Network meta-analysis of dietary supplements for ulcerative colitis management

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Frontiers in Medicine Published April 23, 2026 Medically reviewed April 25, 2026 DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider that specific dietary supplements may aid ulcerative colitis management, but evidence is limited and requires validation.

This is a network meta-analysis that synthesized evidence from 24 randomized controlled trials involving 1,491 participants with ulcerative colitis. The review evaluated 14 types of dietary supplements, including probiotics, selenium, flaxseed extract, vitamin A, resveratrol, curcumin, butyrate, synbiotics, and Achillea wilhelmsii, compared to conventional medical treatment or placebo.

The authors reported that probiotics and selenium had significant advantages for reducing the clinical activity index, with mean differences of −1.64 (95% CI −2.91 to −0.38) and −2.43 (95% CI −4.85 to −0.01), respectively. For the Mayo score, flaxseed extract and vitamin A showed a clear advantage, with mean differences of −1.53 (95% CI −2.82 to −0.24) and −1.93 (95% CI −3.82 to −0.04).

Regarding quality of life (IBDQ), probiotics, flaxseed extract, resveratrol, curcumin, and butyrate were associated with higher scores, with mean differences ranging from 7.78 (95% CI 1.39 to 14.17) for probiotics to 25.80 (95% CI 2.00 to 49.60) for curcumin. For C-reactive protein levels, synbiotics, flaxseed extract, and Achillea wilhelmsii showed significant reductions, with mean differences of −0.69 (95% CI −1.16 to −0.23), −0.8 (95% CI −1.16 to −0.44), and −2.95 (95% CI −3.52 to −2.38), respectively.

The authors noted limitations, including the number and quality of included studies, and emphasized that conclusions need validation by more high-quality, large-sample RCTs. Safety data were not reported. The findings suggest differentiated efficacy of supplements for adjuvant ulcerative colitis therapy, but associations do not establish causation, and results should not be generalized beyond ulcerative colitis.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedApr 2026

View Original Abstract ↓

BackgroundIn recent years, the application of dietary supplements in the treatment of ulcerative colitis (UC) has attracted more and more scholars’ attention, and a number of studies have shown that dietary supplements have a non-negligible role in improving the clinical symptoms and quality of life of UC patients. This article aims to compare the efficacy and safety of dietary supplement therapy of UC through a comprehensive network meta-analysis method.MethodologyA comprehensive literature search was conducted in multiple databases, including PubMed, the Cochrane Library, Embase, and Web of science, from their inception up to 30 October 2025. Network and routine meta-analyses using the mvmeta package in Stata 16.0 and Stata 12.0 software, and literature quality and risk of bias assessed using RevMan 5.3 software.ResultA total of 24 randomized controlled trials were conducted with 1,491 participants and 14 dietary supplements. The results showed that probiotics [MD = −1.64, 95% CI (−2.91 to −0.38)] and selenium [MD = −2.43, 95% CI (−4.85 to −0.01)] had significant advantages compared with conventional medical treatment or placebo in reducing clinical activity index. Flaxseed extract [MD = −1.53, 95% CI (−2.82 to −0.24)] and vitamin A [MD = −1.93, 95% CI (−3.82 to −0.04)] had a clear advantage over conventional medical treatment or placebo in reducing the Mayo score; at the same time, in terms of IBDQ, probiotics [MD = 7.78, 95% CI (1.39 to 14.17)], flaxseed extract [MD = 8.58, 95% CI (2.31 to 14.85)], resveratrol [MD = 9.18, 95% CI (2.45 to 15.91)], curcumin [MD = 25.80, 95% CI (2.00 to 49.60)], butyrate [MD = 20.50, 95% CI (9.80, 31.20)] with higher scores compared to conventional drugs or placebo, indicating an improved quality of life for patients; synbiotics [MD = −0.69, 95% CI (−1.16 to −0.23)], flaxseed extract [MD = −0.8, 95% CI (−1.16 to −0.44)], and Achillea wilhelmsii [MD = −2.95, 95% CI (−3.52 to −2.38)] all showed significant advantages compared with conventional medical therapy or placebo for reducing C-reactive protein levels.ConclusionVarious dietary supplements have shown differentiated efficacy in adjuvant UC therapy. Probiotics and selenium are effective in improving clinical symptoms; flaxseed extract showed consistent benefits in improving Mayo score, IBDQ score, and reducing CRP, ESR, and FCAL, and had a wide range of application prospects. Butyrate and curcumin have significant effects in improving quality of life; synbiotics and Achillea wilhelmsii have outstanding advantages in reducing CRP. Due to the limitations of the number and quality of included studies, the above conclusions still need to be validated by more high-quality, large-sample RCTs.