Medicinal and Edible Plants for the Management of Inflammatory Bowel Disease: Synergistic Modulation of the Microbiota–Metabolite–Immune Axis

Inflammatory bowel disease (IBD) is a chronic condition driven by the intertwined interplay of gut dysbiosis, immune perturbation, and metabolic imbalance. Current single-target therapies often fail to durably restore homeostasis in this complex ecosystem, and have thereby increased interest in diet-based holistic interventions. Plants traditionally used as both food and medicine, such as Crataegus pinnatifida, Ganoderma lucidum, and Codonopsis pilosula, are natural products that possess both nutritional and therapeutic attributes. The use of such plants is commonly referred to as medicinal food homology (MFH) in East Asian literature. Their multi-component nature offers the potential to modulate intestinal homeostasis through multi-target synergy. This review systematically discusses how MFH regulates the “microbiota–metabolite–immune” axis via key bioactive constituents like polysaccharides, curcumin, and geniposide. Specifically, these constituents differentially influence short-chain fatty acid (SCFA) production, oxidative stress, and bile-acid signaling to thereby enable integrated regulation of the gut micro-ecosystem and host immune function. In parallel, we critically address the translational challenges of extrapolating animal-model findings to clinical applications, and propose a precision-intervention framework that integrates chemical standardization, multi-omics, artificial intelligence, and advanced ex vivo validation models to both overcome MFH’s intrinsic complexity and facilitate evidence-based, personalized IBD management.