparison group, before and after the intervention showed statistically significant differences (p < 0.001). However, when comparing the mean severity scores specifically for abdominal pain between the two groups before and after taking the medications, no statistically significant differences were observed (p = 0.116 and p = 0.916). 2) Safety. After the consumption of CM and TC, there were 7 patients in the test (CM) group and 13 patients in the comparison (TC) group reporting adverse events; and all 20 subjects experienced only a single adverse event. The analysis of the proportion of patients with adverse events between the CM group and the TC group revealed no statistically significant difference (p = 0.1). The most frequently observed adverse event in the CM group was constipation (3 cases, 10%), followed by nausea, drowsiness, frequent hunger, and frequent burping (1 case each, 3.33%). In the turmeric group, burping was the most common reported adverse event (5 cases, 16.67%), followed by frequent hunger at 13.33%. 3) Satisfaction. When comparing the mean difference in satisfaction scores following the provision of services and the use of medications, it was found that both groups reported high levels of satisfaction. However, there was no statistically significant difference between the two groups (p = 0.916).

Discussion: The analysis of the effectiveness of cinnamon stomachic mixture and turmeric capsules in relieving the severity of flatulence, abdominal pain, and other symptoms based on SODA form showed comparable effectiveness and satisfaction. Adverse events experienced in both groups were minimal and resolved spontaneously.

Conclusion and recommendation: Cinnamon stomachic mixture was found to have comparable efficacy and safety to turmeric capsules in relieving the severity of flatulence, abdominal pain, and other non–pain symptoms in patients with flatulence. For future research, it is recommended that a study should be conducted to compare the efficacy and safety of cinnamon stomachic mixture against turmeric capsules in alleviating the symptoms of functional dyspepsia, which is the new indication of turmeric in NLEHM.