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Effect of garlic and cabbage on healing of gastric ulcer in experimental rats

Article  in  Medicinal Chemistry Research · June 2014

DOI: 10.1007/s00044-014-1092-z

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Med Chem Res
DOI 10.1007/s00044-014-1092-z
ORIGINAL RESEARCH
Effect of garlic and cabbage on healing of gastric ulcer
in experimental rats
Taibi Ben Hadda • Naser A. ElSawy •
Eslam A. M. Header • Yahia N. Mabkhot •
Mohammad S. Mubarak
Received: 27 October 2013 / Accepted: 9 June 2014
Ó Springer Science+Business Media New York 2014
Abstract The effect of garlic (Allium sativum) and cab-
bage (Brassica oleracea var. capitata) extracts on the
healing of gastric ulcer in experimental rats has been
investigated. Thirty-three albino male rats (115 ± 4 g
B.Wt. each) were used and divided into 6 groups (n = 6
rats); one was used as a negative control while the others
were given aspirin orally (200 mg/kg B.Wt.). One of these
groups was employed as a positive control and the others
were administrated with 150 or 300 mg/kg B.Wt. doses of
garlic and cabbage juice for 7 days. The length of the
gastric ulcer, the volume of gastric juice, the total acidity,
the pH value, the total bacterial count, and the histopa-
thological changes of the stomach were examined. Results
revealed that oral administration with both tested plant
extracts reduced the length of gastric ulcer, the total acid-
ity, the volume of gastric juice, the bacterial count, and the
histopathological changes caused by aspirin. On the other
hand, both aqueous plants extract increased the pH value of
gastric juice. It is concluded that, garlic and cabbage
extract could be used for healing acute gastric ulcer.
T. Ben Hadda (&)
Laboratoire Chimie Matériaux, FSO, Université Mohammed 1er,
60000 Oujda, Morocco
e-mail: taibi.ben.hadda@gmail.com; tbenhadda@yahoo.fr
N. A. ElSawy (&)
Department of Anatomy and Embryology, Faculty of Medicine,
Zagazig University, Zagazig, Egypt
e-mail: naser_elsawy@ymail.com
N. A. ElSawy
Department of Laboratory Medicine, Faculty of Applied Medical
Sciences, Umm Al Qura University, Makkah, Saudi Arabia
E. A. M. Header
Clinical Nutrition, Faculty of Applied Medical Sciences, Umm
Al Qura University, Makkah, Saudi Arabia
MEDICINAL
CHEMISTRY
RESEARCH
Keywords Garlic (Allium sativum) 
Cabbage (Brassica oleracea var. capitata) juice 
Aspirin ulcer  Histopathological changes  pH value 
Bacterial count  Gastric juice
Introduction
Peptic ulcers are erosions or open sores in the mucous
lining of the stomach or duodenum (the first part of the
small intestine). The term ‘‘peptic’’ distinguishes peptic
ulcers from ulcerations that affect other parts of the body
(e.g., diabetic leg ulcers). Peptic ulcer should never be
treated without proper diagnosis, since they are usually
caused by infection from Helicobacter pylori (H. pylori).
Patients with peptic ulcer due to infection should receive
conventional treatment directed toward eradicating the
organism. This treatment consists of various combinations
of antibiotics, acid blockers, and bismuth-under medical
supervision. In addition, ulcers can also be caused or
E. A. M. Header
Department of Nutrition and Food Science, Faculty of Home
Economics, Minufiya University, Shebin El Kom, Egypt
Y. N. Mabkhot
Department of Chemistry, Faculty of Science, King Saud
University, Riyadh, Saudi Arabia
M. S. Mubarak
Department of Chemistry, The University of Jordan, Amman
11942, Jordan
123

aggravated by stress, alcohol, smoking, and dietary factors
(Suadicani et al., 1999).
The symptoms of peptic ulcer are occasionally painless.
However, the most common symptom is a dull ache in the
upper abdomen that usually occurs 2–3 h after a meal;
eating relieves the ache. Other common symptoms include
weight loss, bloating, belching, and nausea. Untreated,
peptic ulcers often bleed and may cause sharp burning pain
in the area of the stomach or just below it (David et al.,
2002).
Many years ago, researchers reported that cabbage juice
accelerates healing of peptic ulcers. According to some
reports, daily intake of a quart of cabbage juice led to
symptom relief. Although only preliminary research sup-
ports this approach of treatment, many doctors claim
considerable success using one quart per day for
10–14 days, with ulcer symptoms frequently decreasing in
only a few days; carrot juice may be added to improve the
flavor (Cheney, 1949; Noess, 1984).
On the other hand, garlic has been reported to have anti-
Helicobacter activity in test-tube studies. In a preliminary
trial, garlic added as supplement (300 mg in tablets three
times daily for 8 weeks) failed to eradicate H. pylori in
participants with active infections (Sivam et al., 1997;
Chung et al., 1998). Similarly, addition of 10 sliced cloves
of garlic to the meals of participants with active H. pylori
infections failed to inhibit the growth of the organism
(Jensen et al., 1992). Further trials using garlic extracts are
needed to validate the anti-Helicobacter activity observed
in test tubes. Therefore, there is weak evidence to support
the use of garlic for H. pylori-related peptic ulcers (Graham
et al., 1999).
Garlic oil, however, was evaluated for gastro protective
activity against ethanol-induced ulcers. Reactive oxygen
species are involved in the pathogenesis of these ulcers.
The possible involvement of garlic oil in restraining the
oxidation process produced in gastric tissues was also
investigated. Effect of garlic oil on ulcer index, lipid per-
oxidation, and antioxidant enzyme activity (GPx, catalase,
SOD) was undertaken. Pretreatment with garlic oil in doses
of 0.25 and 0.5 mg/kg, 30 min before administration of
ethanol (1 mL of 100 %) caused a decrease in ulcer index
and lipid peroxidation and improved the decrease in anti-
oxidant enzyme levels caused by ethanol. This result sug-
gests that garlic oil possesses antioxidant properties and
provides protection against ethanol-induced gastric injury
(Khosla et al., 2004).
In view of the wide interest in the treatment of ulcer, we
present, herein, data pertaining to the anti-ulcer activity of
garlic (Allium sativum) and cabbage (Brassica oleracea
var. capitata) juice in experimental rats. These natural
foods may be used as starting points in the development of
new ulcer drugs.
123
Med Chem Res
Materials and methods
Material and rats
Garlic (Allium sativum L.) and cabbage (Brassica oleracea
var. capitata) were purchased as crude dried material from
local markets in Egypt. Garlic and cabbage were ground
using a porcelain grinder to pass through sieve-mesh pores
of 1 mm in diameter. Extracts were prepared by mixing
1 gm of powdered leaves with 100 mL of distilled water.
The mixture was boiled for 10 min and left to cool for
15 min. The aqueous extract was filtered, using filter paper,
to remove the particulate matter (0.2 mm) and the filtrate
was freely dried (Lyophilized) and reconstituted in 1.5 mL
of distilled water (100 mg/kg body weight) (Shin, 2005).
Aspirin was obtained as Aspegic from the Amirya
Pharmaceutical Industries (Cairo, Egypt). Injections were
prepared by dissolving one vial’s content in 25 mL of
distilled water. A volume of 1 mL of this solution was
given orally (at the level 200 mg/kg body weight) for 1 day
to induce acute gastric ulcer in Albino male rats. Rats were
fed on a ration (a basal diet devoid from starch) composed
of wheat bran, soya bean powder 44 %, fish meal, molas-
ses, fibers 3.3 %, sodium chloride, calcium carbonate,
calcium phosphate, methionine, and ash (net protein 22 %
and fats 4.7 %). The diet was fed and water was provided
ad libitum for the experimental period. This ready to use
ration for Sprague–Dawley rats was made by the Cairo
Agric. Dev. Company (Giza, Egypt). Albino male rats
(115 ± 4 g B.Wt.) of Sprague–Dawley strain were
obtained from the Laboratory of Animal Colony, Faculty of
Home Economics, Minufiya University, Egypt. Two
microbial cultures were employed, the first was nutrient
agar for recording the total count of bacteria and the second
was potato dextrose agar for counting the molds and yeasts.
Methods
Grouping design and feeding of rats
The experiment was performed in the Animal House of the
Faculty of Home Economics, Minufiya University. Rats
were housed in wire cages in a room maintained at
25 ± 2 °C and kept under normal healthy conditions. All
rats were kept on basal diet for a week before treatment.
After 1 week, rats were divided into two main groups. The
first group (n = 6 rats) was fed on the basal diet only as a
negative control (healthy rats) while rats in the second
group (n = 30 rats) were treated orally with 200 mg/kg
B.Wt. of aspirin solution for induction of acute gastric
ulcer according to a procedure previously described
(Agrawal et al., 2000). Rats with aspirin-induced gastric
ulcers were divided into five groups (n = 6 rats in each
Med Chem Res
group). One group was left as a positive control while the
other groups were administrated with garlic and cabbage
juice at doses of 150 and 300 mg/kg B.Wt for 7 days.
Measurement of the length of gastric ulcer
On the last day of experimental period, all rats were starved
for 12–14 h and only allowed to drink water. Next morn-
ing, all rats were sacrificed, and their stomachs were tied
around both openings (cardiac & pyloric sphincters) and
injected with distilled water (3 mL). The gastric juice was
then collected in sterilized tubes. The stomachs were
opened longitudinally, washed with saline and examined
under dissecting microscope for ulcer. The length of gastric
ulcer was measured and expressed as mean ± SD for each
group. The curative ratio was then calculated for each
treated group according to the method described by Akhtar
and Ahmad (1995), using the following equation:
Curative ratio ðCRÞ ¼ ðLC  LT=LCÞ  100;
where LC is the length of ulcer in positive control group
and LT is the length of ulcer in treated group.
Measurement of the volume of gastric juice
Gastric juice was collected in tubes and centrifuged at
500 rpm for 5 min. The volume of gastric juice was mea-
sured with a graduated cylinder.
Determination of the standard normality of NaOH
Normality of NaOH solution was determined according to
the method previously described (AOAC, 1995).
Microbiological examination
1- Total bacterial count
Petri dishes were prepared for recording the total bac-
terial counts on the nutrient agar media (Oxoid, 1979) as
described in the literature (Difco’s Manual, 1971).
2- Molds and yeasts
The enumeration of molds and yeasts was carried out as
recommended by the Standard Methods for the Examina-
tion of Diary Products (1960) using potato dextrose agar
(acidified media).
Organs weight analysis
Hearts, lungs, livers, spleens, and kidneys of the sacrificed
rats were carefully removed, washed with saline solution,
dried with filter paper, and weighed independently. The
relative organs weight was calculated as previously
described (Chapman et al., 1959) using the following
equation:
Relative organ’s weight ðROWÞ
¼ ðOrgan weight=Total body weightÞ  100:
Histopathological study
Specimens from stomachs were collected from rats of all
experimental groups, fixed in 10 % neutral buffered for-
malin (pH 7.0), dehydrated in ethyl alcohol, cleared in xylol,
and embedded in paraffin. Four to six microns thick sections
were prepared and stained with hematoxylin and eosin for
examination of both fore and glandular parts of the stomach
according to a procedure outlined by (Carleton, 1976).
Statistical analysis
Data were analyzed by means of one-way analysis with a
program at the Scientific Computer Center, Faculty of Home
Economics, Minufiya University, using the statistical ana-
lysis software (Duncan Multiple Range Test, one-way
ANOVA test) according to Armitage and Berry (1987). Data
are expressed as the mean ± SD, and P \ 0.05 was con-
sidered statistically significant.
Results and discussion
In the present work, the effect of garlic (Allium sativum) and
cabbage (Brassica oleracea var. capitata) extract on the
healing of acute gastric ulcer induced by aspirin in rats was
investigated. Parameters involved were length of gastric ulcer,
volume of gastric juice, pH, total acidity, microbiological
examination, relative organs weight, and histopathological
examination of fore and glandular parts of stomachs.
Effect of garlic and cabbage extract on the length
of gastric ulcer in rats
Data presented in Table 1 show the effect of garlic (Allium
sativum L.) and cabbage (Brassica oleracea var. capitata)
extracts on the length of gastric ulcer in the rats. Results
reveal that a single oral administration of aspirin (200 mg/
kg B.Wt.) induced gastric ulcer in rats; the mean length of
gastric ulcer in positive control and negative control groups
were 6.87 ± 0.89 and zero mm, respectively. This means
that the mean length of gastric ulcer in positive controlled
group has increased by 6.87 ± 0.89 mm. In addition,
results reveal that oral administration of garlic juice at a
dose of 300 mg/kg B.Wt., and cabbage juice at the same
dose for 7 days after aspirin (200 mg/kg B.Wt.) decreased
the length of gastric ulcer to 1.86 ± 0.14, 2.33 ± 0.21 mm,
respectively.
123
 Med Chem Res

Table 1 Effect of garlic (Allium sativum L.) and cabbage (Brassica Table 2 Effect of garlic (Allium sativum L.) and cabbage (Brassica
oleracea var. capitata) extract at two doses on the length of gastric oleracea var. capitata) extract at two doses on the volume of gastric
ulcer in rats juice collected from stomachs of rats
Groups Aspirin and Doses Gastric ulcer CR Groups Aspirin and Doses Volume of DR
extracts (mg/kg B.Wt.) length (mm) (%) extracts (mg/kg B.Wt.) gastric juice (mL) (%)
Mean ± SD Mean ± SD

Control -ve Control -ve

1 – – 0.00 – 1 – – 0.26 ± 0.05e –
Control ?ve Control ?ve
2 Aspirin (Asp) 200 6.87 ± 0.89a – 2 Aspirin (Asp) 200 0.8 ± 0.14a –
Treated groups with plant extracts Treated groups with plant extracts
3 (Asp) ? garlic 150 2.85 ± 0.163bc 58.51 3 (Asp) ? garlic 150 0.44 ± 0.03bc 45.00
de
4 (Asp) ? garlic 300 1.86 ± 0.14 72.92 4 (Asp) ? garlic 300 0.34 ± 0.05d 57.5
5 (Asp) ? cabbage 150 3.13 ± 0.41bc 54.44 5 (Asp) ? cabbage 150 0.59 ± 0.13b 26.25
6 (Asp) ? cabbage 300 2.33 ± 0.21c 66.08 6 (Asp) ? cabbage 300 0.37 ± 0.01c 53.75
Means with different superscript letters in the column denote high Means with different superscript letters in the column denote high
significant differences (P \ 0.01), but those with similar superscript significant differences (P \ 0.01), while similar superscript letters
letters denote non- significance denote non- significance
CR curative ratio DR decrease ratio

These results are in agreement with those obtained by
Block (1985), who concluded that garlic has an important
dietary and medicinal role. Most of its prophylactic and
therapeutic effects are ascribed to specific oil- and water-
soluble organosulfur compounds, which are responsible for
the typical odor and flavor of garlic. Meanwhile, Jain
(1993) reported that garlic oil preparation has a good anti-
tuberculosis activity in guinea pigs with an intra-peritoneal
dose of 0.5 mg/kg. In addition, complete lack of resistance
of bacteria to garlic has been found; as a result of this
bactericidal activity of garlic, toxin production by the
bacteria is prevented.
Similarly, Gowsala(2001) found in a study that garlic
juice has been used worldwide to fight bacterial infections.
Allium vegetables, particularly garlic (Allium sativum L.)
exhibits a broad antibiotic spectrum against both gram-
positive and gram-negative bacteria. On the other hand,
Thaly (1965) reported that cabbage is one of the most
highly anti-inflammatory, antibacterial, antirheumatic,
heals tissues by encouraging cells to proliferate, a liver
decongestant, and protects the stomach from gastric
hydrochloric acid. Fresh juices can be used as a diuretic
and antiseptic for the urinary tract and to ease fluid reten-
tion and to reduce or prevent kidney stones, arthritis, and
gout.
Effect of garlic and cabbage extract on the volume
of gastric juice in rats
Shown in Table 2 are the data pertaining to the effect of
garlic and cabbage extract on the volume of gastric juice
obtained from rats with aspirin-induced gastric ulcer
(positive control group) at a dose of 200 mg/kg B.Wt.
Results revealed that the mean length of gastric ulcer in
positive control was 0.8 ± 0.14 mL compared with
0.26 ± 0.05 mL in normal rats (negative control group).
Oral administration with garlic extract at a dose of 300 mg/
kg B.Wt. and cabbage juice at the same dose for 7 days to
the positive control group (200 mg/kg B.Wt.) caused the
highest decrease in the volume of gastric extract in rats. On
the other hand, oral administration with garlic extract at a
dose of 150 mg/kg B.Wt. and cabbage extract at the same
dose for 7 days to the same positive control group
(200 mg/kg B.Wt.) caused the lowest decrease in the vol-
ume of gastric juice in rats. It was reported that the increase
of acid secretion leads to gastric damage and is associated
with the greater acid back-diffusion, oxygen radical gen-
eration, and lower mucosal glutathione and mucus pro-
duction (Chen-Road and Su-Lin, 1997).
Gastric cancer is the major cancer in the developing
world and one of the top two worldwide. H. pylori are
bacteria implicated in the etiology of stomach cancer
(Fuchs and Mayer, 1995). It was found that incidence of
stomach cancer is lower in individuals with a high intake of
allium vegetables in developed and developing (high risk)
countries, due to the antibiotic activity allium vegetables
particularly garlic (Sivam et al., 1997). This is in agree-
ment with results obtained by (Cellini et al., 1996). They
tested 16 clinical isolates of H. pylori and showed 90 %
inhibition of the isolates with aqueous garlic extract at
5 mg/mL. The concentration used in that study is the total
weight of garlic per milliliter. However, calculations show
that the minimum inhibitory concentrations reported in the
two studies are comparable. It is plausible that the

123
Med Chem Res

Table 3 Effect of garlic (Allium sativum L.) and cabbage (Brassica Table 4 Effect of garlic (Allium sativum L.) and cabbage (Brassica
oleracea var. capitata) extract at two doses on the PH of gastric juice oleracea var. capitata) extract at two doses on the total acidity of
collected from stomachs of rats gastric juice collected from stomachs of rats
Groups Aspirin and Doses pH of IR Groups Aspirin Doses Total DR
extracts (mg/kg B.Wt.) gastric juice (%) and (mg/kg acidity (%) (%)
Mean ± SD extracts B.Wt.) Mean ± SD

Control -ve Control -ve

1 – – 4.57 ± 0.24ab – 1 – – 0.41 ± 0.04bc –
Control ?ve Control ?ve
2 Aspirin (Asp) 200 3.07 ± 0.58a – 2 Aspirin (Asp) 200 0.75 ± 0.1a –
Treated groups with plant extracts Treated groups
3 (Asp) ? garlic 150 5.01 ± 0.11c 63.19 with plant
extracts
4 (Asp) ? garlic 300 5.52 ± 0.213d 79.8
3 (Asp) ? garlic 150 0.65 ± 0.12b 13.33
5 (Asp) ? cabbage 150 4.65 ± 0.05ab 51.46
cd 4 (Asp) ? garlic 300 0.41 ± 0.12bc 45.33
6 (Asp) ? cabbage 300 5.13 ± 0.16 67.1
5 (Asp) ? cabbage 150 0.67 ± 0.121b 10.66
Means with different superscript letters in the column denote high 6 (Asp) ? cabbage 300 0.43 ± 0.122bc 42.66
significant differences (P \ 0.01), while similar superscript letters
denote non- significance Means with different superscript letters in the column denote high
IR increase ratio significant differences (P \ 0.01), while similar superscript letters
denote non- significance
DR Mean decrease ratio
sensitivity of H. pylori to garlic extract at such a low
concentration may be related to the reported lower risk of
stomach cancer in those with a high alliums vegetable ulcers, gastritis, heartburn, and ulcerative colitis (Thaly,
intake. 1965).
The crude methanol extract of the leaf of Allium asc-
Effect of garlic and cabbage extract on the pH of gastric alonicum was screened in vitro against five strains of H.
juice in rats pylori (Hp) (ATCC 24376, UCH 97001, UCH 97009, UCH
98026 ,and UCH 99039) for antibacterial activity by the
The effect of garlic (Allium sativum L.) and cabbage agar diffusion method in Mueller–Hinton agar supple-
(Brassica oleracea var. capitata) extract on the pH of mented with defibrinated horse blood. All strains were
gastric juice is listed in Table 3. Data clearly reveal that inhibited by the extract to varying degrees. The minimum
oral administration of aspirin at a dose of 200 mg/kg B.Wt. inhibitory concentrations (MICs) of the extract against all
(positive control) decreased the pH of gastric juice to tested strains ranged from 6.25 to 12.5 mg/mL. The effect
3.07 ± 0.58 as compared with 4.57 ± 0.24 of normal rats of increasing concentrations of the extract on the urease
(negative control). Data also show that oral administration activity of three of the Helicobacter pylori strains was
of garlic at a dose of 300 mg/kg B.Wt., for 7 days after investigated further. Results showed that increasing the
aspirin (200 mg/kg B.Wt.) increased the pH to concentration of the extract decreased the urease activity of
5.52 ± 0.213 compared with control (?ve), while oral all strains tested. Phytochemical screening of the plant
administration of cabbage at a dose of 150 mg/kg B.Wt., showed that it contains alkaloids, cardiac glycosides ,and
for 7 days after aspirin (200 mg/kg B.Wt.) increased the saponins. The anti-Hp activity observed is discussed in
value to 4.65 ± 0.05. relation to the chemical constituents isolated from these
Cabbage is one of the most highly rated leafy vegetables plants and their traditional uses. Result of this work sug-
and is a marvelous food item. It is grown for its enlarged gests that Allium ascalonicum has some therapeutic
edible and terminal buds and is eaten all over the world. It potential against H. pylori infection, which could be
is excellent as a muscle builder and cleaner. There are explored for patients with gastroduodenal disorders (Ade-
several varieties of cabbage that differ in size, shape and niyi and Anyiam, 2004).
color of leaves, and in size, shape, color ,and texture of
head (Thaly, 1965). Cabbage has long been used to heal Effect of garlic and cabbage juice on the total acidity
ulcers as it contains mucilage that coats the lining of the (%) of gastric juice in rats
digestive tract, protecting it from irritants and excessive
acid. It is recommended that two or three glasses of freshly Data presented in Table 4 show the effect of garlic (Allium
extracted juice be taken between meals to relieve peptic sativum L.) and cabbage (Brassica oleracea var. capitata)

123

Table 5 Effect of garlic (Allium sativum L.) and cabbage (Brassica
oleracea var. capitata) extract at two doses on the total bacterial
count (T.B.C) of gastric juice in rats
Groups Aspirin and Doses T.B.C Correction
extracts (mg/kg C.F.U/mL (%)
B.Wt.)
Control –ve
1 – – 0.113 9 103f –
Control ?ve
2 Aspirin (Asp) 200 0.78 9 103a – cially H. pylori increases the risk of peptic ulcer recur-
Treated groups with plant extracts
3 (Asp) ? garlic 150 0.43 9 103bc 44.87
4 (Asp) ? garlic 300 0.31 9 103d 60.25
5 (Asp) ? cabbage 150 0.46 9 103b 41.02
6 (Asp) ? cabbage 300 0.36 9 103c 53.84
Means with different superscript letters in the column denote high
significant differences (P \ 0.01), while similar superscript letters
denote non- significance
extracts at two doses on the total acidity of gastric juice in
rats. Data reveal that oral administration of garlic at a dose
of 300 mg/kg B.Wt., for 7 days after aspirin (200 mg/kg
B.Wt.) caused a significant decrease in total acidity of
gastric juice compared with positive control (0.41 ± 0.12
and 0.75 ± 0.1 for positive and negative control, respec-
tively). Data presented also reveal that both aqueous plant
extracts reduced the total acidity of gastric juice compared
with positive control.
Very few studies have dealt with chemically character-
ized garlic. The composition of garlic depends on the
source, age, storage conditions, and type of processing and
method of consumption. Unfortunately, the different forms
of garlic are frequently referred to as ‘‘garlic’’ in both the
lay and scientific literature. Additionally, it was showed
that the amount and composition of organosulfur com-
pounds vary within the different strains of garlic (Lawson,
1996), and the problem is compounded by the volatile and
reactive nature of these compounds. Hence, there is a clear
necessity for standardization of garlic preparations, espe-
cially for use in biological studies.
Effect of garlic and cabbage extract on the total
bacterial count (T.B.C) of gastric juice in rats
Displayed in Table 5 are the results pertaining to the effect
of garlic (Allium sativum L.) and cabbage (Brassica oler-
acea var. capitata) extracts at two doses on the total bac-
terial count (T.B.C) of gastric juice in rats. It was found
that gastric juice of ulcerated rats (positive control group),
has higher T.B.C compared with normal rats (negative
control); 7.8 9 102 compared to 1.13 9 102 C.F.U/mL,
respectively. It is evident that the best treatment was when
123
Med Chem Res
garlic was administered at a dose of 300 mg/kg B.Wt.; this
dose caused the lowest T.B.C (0.31 9 103 C.F.U/mL).
Oral administration of cabbage at the same dose also
caused a decrease of T.B.C which was 3.6 9 102 C.F.U/
mL. These results are in agreement with those obtained by
Baibekov and Mavlian (1986) who found that chronic
gastric ulcer was associated with a rise in the relative
amounts of parietal microflora. In the same time, Mahachai
et al., (2004) reported that infection with bacteria, espe-
rences and bleeding complications.
The antibacterial effect of aqueous garlic extract (AGE)
was investigated against Helicobacter pylori. Sixteen
clinical isolates and three reference strains of H. pylori
were studied. Two different varieties of garlic were used.
The concentration of AGE required to inhibit the bacterial
growth was between 2 and 5 mg mL-1. The concentration
for both AGE types, which inhibited 90 % (MIC90) of
isolates, was 5 mg mL-1. The minimum bactericidal con-
centration (MBC) was usually equal to or two fold higher
than minimum inhibitory concentration (MIC). Heat
treatment of extracts reduced the inhibitory or bactericidal
activity against H. pylori; the boiled garlic extract showed
a loss of efficacy from two to four fold the values of MIC
and MBC obtained with fresh AGE. The antibacterial
activity of garlic was also studied after combination with a
proton pump-inhibitor (omeprazole) in a ratio of 250:1. A
synergistic effect was found in 47 % of strains studied; an
antagonistic effect was not observed Cellini et al. (1996).
Didry et al. (1992) reported on the combinations of
antibiotics and known antimicrobial natural products,
naphthoquinones ,and Allium extracts. The chessboard
broth method was applied to assess the activity of these
combinations against aerobic and anaerobic bacteria. If no
antagonism was observed, the combinations studied lead
from partial to total synergism, mainly against aerobic
bacteria. Gowsala (2001) demonstrated in vitro that H.
pylori are susceptible to garlic extract at a fairly moderate
concentration. Even some antibiotic-resistant H. pylori
strains are susceptible to garlic. Clinical trials are necessary
to explore the possibility of using garlic as a low-cost
remedy against H. pylori.
Garlic tested in this study had bactericidal and/or anti-
adhesive effects on H. pylori. Ingestion of the plants with
anti-adhesive properties could provide a potent alternative
therapy for H. pylori infection, which overcomes the
problem of resistance associated with current antibiotic
treatment (Mahony, 2005). Propolis and Zingiber officinal
have been shown to be specifically targeted against H.
pylori strains, to possess anti-inflammatory, antioxidant
and antitumoral activity ,and to be used in traditional
medicine for the treatment of gastrointestinal ailments
Nostro (2006). Reuter et al. (1996) have recently reviewed
Med Chem Res
the therapeutic effects of garlic, on the cardiovascular
system, as antibacterial, anticancer, antioxidant, immuno-
modulatory, anti-inflammatory, hypoglycemic ,and hor-
mone-like effects. This review focuses on recent research
on protective effects of garlic against H. pylori and other
bacterial infections.
There is extensive literature on the antibacterial effects
of fresh garlic juice, aqueous and alcoholic extracts,
lyophilized powders, steam distilled oil ,and other com-
mercial preparations of garlic. Fenwick and Hanley (1985)
undertook a thorough review of the antibacterial effects of
garlic and other allium vegetables up to mid-1984; more
recently, the antibacterial effects of garlic have been
reviewed by Reuter et al. (1996). Garlic has been reported
to inhibit several strains of gram ?ve and gram -ve bac-
teria. Noteworthy among the reported findings are as fol-
lows: (1) Garlic exhibits a broad antibiotic spectrum
against gram-positive and gram-negative bacteria. Entero-
toxic coli strains and other pathogenic intestinal bacteria,
which are responsible for diarrhea in humans and animals,
are more easily inhibited by garlic than the normal intes-
tinal flora (Caldwell and Danzer, 1988; Rees et al., 1993).
Garlic is active even against organisms that have become
resistant to antibiotics. The combination of garlic extracts
with antibiotics leads to partial or total synergism (Didry
et al., 1992).
Diallyl thiosulfinates play an important role in the
antibiotic activity of garlic. Hughes and Lawson (1991)
showed that the antimicrobial activity of garlic is com-
pletely abolished when the thiosulfinates (e.g., allicin) are
removed from the extract. Also, upon reduction of allicin to
diallyl disulfide, the antibacterial activity is greatly reduced
(Reuter et al., 1996). Feldberg et al. (1988) reported that
allicin exhibits its antimicrobial activity mainly by imme-
diate and total inhibition of RNA synthesis, although DNA
and protein synthesis are also partially inhibited, suggest-
ing that RNA is the primary target of allicin action. The
structural differences of the bacterial strains may also play
a role in the bacterial susceptibility to garlic constituents.
The cell membrane of Escherichia coli contains 20 %
lipid, whereas that of Staphylococcus aureus contains only
2 % lipid. The lipid content of the membranes will have an
effect on the permeability of allicin and other garlic con-
stituents. On the basis of this hypothesis, it is interesting to
attribute the difference in susceptibility we observed
between gram-negative H. pylori (40 lg/mL) and gram-
positive Staphylococcus aureus ([160 lg/mL) to garlic
extract (Sivam et al., 1997). A pattern of inhibition char-
acterized by: (i) a lag of approximately 15 min between
addition of allicin and onset of inhibition, (ii) a transitory
inhibition phase whose duration was proportional to allicin
concentration and inversely proportional to culture density,
(iii) a resumed growth phase which showed a lower rate of
growth than in uninhibited controls, and (iv) an entry into
stationary phase at a lower culture density. Whereas DNA
and protein syntheses showed a delayed and partial inhi-
bition by allicin, inhibition of RNA synthesis was imme-
diate and total, suggesting that this is the primary target of
allicin action (Feldberg et al., 1988).
Aspirin and related drugs (non-steroidal anti-inflamma-
tory drugs), alcohol, coffee (including decaf), and tea can
aggravate or interfere with the healing of peptic ulcers.
Smoking is also known to slow ulcer healing. Whether or
not an ulcer is caused by infection, patients with peptic
ulcer should avoid use of these substances (Allison et al.,
1992). Vitamin A is needed to heal the linings of mucous
membranes of the stomach and intestines. In one controlled
trial, vitamin A supplement facilitated healing in a small
group of patients with stomach ulcer. The amount used in
that study (150,000 IU per day) can be toxic and may also
cause birth defects. Such a high dose should not be taken
by a pregnant woman, by a woman who could become
pregnant, or by anyone else without careful supervision
from a doctor (Patty et al., 1982). Objective evidence of
ulcer healing from taking vitamin A has been reported by
the same research group. The effect of lower amounts of
vitamin A has not been studied in people with peptic ulcer
(Patty et al., 1984).
Zinc is also needed for the repair of damaged tissue and
has protected against stomach ulceration in animal studies.
In Europe, zinc combined with acexamic acid, an anti-
inflammatory substance, is used as a drug in the treatment
of peptic ulcers. In a small controlled trial, high amounts of
zinc accelerated the healing of gastric ulcers compared
with placebo. Some doctors suspect that such an excep-
tionally high intake of zinc may be unnecessary, suggesting
instead that people with ulcers wishing to take zinc sup-
plements use only 25 to 50 mg of zinc per day. Even at
these lower levels 1–3 mg of copper per day must be taken
to avoid copper deficiency that would otherwise be induced
by the zinc supplement (Jimenez et al., 1992).
Effect of garlic and cabbage juice on relative organs
weight in rats
Organs weight analysis revealed that oral administration of
water garlic (Allium sativum L.) and cabbage (Brassica
oleracea var. capitata) juice significantly decreased the
liver, spleen ,and kidneys weights and did not significantly
change the heart and lungs weights.
Histopathological results
Examined sections of control rat showed the normal his-
tology of stomach, which consists of mucosa, submucosa
musculosa, and serosa (Fig. 1). On the other hand, stomach
123

Fig. 1 Stomach of control rat showing the normal gastric mucosa (H
and E 9200)
Fig. 2 Stomach of rat from (control ?ve) showing ulcer of the
glandular stomach characterized by marked necrosis and sloughing of
lamina epithelial associated with leucocyte cells infiltration in the
necrotic glands and hemorrhage (H and E 9200)
of the rat from treated groups (positive control) revealed
ulcer of the glandular stomach characterized by marked
necrosis and sloughing of lamina epithelialis associated
with leucocytic cells infiltration in the necrotic glands and
hemorrhage (Fig. 2). Examined stomachs of rats treated
with (garlic 150 mg/kg B.Wt.) showed focal necrosis of
lamina epithelialis associated with leucocytic cells infiltration
in lamina propria (Fig. 3). Meanwhile, no histopathological
123
Med Chem Res
Fig. 3 Stomach of rat from group 3 (garlic 150 mg/kg B.Wt.)
showing necrosis of lamina epithelialis and heucocytic cells infiltra-
tion in the lamina propria (H and E 9200)
Fig. 4 Stomach of rat from group 4 (garlic 300 mg/kg B.Wt.)
showing no histopathological alterations (H and E 9200)
alterations were observed in stomachs of rats treated with
(garlic 300 mg/kg B.Wt.) (Fig. 4). However, stomach sec-
tions of rats treated with (150 mg/kg B.Wt.) showed focal
necrosis and desquamation of gastric epithelium and glands
(Fig. 5). Likewise, examined stomach sections of rats treated
with (cabbage 300 mg/kg B.Wt.) revealed normal gastric
mucosa (Fig. 6).
Helicobacter pylori weaken the protective mucous
coating of the stomach and duodenum, which allows acid
Med Chem Res
Fig. 5 Stomach of rat from group 5 (cabbage 150 mg/kg B.Wt.)
showing focal necrosis and desquamation of gastric epithelium and
glands (H and E 9200)
Fig. 6 Stomach of rat from group 6 (cabbage 150 mg/kg B.Wt.)
showing normal gastric mucosa (H and E 9200)
to get through to the sensitive lining beneath. Both acid and
bacteria irritate the lining and cause a sore, or ulcer. H.
pylori are able to survive in stomach acid because it
secretes enzymes that neutralize the acid. This mechanism
allows H. pylori to make its way to the ‘‘safe’’ area—the
protective mucous lining. Once there, the bacterium’s
spiral shape helps it to burrow through the lining (Walsh
and Peterson ,1995).
Helicobacter pylori are a major human pathogen that is
responsible for a number of gastrointestinal infections
(Uwins, 2006). H. pylori infections have been associated
with the pathogenesis of a number of stomach and gastro
duodenal diseases. About half of the Taiwanese folk
medicinal plants tested, were found to possess a high anti-
H pylori activity (Wang, 2005).
Recommendations (i) Garlic and cabbage extract have
effective ingredients, which can protect from gastric ulcers;
they may be beneficial addition to the meal. (ii) Nutritional
and health educational programs should be organized and
directed to protect the public from peptic ulcer and its
complications. (iii) Plants (Garlic and Cabbage) that have
been tested in rats could also be used for patients with ulcer
in hospitals to evaluate their nutritional status.
Acknowledgments The authors extend their appreciation to the
Deanship of Scientific Research at King Saud University for funding
the work through the research group project Number RGP- VPP- 007.
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