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75 Akram Et AlDiarrheaJMPR 11 1702

75 Akram Et AlDiarrheaJMPR 11 1702

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Journal of Medicinal Plants Research Vol. 6(25), pp.4159-4162 ,5 July, 2012 Available online at http://www.academicjournals.

org/JMPR DOI: 10.5897/JMPR011.1702 ISSN 1996-0875 ©2012 Academic Journals


Efficacy of herbal medicines in diarrheal diseases: A review
M. Akram1*, Muhammad Irfanullah Siddiqui2, Naveed Akhter3, Muhammad Khurram Waqas4, Saim Jamil1, Muhammad Akram5, Aubid Allah Khan3, Asadullah Madni3 and H. M. Asif3

Shifa ul Mulk Memorial Hospital, Hamdard University, Karachi, Pakistan. Department of Community Medicine, Faculty of Medicine, Umm Al-Qura University, Saudi Arabia. 3 Department of Pharmacy, the Islamia University of Bahawalpur, Pakistan. 4 Department of Pharmacy, the University of Faisalabad, Pakistan. 5 Department of Pharmacy, University of Sargodha, Pakistan.
Accepted 1 February, 2012


Medicinal plants have been used for treating diarrhea and other ailments. People all over the world are interested in using herbal medicines for various diseases. Allopathic system of medicine with their known side effect is not able to replace herbal medicine. Herbal medicine activities as anti-bacterial and antidiarrheal have been discussed that confirm the scientifically basis of the drug use in Unani system of medicine. This paper reviews the efficacy of some medicinal plants used for treatment of diarrhea and their anti‐diarrheal activities have been investigated preclinically and clinically. Basic scientific research has revealed the mechanisms by which some plants exhibit their therapeutic effects. The present literature emphasizes on efficacy of herbal medicine in diarrhea as well as its safer options of treatments. The present study indicates that the extracts of some plants may provide a safe and effective adjunctive therapeutic approach for the treatment of diarrhea. Key words: Diarrhea, infectious agents, medicinal plants, efficacy.

INTRODUCTION Diarrhea is a condition in which there is increase in stool weight to greater than 300 g per day. This is usually accompanied by increased stool frequency. Infectious agent responsible for diarrhea are enteroadhesive Escherichia coli, enteropathogenic E. coli, enterotoxigenic E. coli, Shigella, Salmonella (nontyphoid), campylobacter jejuni, Giardia lamblia, Entamoeba histolytica and Cryptosporidium. Host factors for persistant diarrhea include malnutrition, lactose intolerance and repeated bouts of diarrhoea. Herbal medicine has gained sufficient importance because of their safety, efficacy and cost effectiveness. Leucas aspera This plant belong to Lamiaceae family. Uses It is used for diarrhea, blood purifier, and loss of appetite. Stems of L. aspera are mixed with leaves of Azadirachta indica and leaves and fruits of Coccinia cordifolia and taken. Symplocos racemosa
*Corresponding author. E-mail: makram_0451@hotmail.com. Tel: 92-021-6440083. Fax: 92-021-6440079.

It is called lodh pathani and belongs to Symplococaceae family. It antibacterial activities have been studied. It


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inhibits the growth of variouis bacteria including E. Coli and organisms responsible for dysentery (Agarwal, 1998). Chikni mitti

billiary tract obstructions. It has anti-inflammatory effect and is prescribed in gouty arthritis and rheumatoid arthritis as well as other musculoskeletal disorders where it helps in relieving pain. Geranium wallichianum D. Don ex sweet

Tibbi name: Chikni mitti Englsih name: Kaolin Scentific name: Kaolinum Uses It is used in diarrhea and stops loose motion. It is also used in intestinal ulcers and is useful for relieving pain in inflammation (Usmanghani and Saeed, 1997). Mentha longifolia L. Local name: Wanly; whole plant is used for medicinal purposes. It is effective in vomiting and all types of diarrhea and dysentery. Its powder is used in asthmatic conditions where it acts as bronchodilator and reverses the bronchial obstructions. Acacia niloltica (L.) Delile Local name: Kikar. It is effective in toothache. It has astringent activity. Wood, leave and gum is usually prescribed. Wood is used in house constructions and is used as fuel in Punjab and rural areas where gas is not available. Its gum is effective in diarrhea and dysentery. Its efficacy in diabetes mellitus has also been reported but further study should be carried out to find out active constituents that are responsible for these activities. Acorus calamus L. Local name: Skhawaja. Rhizome of this plant is prescribed. It is effective in respiratory tract infections including cough. It is antispasmolytic and is used in abdominal colic. Its activity as antidysenteric agent has been reported as well. Berberis lycium Royle Local name: Toor Kwaray. It is eaten and is prescribed in diarrhea and dysentery. Its efficacy in diarrhea has been studied. It is effective in respiratory tract infections especially tonsillitis and pharyngitis. It relieves abdominal pain and is prescribed in all types of abdominal pain where it acts as antispasmolytic agent. It is prescribed in liver ailments including hepatitis, hepatoma, jaundice and

Local name: Sra zeal. Roots of this plant are used for medicinal purposes. It is effective in mouth ulcers. It is prescribed in diarrhea and dysentery. It stops bleeding and is effective in leucorrhea. Oxalis corniculata L. Botanical name: Oxalis corniculata L., Local name: Khati Booti, Family: Oxalidaceae. Part used includes fruit and seeds. This plant in combination with cumin seeds is used for treatment of diarrhea and dysentery (Javaid and Shah, 2007). Parthenium hysterophorus Botanical name: Parthenium hysterophorus L.; Local name: Chatak chandni, Family: Asteraceae. Part used: Whole plant. This plant is used in diarrhea and dysentery. Hypericum perforatum L. Local name: Sheen chai. Part used: Fruit and shoot. It is prescribed in urolithiasis. It is effective in abdominal pain and acts as antispamolytic agent. Its decoction is prescribed in irregular menstruation. It is used as blood purifier and is found effective in piles, prolapsed uterus and anus and diarrhea (Ahmadi et al., 2010). Justcia adhatoda L. Local name: Baikar, Part used: Leaves. It is effective in diarrhea and dysentery. It is prescribed in musculoskeletal disorders in relieving pain. It is effective in respiratory tract infections such as pneumonia and cough. It is prescribed in relieving swelling conditions. It antispasmodic and is prescribed in abdominal pain. It is blood purifier and is used in scabies, eczema and various other skin disorders. It is commonly used in ear and nose diseases where it acts as antiseptic and intibacterial agent (Abbasi, 1999). Allium cepa L. English name: Onion; local name: Piaz; Arabic name:

Akram et al.


Basal. This is usually prescribed in diarrhea and dysentery. it is prescribed in gastrointestinal disorders. It is effective in cholera. It is used in respiratory tract infections. It helps in reducing temperature and is prescribed in fever. It is effective in sexual disorders and helps in improving sperm production (Bartram, 1995). It is used in hepatic disorders including hepatitis. Ocimum bacilicum O. bacilicum seeds are used in chronic diarrhea, dysentery and gonorrhea in the form of infusion. Seeds are recommended in complaints of urinary tract infections such as gonorrhoea (Baquar, 1989). Randia spinosa The bark is effective in diarrhea, dysentery, rheumatism, pain of bruises and rheumatic pains (The wealth of India, 1969). Quercus incana It is used in premature ejaculation and sexual weakness, diarrhea and dysentery (Usmanghani and Saeed, 1997). Ziziphora tenuior Tibbi name; Mushk taramshi, Family; Lamiaceae. It is used in fever and with butter or milk in dysentery (Jain and Filipps, 1991). Safoof Muqliasa Muqliasa is word of Suryani Language, which is spoken for word Biryan (Roasted) as all its ingredients are used in roasted form. It is prescribed in diarrhea and dysentery. It decreases the intestinal movement and relieves the pain during dysentery. It acts as spasmolytic and is effective in abdominal colic. Its ingredient is used in digestive problems as a simple drug. In compound form, all ingredients work synergistically and help in increasing efficacy of this formulation. This drug contains various ingredients including Asparagus officinalis, Carum carvi, Terminelia chebula, Allium ascalonicum, Linum usitatissimum and Pistacia lantiscus (Hifzul, 2003).

was introduced by Kindi. It is also known as Jawarish Kindi. It is also called Majun Panjnosh /Fanjnosh due to its five ingredients. This is available in Pakistan and India varying more or less ingredients. It is effective in gastric disorders, and is prescribed in viral, bacterial infections. It is effective in loose motion; ingredients of this formulation include Rosa damascena flower, Cyperus scariosus root, Valerina wallichil DC root, Pistacia lantiscus gum, Caryophyllus aromatica bud, Nardostachis jatamansi root, Myristica fragrans fruit coat, and Amomum subulatum seed ((Hifzul, 2003).

RESEARCH STUDY The effect of steep water and slurry from two varieties of sorghum (red and white) was evaluated on some bacteria that are involved in causing diarrhea; these organisms includes Salmonella typhimurium, Shigella disenteriae, Staphylococcus aureus, Escherichia coli and Enterobacter spp. Both the steep water and slurry were found to be effective against all test organisms, except for Enterobacter which was only inhibited by the steep water from a white variety of sorghum. The slurry of white and red sorghum were effective against E. coli and S. dysenteriae, while the steep water from red and white varieties were effective against S. dysenteriae. This study shows that sorghum could be used to treat bacterial diarrhea (Ojokoh, 2011). A study was conducted to evaluate the antibacterial activity of aqueous, ethanol and acetone extracts against 66 multidrug resistant isolates of pathogens (E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Enterococcus faecalis) by disc diffusion method. Zingiber officinale and Punica granatum exhibited antibacterial activity against E. coli. Terminalia chebula and Ocimum sanctum showed antibacterial activity against K. pneumoniae. Cinnamomum cassia was efficacious against P. aeruginosa while A. indica and O. sanctum showed antibacterial activity against E. faecalis. This study validates the use of these medicinal plants in the treatment of infectious diseseases (Anjana et al., 2009). The antimicrobial activities of various extract of Z. officinale (ginger) against E. coli and P. aeruginosa were investigated using the Agar and tube diffusion method. This study indicated that ginger is effective against these organisms. This study shows its antimicrobial activity, thus confirming its use in folk medicine (Auta et al, 2011). Z. officinale has been used for treatment of diarrhea. A study was carried out to evaluate the anti-diarrheal activity of Z. officinale. Albino wistar rats were selected for study. Diarrhoea was induced by castor oil. Z. officinale extract was given to albino rats (wistar). The level of protection offered by the extracts was compared with a standard anti-diarrhea agent (Diphenoxylate). The effect of the extract on the intestinal motility was also investigated. The extract showed reduction in the transit

Anooshdaru Sada It is a Persian word, which means Dawae Hazim (Digestive). It is an Indian origin drug. In Arabs, this drug


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time of ingested charcoal that is indicative of reduction in the intestinal motility. Conclusively, Z. officinale has anti-diarrhea activity. Previous study shows that the extracts have antimicrobial action as well (Nwoko et al., 2008). Diarrhea is common in developing countries that are caused by various organism including enteropathogenic E. coli (EPEC). Pathology of enteropathogenic E. coli (EPEC) infection is due to the inflammatory responses of infected intestinal epithelium through secretion of proinflammatory cytokines such as interleukin (IL)-8. Various medicinal plants are used as antidiarrheal agents. A study was carried out to investigate the effect of medicinal plants on secretion of IL-8 by epithelial cells in response to EPEC infection. For the study, four medicinal plants were selected including Aegle marmelos, Cyperus rotundus, Psidium guajava and Z. officinale. The decoction of these plants was used to evaluate effect on secretion of IL-8 by a human colon adenocarcinoma cell line, HT-29 infected with E. coli E2348/69. Two protocols were used, including pre-incubation and post-incubation. Result of this study was that secretion of IL-8 was decreased by P. guajava in the post-incubation protocol and increased in the pre-incubation protocol. A similar increase was seen with C. rotundus in the preincubation protocol. There was no effect on IL-8 secretion by the A. marmelos and Z. officinale in both protocols and with C. rotundus in the post-incubation protocol. The postincubation protocol, in terms of clinical relevance, indicates the effect of the plant decoctions when used as treatment. Hence P. guajava is effective in reducing the acute inflammatory response of the intestinal epithelial cells in response to EPEC infection (Brijesh et al, 2011). Conclusion Modern medicine has also begun to admit that herbal medicines are effective for various diseases. There are a number of herbs that have anti-diarrheal activity. Basic scientific research has helped us in understanding the mechanisms by which medicinal plants exert the therapeutic effects. In this work, the herbs that have potential for treatment of diarrhea have been documented. With great progress in the modern system of medicine, herbal medicines are still in use for various ailments. These are efficient, cost effective and exert fewer side effects, according to several studies.

REFERENCES Abbasi MA (1999). Ethanobotanical study of District Haripur, PhD dissertation, University of Peshawar, Peshawar, Pakistan, pp. 119123. Ahmadi CH, Minaei S, Bassiri AR, Almassi M, Arabhosseini A (2010). Moisture desorption isotherms of St. John’s wort (Hypericum perforatum L.) leaves at three temperatures. Int. J. Food Agric. Environ., (JFAE) 8(3,4): 132-135. Agarwal VS (1998). Economic plants of India, Kalaish Prakashan, Calcutta, India, pp.194-196. Anjana S, Chandraker S, Patel V, Ramteke P (2009). Antibacterial activity of medicinal plants against pathogens causing complicated urinary tract infections, Ind. J. Med. Pharmac. Sci., 71(2): 136-139 Auta K, Galadima A, Bassey J, Olowoniyi O, Moses O, Yako A (2011). Antimicrobial properties of the ethanolic extracts of Zingiber officinale (Ginger) on Escherichia coli and Pseudomonas areuginos, Ann. Biol. Res., 2 (3): 307-311) Baquar SR (1989), Medicinal and poisonous plants of Pakistan, Printas, Karachi, pp. 279-280 Bartram T (1995) Encyclopaedia of herbal medicine, grace publishers, mulberry court, Stour road, Christ church, New Zealand, pp. 342-344. Brijesh S, Pundarikakshudu T, Tannaz J (2011). Study on effect of antidiarrheal medicinal plants on enteropathogenic Escherichia coli induced interleukin-8 secretion by intestinal epithelial cells. Altern. Med. Stud., 1(16): 64-69 Hifzul K (2003). Shamsher’s Morakkabat (Unani Formulations) . Ed 1, Shamsher Publisher and Distributors, Dist. Aligarh, India, p. 59 Jain SK, Filipps RA (1991), Medicinal plants of India, volume 1, Reference publications Inc. Michigan, U.S.A., pp. 849-850. Javaid A, Shah MBM (2007). Phytotoxic effects of aqueous leaf extracts of two Eucalyptus spp. against Parthenium hysterophorus L. Sci. Int., 19(4): 303-306. Nwoko E, Unekwe E, Chilaka KC, Nwobodo EC, Okwuosa CN (2008). The Anti-Diarrhea Properties of Zingibier Offcinale, Trop. J. Med. Res., 12(1): 18-21 Ojokoh A (2011). In vitro effect of steep water and slurry from fermented sorghum varieties on bacteria that causes diarrhea. Afr. J. Biotech., 10(77): 17712-17715 Usmanghani K, Saeed A (1997). Indusyunic Medicine, Department of pharmacognosy, University of Karachi, pp. 630-632 The wealth of India (1969). A dictionary of Indian raw material and industrial products. Ph-Re, Council of Sceintific and industrial Research, New Delhi, India, (8): 303-305

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