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From the ancient times, plants have afforded themselves for the treatment of wide variety of diseases. This herbal basket of the nature has been explored in this review to highlight some of its potential herbs for the cure of Peptic Ulcer Disease (PUD). The motto behind the review on PUD was due to the wide spreading nature of peptic ulcer in all class of population, which may be due to the rapidly changing food habits and stress, causing an imbalance between the gastric offensive and defensive factors. Plants are getting more reliability in current days, because they lack significant side effects and are safe. On the other hand, the synthetic antiulcer drugs are constantly reported to possess critical adverse effects like arrhythmia, gynaecomastia, impotency, arthralgia etc. The relapse rate of ulcer has also been reported to be high in such molecules. A few plants have been reviewed to bring their mechanism of anti-ulcerogenic properties to the front, to promote more research on them. Some phytoconstituents have been discussed along with the research conducted by researchers in different ulcer models for better understanding the activity of the plants. The review may hopefully put some light on this particular section of research oriented towards searching new herbal moieties to treat the PUD. Keywords: Ulcerogenic, H. pylori, Defensive factors, ethnomedicinal, phytoconstituents, gastroprotective.
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Tripathy et al Journal of Drug Delivery & Therapeutics. 2016; 6(3):27-33 27
© 2011-16, JDDT. All Rights Reserved ISSN: 2250-1177 CODEN (USA): JDDTAO
Available online on 15.05.2016 at
Journal of Drug Delivery and Therapeutics
An International Peer Reviewed Journal
Open access to Pharmaceutical and Medical research
© 2016, publisher and licensee JDDT, This is an Open Access article which permits unrestricted noncommercial use, provided the original
work is properly cited
Tripathy Surendra*, Afrin Rafat
Varanasi College of Pharmacy, Varanasi-221006, India
*Corresponding Author’s Email:
Received 02 April 2016; Review Completed 28 April 2016; Accepted 29 April 2016, Available online 15 May 2016
Peptic ulcer disease (PUD), which includes gastric and
duodenal ulcers, is the most common gastrointestinal
problem and demands a well targeted therapeutic
strategy. The most common sites for ulcers are the
stomach and the first few centimeters of the duodenum.
Peptic ulcer causes break off in the continuity of the
mucosa of stomach or duodenum as a consequence of
some medications like non-steroidal anti-inflammatory
drugs (NSAIDS), gastric acids and pepsin, finally
causing lesions1. Basically, word ‘peptic’ is derived
from Greek term ‘peptikos’ whose meaning is related to
digestion .Various reports indicate that old age group
patients are more susceptible to gastric ulcer. Younger
individuals have higher risk of duodenal ulcers2,3,4. The
pathogenesis of peptic ulcer disease shows a complex
imbalance between gastric offensive factors like acid,
pepsin secretion, Helicobacter pylori (H.pylori), bile
salts, ethanol, some medications like NSAIDS, lipid
peroxidation, Zollinger-Ellison syndrome and defensive
mucosal factors like prostaglandins, nitric oxide, gastric
mucus, cellular renovation, blood flow, mucosal cell
shedding, glycoproteins, mucin secretion, proliferation
and antioxidant enzymes like catalase , superoxide
dismutase and glutathione levels5.
Acute peptic ulcers involve tissues down to the depth of
the submucosa, and the lesions may be single or
multiple. Reasons for the development of acute ulcers
include severe illness, shock, burns, severe emotional
disturbance, and postsurgical complications. Chronic
peptic ulcers penetrate through the epithelial and muscle
layers of the stomach wall. There are several symptoms
of ulcer like changes in appetite, nausea, bloody or dark
stools, weight loss, indigestion, vomiting, and chest
pain. Complications of peptic ulcers include
haemorrhage, perforation, pyloric stenosis and the
development of malignant tumors. Poor digestion and
elimination, improper metabolism, mental and physical
stress, and difficult to digest food enhance the
development of ulcers. Peptic ulcer can be categorized
on the basis of location and on the severity of disease.
Numerous other factors are also responsible for
progression of peptic ulcers like Tumor Necrosis Factor-
α (TNF α), Reactive Oxygen Species (ROS), release of
histamine, incidence of apoptosis and bile acids
A number of drugs are available for the cure of peptic
ulcers, but clinical evaluation of these drugs indicates
high relapse rate, side effects and drug interactions.
These complications enforces for the development of
new antiulcer drugs and the search for novel molecules
from the drug basket of nature, which is the herbal
resources. Plants have been a valuable source of new
From the ancient times, plants have afforded themselves for the treatment of wide variety of diseases. This herbal basket of
the nature has been explored in this review to highlight some of its potential herbs for the cure of Peptic Ulcer Disease
(PUD). The motto behind the review on PUD was due to the wide spreading nature of peptic ulcer in all class of population,
which may be due to the rapidly changing food habits and stress, causing an imbalance between the gastric offensive and
defensive factors. Plants are getting more reliability in current days, because they lack significant side effects and are safe.
On the other hand, the synthetic antiulcer drugs are constantly reported to possess critical adverse effects like arrhythmia,
gynaecomastia, impotency, arthralgia etc. The relapse rate of ulcer has also been reported to be high in such molecules. A
few plants have been reviewed to bring their mechanism of anti-ulcerogenic properties to the front, to promote more
research on them. Some phytoconstituents have been discussed along with the research conducted by researchers in different
ulcer models for better understanding the activity of the plants. The review may hopefully put some light on this particular
section of research oriented towards searching new herbal moieties to treat the PUD.
Keywords: Ulcerogenic, H. pylori, Defensive factors, ethnomedicinal, phytoconstituents, gastroprotective.
Tripathy et al Journal of Drug Delivery & Therapeutics. 2016; 6(3):27-33 28
© 2011-16, JDDT. All Rights Reserved ISSN: 2250-1177 CODEN (USA): JDDTAO
molecules and considered as an alternative strategy in
search for new drugs for numerous ailments. There are a
number of plants used in traditional medicine known to
possess antiulcer properties that may, after a few
possible chemical modifications, provide new and
improved antiulcer agents8.
From ancient times, herbs have been used to treat all
types of ailment. The herbal medicines are advantageous
than synthetic drugs as they are much safer than
synthetic drugs. Synthetic medications are less stable
than herbal medicines. Compared to synthetic medicines
herbal medicines are less expensive. The use of herbal
medicine can reduce toxicities and improve remedial
outcomes. Synthetic drugs also lead to many deaths each
year and are quickly becoming a major public health
concern. In short we can say that natural therapies are
less expensive, more valuable, and much safer. The plant
drugs possessing the active principles such as flavonoid,
tannins, terpenoids are found to show the antiulcer
activity9 (Table: 1). The different classes of synthetic
drugs are used in the treatment of peptic ulcer but many
of these drugs exhibit serious side effects like
arrhythmias, gynaecomastia, impotence, arthralgia,
hypergastrinemia and haemopoeitic changes.
Alternative approach in recent days is the research of
medicaments from ayurvedic or traditional medicinal
system. The use of phytoconstituents as drug therapy to
treat major ailments has proved to be clinically effective
and less relatively toxic than the existing drugs and also
reduces the offensive factors serving as a tool in the
prevention of peptic ulcer. In this modern era also
majority of the world populations still use herbal
medicine mainly in developing countries, for primary
health care because of better acceptability, compatibility
with the human body and lesser side effects. The
chemical constituents present in the herbal medicine or
plant are a part of the physiological functions of living
flora and hence they are believed to have better
compatibility with human body. This review outlines the
properties of some medicinal plants that exhibit antiulcer
Table 1: Some ulcer protective phytoconstituents10
Name of the Plant
Mangifera indica
Azadirachta indica
Ocimum sanctum
Fixed oil eugenol
Annona squamosa
Tannic acid
Mimosa pudica
Alkaloid mimosine
Terminalia chebula
Tannins, Gallic acid, chebullinic acid, sorbitol
Ficus religiosa
Flavonoids- Naringenin
Carica papaya
Chymopapain, papain
Aegel marmelos
Moringa loeifera
Quercetin, beta setosterol, beta carotene
Psidium guajava
Quercetin, guaijaverin, flavonoids
Sesbania grandiflora
Tannins, saponins
Shorea robusta
Ursolic acid, amyrin
Allium sativum
Alliin, allicin
Aloe vera
Barbaloin, isobarbaloin, saponins
Bacopa moniera
Bacoside A
For the development of a successful antiulcer herbal
agent, it is quite necessary to understand the possible
mechanisms of the plant extract. Correlating the
chemical nature of the constituents and their
mechanisms may provide crucial information for the
development of newer herbal drugs as potential antiulcer
agent. Some herbal drugs reported to have antiulcer
activity are described below with a special concern to
their mechanism of action.
Azadirachta indica A.
It is commonly known as Neem and belongs to family
Meliaceae. It has been identified to have potent
gastroprotective and antiulcer effects. This was
experimented in rats at a dose of 2.5 g/kg. It was studied
on various parameters of possible mechanism for
treating ulcer. The main mechanism is to prevent acid-
pepsin secretion. Neem did not show any effect on
mucin secretion though it improved life span of mucosal
cells as evidenced by a decrease in cell shedding in the
gastric juice. Thus the ulcer protective activity is due to
its anti-secretory and proton pump inhibitory activity
rather than on defensive mucin secretion. Bark extract of
Azadirachta indica inhibits H+-K+-ATPase activity in
vitro. It stops oxidative damage of the gastric mucosa by
blocking lipid peroxidation and by scavenging the
endogenous hydroxyl radical (OH), the major causative
factor for ulcer11,12,13.
Momordica charantia L.
Tripathy et al Journal of Drug Delivery & Therapeutics. 2016; 6(3):27-33 29
© 2011-16, JDDT. All Rights Reserved ISSN: 2250-1177 CODEN (USA): JDDTAO
It is commonly known as bitter gourd and karela and
belongs to family Cucurbitaceae. The methanolic extract
of Momordica charantia fruits is effective on gastric and
duodenal ulcers. The extract was administered orally at
two different doses of 100 mg/kg and 500 mg/kg. The
antiulcer activity was suggested to be due to the
increased secretion of mucus and anti-stress activity of
its constituent. The olive oil extract of M. charantia fruit
did show a healing effect in peptic ulcers14,15.
Bacopa monniera
It is commonly known as Brahmi, belonging to family
Scrophulariaceae. It is effective in treating various
gastric ulcer models of rats. The main chemical
constituent for curing the ulcer is bacoside A. It shows
anti-ulcer and ulcer-healing activities. There are multiple
possible mechanisms of bacoside A, which has been
suggested. The first one is for treating ulcer is anti-H.
pylori activity in the dose of 1000 mg/ml and increasing
prostanoids (PGE and PGI2) in the dose of 10 mg/ml. Its
other possible mechanism are mucosal offensive acid-
pepsin secretion and defensive factors like mucin
secretion, mucosal cell shedding, cell proliferation and
antioxidant activity in rats16,17,18.
Aloe barbadencis
It is commonly known as Aloe vera. It belongs to family
Asphodelaceae (Lilliaceae). Aloe vera gel posses
gastroprotective properties. The existing mucilage tissue
at the center of leaves in this plant called aloe gel is used
for various medicinal purposes. Its healing property is
due to a compound called glucomannan, which is
enriched with polysaccharides like mannose. The
glucomannan affects fibroblast growth factor and
stimulates the activity and proliferation of these cells.
The mucilage of aloe vera not only increases amount of
collagen on wound site, but also increases transversal
connections among these bands rather than changing
collagen structure fastening wound healing19,20.
Ficus religiosa
It is commonly known as “peepal tree”. It belongs to
family Moraceae. The alcoholic extract of F. religiosa
has been reported for antiulcer activity against pylorus
ligation induced ulcers, ethanol induced ulcers and
asprin-induced ulcers at dose level of 250 mg\kg and
560 mg\kg in swiss albino rats. The stem bark ethanolic
extract possesses antiulcer activity due to endogenous
production of prostaglandins, which in turn promotes
mucus secretion, apart from this, the plant also possesses
anti-inflammatory and anti-oxidant properties, which
comes together to make the plant as a potential antiulcer
Carica papaya
It is commonly known as Papaya, belonging to family
Caricaceae. The methanolic extract of the seed of the
plant shows gastroprotective and healing effects on ulcer
in rats at a dose of 125, 250, and 500 mg/kg. It
significantly reduced the gastric lesion with 56, 76, and
82 % inhibition. The cytoprotective effect of papaya is
responsible for its Anti-ulcerogenic activity. The enzyme
P1G10 present in papaya has shown healing activity of
chemically induced gastric ulcer23,24,25.
Ananas comosus
It is commonly known as Pineapple, belonging to family
Bromeliaceae. The dichloromethane extract of pineapple
has been found with the ability to protect the gastric
mucosa against injuries caused by 0.3 M HCl, absolute
ethanol, non-steroidal anti-inflammatory drugs, and
pylorus ligation, in mice and rats. The mechanism of
action of the DCM extract suggested that the effective
gastroprotective action is due to the sulfhydryl group.
Vianain, present in pineapple has also shown wound
healing property in a guinea pig ischemic ulcer
Cynodon dactylon
It is commonly known as Durva grass or Doob ghas,
belonging to family Poaceae. Doob ghas was proved for
antiulcer activity in albino rats at a dose level of 200,
400 and 600 mg per kg. Doob grass herb contains
flavonoids. The alcoholic extract showed the presence of
flavanoids, which is supposed to be responsible for
antiulcer property28,29,30.
Glycyrrhiza glabra
It is commonly known as licorice, belonging to family
Leguminosae. It showed effective healing on ethanol-
induced ulcers. It reduces stomach secretions and also
produces thick protective mucus which covers the lining
of stomach, therefore protects from peptic ulcers.
Further it has been reported to increasing the local
concentration of prostaglandins which promotes mucous
secretion and cell proliferation in the stomach31,32.
Ocimum sanctum
It is commonly known as Tulsi and belongs to family
Lamiacae. It is considered as a sacred plant by the
Hindus in India. Advanced studies on this plant have
been reported that it has antiulcer activity. The fixed oil
has proved to show antiulcer activity because of its
lipoxygenase inhibitory activity, histamine antagonistic
and anti-secretory effects33,34,35.
Panax ginseng (Korean red ginseng)
It is a species of ginseng. It belongs to family
Araliaceae. Korean red ginseng gives healing effect on
gastric ulcer at a dose of 30, 100, and 300 mg/kg,
peroral, occurred 1 hr before the ulcer induction in mice.
The supposed mechanism of Ginseng species are
significant increase in mucin secretion and inhibited
malondialdehyde (MDA) and H+/ K+ ATPase activity
in the stomach36,37.
Musa sapientum
It is commonly known as Kela, belonging to Musaceae
family. Musa at a dose of 100 mg/kg was studied for its
antiulcer and mucosal defensive factors in NIDDM rats .
Anti-ulcerogenic effect of Musa may be due to its anti-
secretory and cyto-protective activity. This is a
mucoadhesive agent that form lining in stomach and
Tripathy et al Journal of Drug Delivery & Therapeutics. 2016; 6(3):27-33 30
© 2011-16, JDDT. All Rights Reserved ISSN: 2250-1177 CODEN (USA): JDDTAO
duodenum and protect it from the corrosion of acid and
Brassica oleraceae
It is commonly known as cabbage, belonging to family
Brassicaceae. The aqueous extract of Brassica oleracea
var. capitata plant was used in the gastric disorders like
ulcer at a dose of 0.250, 0.50 and 1.0 mg/kg on Wistar
rat. There is a chemical Lysophosphatidic acid (LPA),
present in cabbage. It is a lipid mediator involved in a
variety of physiological responses, like wound healing.
This phospholipid shows an antiulcerogenic activity40,41.
Solanum nigrum
It is commonly known as Potato, belonging to family
Solanaceae. It has gastric antiulcerogenic effects.
Solanum nigrum was found to possess antiulcerogenic as
well as ulcer healing activities. Antiulcer activity was by
blocking acid secretion through inhibition of H+
K+ATPase and decreasing secretion of gastrin
Commiphora molmol
It is commonly known as Guggul, belonging to family
Burseraceae. It is widely used as an anti-inflammatory
and wound healing agent. Its gastric ulcer activity at a
dose of 500 mg/kg in rats was evaluated. The protective
effect of Commiphora molmol has shown its effect on
mucus production, increase in nucleic acid and non-
protein sulfhydryl concentration. It has been also
diagnosed for free radical-scavenging properties43,44.
Vaccinium oxycoccos
It is commonly known as Cranberry, belonging to family
Ericaceae. Cranberry juice is effective in peptic ulcer.
Several H. pylori bacteria shows antibiotic resistance but
can be treated well by cranberry juice. Regular
consumption of cranberry juice could suppress H. pylori
infection in endemically afflicted populations. The
possible mechanism behind the antiulcer activity may be
that, it causes immobilization of H. pylori strains in
human mucus, erythrocytes, and cultured gastric
epithelial cells45,46,47.
Ceratonia siliqua
It is commonly known as Carob, belonging to Fabaceae
(Leguminoceae) family. Carob has shown to reduce the
effect of gastroesophageal reflux and vomiting in
infants. It works by several activities of its constituents
mainly the Flavonoid content. It possesses demulcent
property and the flavonoid content imparts
gastroprotective and antioxidant properties, which
together lend the drug to exhibit antiulcerogenic
A number of researches have been conducted on
different plants for their antiulcer activity. A few
pharmacologically tested Antiulcer plant drugs were
studied and summarized in Table 2.
Table 2: Some pharmacologically tested Antiulcer plants.
Name of Plants
Solvent of
(Plant part)
Ulcer induction method
Emblica officinalis
Ethanol, Aspirin, Cold
Restraint Stress(CRS)
Goel et al, 200249
Asparagus racemosus
CRS, Pyloric ligation,
Aspirin, Cysteamine
Goel et al, 200350
Bambusa arundinaceae
Muniappan et al, 200351
Urtica dioica L.
Kufrevioglu et al, 200452
Utleria salicifolia
CRS, Pyloric ligation,
Aspirin, Ethanol
Rao et al, 200453
Elettaria cardamomum
Pyloric ligation, Aspirin
Jafri et al, 200454
Bauhinia purpurea
Absolute ethanol,
Zakaria et al, 201155
Zingiber montanum
1N HCl
Hossain et al, 201256
Aerva persica Merrill
Ethanol, Pyloric ligation
Vasudeva et al, 201257
Toona ciliate
(Heart wood)
HCl-Ethanol, Pyloric
Malairajan et al, 200758
Excoecaria agallocha
Thirunavukkarasu et al,
Abutilon indicum L.
Ethanol, Pyloric ligation
Dashputre et al, 201160
Heliotropium indicum
Pyloric ligation, Aspirin
Shenoy et al, 201161
Tripathy et al Journal of Drug Delivery & Therapeutics. 2016; 6(3):27-33 31
© 2011-16, JDDT. All Rights Reserved ISSN: 2250-1177 CODEN (USA): JDDTAO
Nigella sativa L.
Pyloric ligation, Aspirin
Rajkapoor et al, 200262
Centella asiatica
Al-Bayati et al, 201063
Buchanania lanzan
Ethanol, Pyloric ligation
Pareta et al, 201064
Terminalia chebula
Ethanol, Pyloric ligation
Raju et al, 200965
Piper aleyreanum
Essential oil,
(Aerial part)
Santos et al, 201266
Scoparia dulcis
(Aerial part)
Babincova et al, 200867
Pithecellobium dulce
(Fabaceae )
Ethanol, Aspirin, CRS
Megala et al, 201268
Lafoensia pacari)
(Stem bark)
Ethanol, Indomethacin,
CRS, Acetic acid
Martins et al, 201269
Albizia lebbeck
(Bark, Leaves)
Ethanol, Indomethacin,
CRS, Acetic acid
Lawande et al, 201270
Andrographis paniculata
(Aerial part)
Gupta et al, 201171
Picralima nitida
Pyloric ligation, Aspirin
Ogochukwu et al, 201172
Cordial sebestena L.
Trivedi et al, 201573
Research on natural products often is guided by
ethnomedicinal knowledge, and their contribution to
drug innovation by providing novel chemical structures
and mechanisms of action is substantial. Large number
of herbal extracts is used in folk medicine to treat
various types of disorders. The synthetic drugs used to
treat it are having side effects and it has been seen that
some synthetic drugs have ulcer as their adverse effect.
In that case, the herbal natural remedy is the obvious
alternative, which is safe and equally effective as the
synthetic drug. Several plant sources have been
highlighted in this article on the basis of traditional
knowledge and reports of different researchers. Apart
from this, searching for new pathways to treat ulcer can
be developed only by understanding the mechanism of
ulcerogenesis, by which it can be targeted. The
investigative parameters which are the major aspects for
herbal drug screening has also been mentioned at
required places in the paper, which will hopefully help
the researchers working in this area.
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How to cite this article:
Tripathy S, Afrin R, Herbal treatment alternatives for peptic ulcer
disease, Journal of Drug Delivery & Therapeutics. 2016; 6(3): 27-33
... Already, drug classes such as proton pump inhibitors, histamine (H 2 ) inhibitors, and antacids have been used to treat this disease for the past decades. However, these antiulcer agents have several shortcomings, such as impotency, arrhythmia, gynecomastia, arthralgia, and numerous drug-drug interactions, which make them unsafe for human use [6]. Additionally, the eradication of H. pylori-infested peptic ulcers remains a challenge resulting in the adoption of triple and quadruple therapies with their attendant problems of polypharmacy. ...
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Allanblackia floribunda has been used to treat an upset stomach in African traditional medicine, but its efficacy and safety have not been scientifically studied. The present research is aimed at assessing the antiulcer property of the seed extract of the plant to validate its traditional claim. Rats were pretreated with three doses of aqueous extract of A. floribunda (AFE) at 30, 100, and 300 mg/kg or omeprazole 10 mg/kg for 1 hr before the acute gastric ulcer was induced by oral administration of 5 mL/kg of 98% ethanol. The animals were sacrificed under anesthesia, and the stomach and blood were collected. The gross histology of the stomach, percentage protection conferred by the treatment, gastric pH, and serum TNF-α and INF-γ were assessed as well as the expression of Ki67 antigens. The antioxidant properties as well as the acute toxicity profile of the plant extract were also assessed. The results show that A. floribunda conferred significant protection on the rats against gastric ulceration with % protection of 46.15, 57.69, and 65.38 for AFE 30, 100, and 300 mg/kg, respectively, as well as 69.23% for omeprazole 10 mg/kg. The plant extract caused marked reductions in gastric pH, TNF-α, and INF-γ with statistical significance (p
... Peptic ulcer treatment with natural products is now considered as an alternative to manage the disease (Kangwan et al., 2014 ;Tripathy and Afrin, 2016). Natural products of animal or vegetable origin and medicinal plants have long been recognized as a rich source of potent therapeutics and are widely used in the traditional medecine. ...
Gastric ulcer associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin is a major public health problem. The present study was undertaken to determine the camel milk antioxidant activity, tested on DPPH, and its gastro-protective effect, investigated in Wistar rats subjected to gastric ulcer induced by a nonsteroidal anti-inflammatory agent, indomethacin. The study was performed on 20 adult male Wistar rats divided into 4 groups of 5 rats each. The negative control group received distilled water, the positive control group received indomethacin, the standard group received ranitidine and the fourth group was pretreated with raw camel milk, for 15 days respectively. On the 16th day, the indomethacin was administered to all rats except those of the negative control group. The ulcer-ogenic effect of indomethacin was highly significant, evidenced by a large number of ulcer lesions, a remarkably high ulcer index, and an important decrease in adherent gastric mucus. Camel milk resulted in significant gastro-protection compared to indomethacin ulcerated rats as manifested by significant decrease in ulcerative lesions number, and the ulcer index with a restored gastric mucus wall. The camel milk protection percentage is close to that of ranitidine. Additionally, in indomethacin-injured rats an increase in white blood cells, granulocytes, serum transaminases, and hemoglobin levels with a lowering in red blood cells were reported. These physiological disturbances were recovered by camel milk. Camel milk seemed to have gastro-protective effect, probably through its strong antioxidant activity, and may be recommended to patients with arthritis.
... Symptoms of GERD consist of difficulty in swallowing (dysphagia), pain during swallowing (odynophagia), acid reflux, heart burn, nausea & vomiting, abdominal pain, sore throat, hoarse voice, cough and sometimes muscle ache or fever. 2 Endoscopically GERD broadly classified into two groups; Erosive esophagitis or Barrett's esophagus (having esophageal mucosal damage) and non-erosive reflux disease, NERD (no mucosal damage). 3,4 The pathophysiology of GERD is multifactorial, involving transient lower esophageal sphincter relaxation (TLESR), reduced LES pressure, poor esophageal clearance, impaired esophageal mucosal defense, visceral hypersensitivity, hiatal hernia and delayed gastric emptying. The enhanced acid secretion and reflux mechanism suggests playing a key role in the elementary pathogenesis of GERD. ...
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The objective of this study was to evaluate the effect of pantoprazole and pregabalin on experimental esophagitis in albino rats. The groups of rats fasted for 24 hours and were subjected to pylorus and forestomach ligation. Rats of different groups received normal saline (3 ml/kg, po; sham control), pantoprazole (30 mg/kg, po), pregabalin (30 mg/kg, po) and their combinations along with a parallel toxic control group. Animals were sacrificed after 8 h and evaluated for the gastric pH, total acidity, free acidity and esophagitis index. The morphological changes were scrutinized by digital microscopy. The beneficial effect of pantoprazole and pregabalin against GERD could be attributed to the anti-secretory action of pantoprazole and reduction in the tracheal lower esophageal sphincter release rate by pregabalin. Combination therapy of gamma-aminobutyric acid derivative promotes proton pump inhibitor based healing of reflux esophagitis in animal model. Keywords: Esophagitis, Pantoprazole, Pregabalin, Pylorus ligation, Gamma-aminobutyric acid.
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Peptic ulcer disease affects many people globally. With the increasing resistance to some orthodox antibiotics such as Clarithromycin and Metronidazole, it is important that new acceptable, safer and effective therapies are developed to manage this disease. Various herbal medicines have been used traditionally for the remedy of peptic ulcer disease (PUD), however scientific information with regards to their anti-peptic ulcer both in-vivo and in-vitro as well as clinical studies supporting their use is still inadequate. The Centre for Plant Medicine Research, (CPMR) Mampong-Akuapem, Ghana manufactures three herbal Products namely Enterica, Dyspepsia and NPK 500 capsules which are currently used for the remedy of PUD as a triple therapy at its out-patient clinic with promising effects. The aim of this review is to gather information from literature on the anti-ulcer properties, pharmacological, phytochemical constituents and related activities of herbal plants used at the CPMR for formulation of the triple herbal therapy. This review may, provide some scientific bases for the use of Enterica, Dyspepsia and NPK 500 capsules in the management of Peptic ulcer at the CPMR out-patient clinic. Methods Organization for the review involved the on and/or offline search for information from available literature using electronic data and scientific research information resources such as PubMed, Science Direct and Google scholar. Results In this review, fifteen ethno-medicinal plants used for the formulation of Enterica, Dyspepsia and NPK capsules have been discussed, presenting the description of the plants, composition and pharmacological activity. Interpretation Tables with the summary of reviewed medicinal plants with their anti-ulcer models and inference on possible mechanisms of action were drawn up. The mechanism(s) of action of individual plants and products (Enterica, Dyspepsia and NPK 500 capsules) must be further investigated and established experimentally in-vitro in addition to in-vivo pharmacological and clinical activity studies to confirm their use in the remedy of PUD.
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The present research shows the prophylactic effect of the aqueous extract of Brassica oleracea var. Capitata (400mg / kg) on gastric ulcer induced on day 5 with indomethacin (75mg / kg) in 20 Rattus rattus var. Albinus fed with a balanced diet heated in microwave. By euthanasia the stomachs were extracted to evaluate the indices of average lesions and ulcerogenic parameters. The mean of necrohemorrhagic lesions corresponded to 20.2 points in animals receiving ranitidine versus 14.2 and 13.2 in animals receiving saline and cabbage respectively. The mean ulcer score was 29.8 in the ranitidine group and 25.4 and 23.2 in animals receiving saline and cabbage respectively. Rats given Brassica had a preventive effect of 8.66 compared to -17.32 of the group under ranitidine. It is concluded that the aqueous extract of Brassica oleracea var. Capitata on gastric ulcers induced in Rattus rattus var. Albinus has a moderate prophylactic effect and is related to the antioxidant capacity of the phytochemical compounds possessed by the cabbage. La presente investigación muestra el efecto profiláctico del extracto acuoso del repollo Brassica oleracea var. Capitata (400mg/kg) sobre úlcera gástrica inducida al quinto día con indometacina (75mg/kg) en 20 Rattus rattus var. albinus sometidos a una dieta balanceada calentada en microondas. Por eutanasia se extrajeron los estómagos para evaluar los índices de lesiones promedio y parámetros ulcerogénicos. El promedio de lesiones necro-hemorágicas correspondió a 20.2 puntos en animales que recibieron ranitidina versus 14.2 y 13.2 de animales que recibieron solución salina fisiológica y repollo respectivamente. El promedio de puntaje de úlcera fue de 29.8 en el grupo que recibió ranitidina y 25.4 y 23.2 para animales que recibieron solución salina fisiológica y repollo respectivamente. Ratas que recibieron Brassica tuvo efecto preventivo de 8.66 comparado con -17.32 del grupo sometidos al efecto de ranitidina. Se concluye que el extracto acuoso de Brassica oleracea var. capitata sobre úlceras gástricas inducidas en Rattus rattus var. albinus tiene un efecto profiláctico moderado y está relacionado con la capacidad antioxidante de los compuestos fitoquímicos que posee el repollo.
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Peptic ulcer embraces both gastric and duodenal ulcers and has been a major threat to the world's population over the past two centuries, with a high morbidity and substantial mortality. Discovery of gastric mucosa infection with Helicobacter pylori (H. pylori) and its association with chronic antral gastritis and peptic ulcer revolutionized the treatment of ulcer illness. H. pylori are causally related to a majority of cases of both duodenal and gastric ulcer, in the west and developing countries. Despite extensive scientific advancements, this disease remains an important clinical setback, largely because of H. pylori infection and widespread use of non-steroidal anti-inflammatory drugs (NSAIDs). Management of peptic ulcer disease generally involves the practice of H 2 receptor antagonists, use of proton pump inhibitors, antacids and different H. pylori eradication regimens. This review article outlines the epidemiology, clinical manifestations, diagnosis and treatment strategies of peptic ulcer disease.
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The present study was performed to evaluate the anti-ulcerogenic activity of ethanol extract of Centella asiatica against ethanol-induced gastric mucosal injury in rats. Five groups of adult Sprague Dawley rats were orally pre-treated respectively with carboxymethyl cellulose (CMC) solution (ulcer control group), Omeprazole 20 mg/kg (reference group), and 100, 200 and 400 mg/kg C. asiatica leaf extract in CMC solution (experimental groups), one hour before oral administration of absolute ethanol to generate gastric mucosal injury. Rats were sacrificed and the ulcer areas of the gastric walls were determined. Grossly, the ulcer control group exhibited severe mucosal injury, whereas pre-treatment with C. asiatica leaf extract exhibited significant protection of gastric mucosal injury. Histological studies revealed that ulcer control group exhibited severe damage of gastric mucosa, along with edema and leucocytes infiltration of submucosal layer compared to rats pre-treated with C. asiatica leaf extract which showed gastric mucosal protection, reduction or absence of edema and leucocytes infiltration of submucosal layer. Acute toxicity study did not manifest any toxicological signs in rats. The present finding suggests that C. asiatica leaf extract promotes ulcer protection as ascertained grossly and histologically compared to the ulcer control group.
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Ulcer is a common gastrointestinal disorder which is seen among many people. It is basically an inflamed break in the skin or the mucus membrane lining the alimentary tract. Ulceration occurs when there is a disturbance of the normal equilibrium caused by either enhanced aggression or diminished mucosal resistance. It may be due to the regular usage of drugs, irregular food habits, stress, and so forth. Peptic ulcers are a broad term that includes ulcers of digestive tract in the stomach or the duodenum. The formation of peptic ulcers depends on the presence of acid and peptic activity in gastric juice plus a breakdown in mucosal defenses. A number of synthetic drugs are available to treat ulcers. But these drugs are expensive and are likely to produce more side effects when compared to herbal medicines. The literature revealed that many medicinal plants and polyherbal formulations are used for the treatment of ulcer by various ayurvedic doctors and traditional medicinal practitioners. The ideal aims of treatment of peptic ulcer disease are to relieve pain, heal the ulcer, and delay ulcer recurrence. In this review attempts have been made to know about some medicinal plants which may be used in ayurvedic as well as modern science for the treatment or prevention of peptic ulcer.
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The effect of alcoholic extract of Nigella sativa was investigated in rats to evaluate the anti-ulcer activity by using two models, i.e. pyloric ligation and aspirin-induced gastric ulcer. The parameters taken to assess anti-ulcer activity were volume of gastric secretion, free acidity, total acidity and ulcer index. The results indicate that the alcoholic extract significantly (P < 0.001) decreases the volume of gastric acid secretion, free acidity, total acidity and ulcer index with respect to control.
Peptic ulcer disease is an imbalance between offensive and defensive gastric factors. A bacterium called Helicobacter pylori has been considered a major causative agent for gastric and duodenal ulcers. This is a major cause of mortality in developing countries. Today, we have a bunch of herbal drugs that have very good potential to treat peptic ulcer and other gastrointestinal disorders both from traditional knowledge and scientific data. This review includes physiological, pathophysiological aspects related to peptic ulcer and liver disease and list of herbal drugs for treatment of gastrointestinal ulcers.
The anti-ulcer activity of methanolic extract of Terminalia chebula (Combretaceae)fruits METC was investigated in pylorus ligation and ethanol induced ulcer models in wistar rats. In both models the common parameter determined was ulcer index. METC at doses of 250,500 mg/kg p.o produced significant inhibition of the gastric lesions induced by Pylorus ligation induced ulcer & Ethanol induced gastric ulcer .The extract (250 mg/kg & 500 mg/kg) showed significant (P<0.01) reduction in gastric volume, free acidity and ulcer index as compared to control. This present study indicates that Terminalia chebula fruit extract have potential anti ulcer activity in the both models. These results may further suggest that methanolic extract was found to possess antiulcerogenic as well as ulcer healing properties, which might be due to its antisecretory activity.
Buchanania lanzan Spreng. plant is well known for its medicinal and therapeutic values in Indian folk medicine. However, to be clinically useful, more scientific rationale are essential. Therefore, in the present study, we investigated the effects of ethanolic extract of Buchanania lanzan Spreng roots (EBL) for its antiulcer activity. To assess the antiulcer activity of varied concentrations of the EBL (200 and 400 mg/kg orally) was evaluated for ethanol induced ulcer in mice and pylorus ligation induced ulcer in rats. EBL showed a dose-dependent protection against gross damaging action of ethanol and Pylorus ligation on gastric mucosa of animals. The treatment with EBL shown significant protection of ulcer index in both the models as well as also inhibited the pylorus ligation-accumulated gastric secretion. Thus, our present study results clearly demonstrate that EBL is in possession of good preventive and therapeutic action on the gastric ulcers.
The objective of present study is to evaluate the anti ulcer activity of ethanol extract of leaves of Heliotropium indicum. The ethanol extract of H. indicum was investigated for its anti ulcer activity against Aspirin plus pylorus ligation induced gastric ulcer in rats, HCl –Ethanol induced ulcer in mice and water immersion stress induced ulcer in rats. The antiulcer activity was assessed by determining and comparing gastric volume, free acidity and ulcer inhibition in aspirin plus pylorus ligation induced gastric ulcer model. The number of lesions in HCI-Ethanol induced peptic ulcer model and mean score value of ulcer inhibition in water immersion stress induced ulcer model. A significant antiulcer activity of plant extract was observed in all the models. Pylorus ligation model showed significant reduction in gastric volume, free acidity and ulcer index as compared to control. Also extract showed significant ulcer inhibition in HCl-Ethanol induced ulcer and ulcer protection index in stress induced ulcer. This present study indicates that Heliotropium indicum leaves extract have potential anti ulcer activity in the three models tested. INTRODUCTION: Gastric ulcers one of the most widespread diseases is believed to be due to an imbalance between aggressive and protective factors. The gastric mucosa is continuously exposed to potentially injurious agents such as acid, pepsin, bile acids, food ingredients, bacterial products (Helicobacter pylori) and drugs. These agents have been implicated in the pathogenesis of gastric ulcer, including enhanced gastric acid and pepsin secretion, inhibition of prostaglandin synthesis and cell proliferation growth, diminished gastric blood flow and gastric motility 1 .
H2-receptor blockers and proton pump inhibitors are now used extensively to control gastric and duodenal ulcer, inflammation and pain, but these drugs have limitations and are not always affordable. The development of novel nontoxic antiulcer drugs, including from medicinal plants, is therefore desirable, and Azadirachta indica A. Juss, commonly known as Neem, is known to have potent gastroprotective and antiulcer effects. This review deals with the pharmacological and biochemical studies carried out regarding the antiulcer activities of Neem extracts and their mechanism of action, including the inhibition of acid secretion. A comparison with ranitidine and omeprazole in some animal models has been included and clinical studies, where available, have also been incorporated, along with a safety evaluation. Neem bark extract has the potential for the development of novel medicines for the therapeutic control of gastric hyperacidity and ulcer. Copyright © 2009 John Wiley & Sons, Ltd.