Picrorhiza kurroa is a medicinal herb traditionally used in Ayurveda for treating liver disorders and inflammatory conditions. In recent years, its potential role in managing colitis has been explored in scientific studies. The justification for its use in colitis is primarily scientific, though it has roots in traditional medicine for general inflammation.

Several preclinical studies have investigated the anti-inflammatory and immunomodulatory properties of Picrorhiza kurroa, particularly its active constituents such as picroside I and II. In animal models of colitis, extracts of Picrorhiza kurroa have demonstrated significant reductions in colonic inflammation, mucosal damage, and pro-inflammatory cytokine levels (such as TNF-α and IL-6). These effects are thought to be mediated by antioxidant activities, inhibition of NF-κB signaling, and stabilization of cellular membranes.

While the bulk of evidence comes from animal studies and in vitro experiments, there is a growing scientific basis for considering Picrorhiza kurroa as a supportive therapy in inflammatory bowel diseases like colitis. However, robust clinical trials in humans are still lacking, which limits the strength of recommendation. Therefore, the evidence rating for its use in colitis is moderate (3 out of 5), supported by promising preclinical data but requiring further validation in human studies.