Int J Pharm Pharm Sci, Vol 6, Issue 10, ??-??Review Article

A COMPREHENSIVE REVIEW ON ULCER HEALING POTENTIAL OF MEDICINAL PLANTS

DIVYA SHARMA1*, SHAILENDRA BHATT1

1Maharishi Arvind Institute of Pharmacy, Mansarovar, Jaipur.
Email: divyasharma1089@gmail.com

Received: 23 Jul 2014 Revised and Accepted: 25 Aug 2014


ABSTRACT

Peptic ulcers are a broad term that includes ulcers of gastrointestinal tract. The formation of peptic ulcers is due to the presence of acid, peptic activity in gastric juice and a breakdown in mucosal defenses. There are two main factors that can disrupt the mucosal resistance to injuryare, non-steroidal anti-inflammatory drugs and H. pylori infection. A number of anti-ulcer drugs such as proton pump inhibitors and H2 receptor antagonists are used for the treatment of peptic ulcer, but these drugs has shown incidence of relapses, side effects, and drug interactions. Plant origin drugs are gaining popularity to treat number of disorders, including peptic ulcer. There is a need for less toxic and potentanti-ulcerogenic drugs. Since long time plant extracts are used to produce promising anti-ulcerogenic effects. The present work was carried out to investigate the possible preventive anti-ulcerogenic effect. In the present study we have reviewed most commonly employed herbal medicines and various animal models which were used in the screening of anti ulcer activity.

Keywords: Anti-ulcer, Medicinal plant, Animal model.


INTRODUCTION

Peptic ulcer is one of the major gastrointestinal disorders and it affecting about 10% of the world population. As a consequence of peptic ulcer about 15000 deaths occur each year [1]. In the Indian pharmaceutical industry, antacids and antiulcer drugs occupy 4.2% of the market share.

An ulcer is basically an inflamed break in the skin or the mucus membrane lining the alimentary tract. Ulceration mainly occurs due to the disturbance of the normal equilibrium caused by either enhanced aggression or diminished mucosal resistance. Today, there are two main techniques for treating peptic ulcer. The first is reducing the production of gastric acid and the second is re-enforcing gastric mucosal protection. There are two major factors that can disrupt the mucosal resistance to injury: non-steroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori infection. Several natural products have been evaluated as therapeutic agents for the treatment of peptic ulcer.

The gastric mucosa is continuously exposed to various injurious agents such as acid, bile acids, pepsin, food ingredients, bacterial products and drugs. These agents have been playedrole in the pathogenesis of gastric ulcer, including enhanced pepsin and gastric acid secretion, cell proliferation growth, inhibition of prostaglandin synthesis and diminished gastric blood flow and gastric motility [2]. Peptic ulcers are once believed to be caused by spicy food, emotional stress, alcohol and smoking are the principal etiological factors associated with peptic ulcer [3]. The Gram-negative bacterium Helicobacter pylori remain present between the mucous layer and the gastric epithelium and are strategically designed to live within the aggressive environment of the stomach. There are many types of ulcer such as mouth ulcer, esophagus ulcer, peptic ulcer, stress ulcer and genital ulcer. The peptic ulcers arefound in the lining of our stomach or duodenum [4]. The two most common types of peptic ulcer are called “gastric ulcer” and “duodenal ulcer.”Gastric ulcers are located in the stomach, characterized by pain; ulcers are frequent in older age group. Eating may add to pain rather than relieve pain. Other symptoms may include nausea, vomiting, loss of appetite, bloody stool, frequent burping and weight loss. While patients with gastric ulcers have normal or diminished acid production, yet ulcers may occur even in absence of acid [5]. Duodenal ulcers are found at the beginning of small intestine and are characterized by severe pain with burning sensation in upper abdomen that awakens patients from sleep. Eating something or taking an antacid medication sometimes makes the pain go away for awhile.

A duodenal ulcer is more frequent in younger individuals and mostly affects males. In the duodenum, ulcers may become visible on both the anterior and posterior walls [6]. In some cases, peptic ulcer can be life threatening with symptoms like bloody stool, sharp stomach pain, and cramps along with vomiting blood [7].

Antiulcer drugs like H2 –receptor blockers, proton pump inhibitors, anti-muscarinic drugs produce adverse reactions such as hypersensitivity, arrhythmia and haemopoietic changes with a possibility of increased rate of ulcer recurrence within one year after cessation of the treatment. Because of the above mentioned demerits reported with the current antiulcer therapy there is a need for the search of newer therapeutic antiulcer agents from plant sources from the alternative therapy of Ayurveda medicine. Some plant extracts produce promising and favorable reasons in the treatment of gastric ulcers. Several plants and herbs are used for the treatment of gastrointestinal disorders including gastric ulcers [8].

In this modern era also 75–80% of the world populations still use herbal medicine for primary health care because of better compatibility with the human body, and lesser side effects [9]. Histological studies revealed that acute toxicity did not shown by these medicinal plants. Preliminary phytochemical screening of these medicinal plants identified the presence of important secondary metabolites like flavonoids and tannins which are the active principles of antiulcer activity [10].

Current treatment of ulcers indeveloping countries has been largely focused on suppression ofpain, with no strategy aimed at a cure. Herbal medicines arepromising as an alternative treatment toavailable synthetic drugs for treatment of ulcerpossibly due to lower costs, availability, and feweradverse effects and perceived effectiveness [11]. Manytropical herbs have been scientifically reported topossess potent antiulcer activity with examples asCarica papaya, Aloevera, Bryophyllumpinnatum and Artocarpusaltilis. A large number of spices and herbs have been evaluated for their antiulcer effects to achieve a constructive outcome. Large numbers of medicinal plants and dietary nutrients have been shown to possess gastro-protective activities such as Aloe, Terminalia Chebula, Ginseng, Capsicum etc.

Present study was conducted to evaluate medicinal plants considered as gastro protective and healing agents on ulcers in ayurvedic resources and beside that to gather evidence for their effectiveness and biological mechanisms in modern investigation. Following compiled data recommended that medicinal plant those are evidently reported for its antiulcer activity.

Screening models for anti ulcer activity

For the screening of the anti ulcer activity, various screening models are used that helps in the understanding of the etiology of ulcer and screening of anti ulcer agents. Animal models which were used in the screening of anti ulcer activity are as follows:

Ethanol induced ulcers

Principle

Alcohol decrease mucosal resistance and causes secretion of gastric juice and due to which protein content of gastric juice is significantly increased. This could be leakage because of plasma protein in the gastric juice this leading to peptic ulcer with weakening of mucosal resistance barrier of gastric mucosa [12].

Aspirin induced ulcers

Principle

Aspirin inhibit the synthesis of prostaglandins which protects the gastric mucosa. Aspirin increases mucosal hydrogen peroxide and hydroxyl ions level to cause oxidative mucosal damage due to the inhibition of gastric peroxidise [13].

Water immersion stress induced model

Principle

Stress can arise from tension, prolonged anxiety, emotion, burns and trauma, severe physical discomfort, surgical shock, haemorrhage thereby resulting in severe gastric ulceration.

Pylorus ligation induced ulcers

Principle

In Pylorus ligation pylorus part of the stomach was ligated, it creates the acidic medium in stomach for longer time and produces the ulcer [14].

Reserpine induced ulcers

Principle

Reserpine induced ulceration has been attributed to the degranulation of gastric mast cells and subsequent liberation of histamine [15].

Serotonin induced ulcers

Principle

Serotonin induced ulceration is arises from a disturbance of gastric mucosal microcirculation.

Indomethacin induced ulcers

Principle

Indomethacin is inhibits the synthesis of prostaglandins which are protective agents for gastric mucosa high doses of the NSAIDs causes ulceration [13].

Histamine induced ulcers

Principle

Histamine causes ulceration by increasing the gastric acid secretion by directly acting on histamine receptors of parietal cells [16].

Hydrochloric acid induced ulcers

Principle

Hydrochloric acid causes ulceration by enhancing the acidity of the stomach contents.

Acetic acid induced ulcers

Principle

Acetic acid induces the ulceration in stomach by increasing the acidity of stomach contents and it also causes gastric obstruction, which leads to the ulceration.

THE ULCER HEALING POTENTIAL OF MEDICINAL PLANTS

In spite of being one of the well known medicinal plants used in Indian traditional medicine to treat several ailments, studies related to the pharmacological properties of some medicinal plants are rare. The antiulcer activity and acute toxicity of a few medicinal plants were studied, and our investigation showed that these medicinal plants could prevent ulcer in rats in a dose-dependent manner. Histological studies illustrated that these medicinal plants did not show any acute toxicity.

Preliminary photochemical screening of these plants identified the presence of secondary metabolites like flavonoids and tannins. A variety of botanical products have been reported to possess antiulcer activity but the documented literature has focused primarily on pharmacological action in experimental animals.

Except a few phytogenic compounds (i. e. aloe, liquorice etc.), limited clinical data are available to support the use of herbs as gastro-protective agents and thus, the data on efficacy and safety of these herbs are limited.

There are several botanical products with potential therapeutic applications because of their high efficacy and low toxicity. It was also found that substances such as flavonoids, aescin, aloe gel and various others that possess antiulcer activity are of particular therapeutic importance as most of the anti-inflammatory drugs used in modern medicine are ulcerogenic[17-19]. Active principles of antiulcer activity are flavonoids, tannins and terpenoids.

SOME POTENTIAL MEDICINAL PLANTS USED IN THE TREATMENT OF ULCER

Some potential plants with antiulcer activity are given in Table 1.

Ficusarnottiana

Description

Ficusarnottiana is an important medicinal plant distributed throughout India, mostly in rocky hills. It has several names including Paraspipal and kodiarasu. The fruits of the plant contain β-sitosterol, gluanolacetate and glucose. In the bark extractsterols, alkaloids, carbohydrates, tannins, phenols and many others are present. Bark of the plant is used as astringent, aphrodisiac, demulcent and emollient [20].

Uses

It is useful in inflammation, diabetes, burning sensation, leprosy, scabies and ulcer.

AlstoniaScholaris R. Br.

Description

Alstoniaspecies are found in the Malaysian region. These trees can grow large, such as Alstonia pneumatophore. Alstonia trees are used in traditional medicine. The Alstoniascholaris is used against malaria, toothache, rheumatism and snake bites and latex is used in treating coughs, sorethroat and fever [21].

Active constituent

The chief active constituents are alkaloids, coumarins, flavonoids, reducing sugars, simple phenolic, steroids, lipid, saponins and tannins. These chemical compounds detected in A. scholaris, could make the plant functional in treating different ailments. Flavonoids are a group of polyphenolic compounds which includesfree-radical scavenging, hydrolytic enzymes inhibitory and anti-inflammatory property. The flavonoids and saponinsare used in ulcer treatments.

Use

Used in ulcers, dysentery and wood paste is applied in rheumatism and toothache.

Asparagus racemosus Wild

Description

They are mainly used as cooling, demulcent, diuretic, tonic and aphrodisiac, and are used both internally and in the preparation of several medicated oils. The fresh juice of the root is used as a demulcent in dyspepsia or diarrhoea [22].

Active constituents

The principal chemical constituents exhibiting medicinal properties are Shatavarin (steroidal saponin). Four types of Shatavarin, Shatavarin I–IV are present in roots. Apart from this, quercitin-3-glucorinide, rutin in shoots; sitosterol, stigma sterol and some other unidentified saponins are found in fruits and seeds.

Use

It is used in leucorrhoea, headache, and also useful in acidity. It is said to relieve pains, so it is given to pregnant ladies before they deliver babies. Root powder is used to increase energy and strength; roots are used as an anti-inflammatory, anti-ulcerogenic, anti-tumor activity.

Azadirachtaindica

Description

Neem is a native tree of India. It is mainly grown in many Asian countries and in the tropical regions of the western hemisphere. The most active, currently identified ingredient of Neem is ‘azadirachtin’. It is used to formulate pesticides that are safe, natural and bio-degradable [23].

Active constituents

The most common active constituents found in NeemAzadirachtin, Nimbin, Nimbidin, Nimbido, Sodium nimbinate.

Use

Seeds are used in skin diseases, and in rheumatism. Bark is useful in malarial fever. Dry fruits are used as tonic and stomachic. Tender twigs are used as tooth brush.

Table 1: Medicinalplants with anti- ulcer activity

Botanical name

Family

Common name Parts used Active constituents Extract Animal Model Reference
Ficusarnottiana

Moraceae

Paras papal Leafs, fruits β - sitosterol, Gluanol acetate and Glucose, Sterols, alkaloids, Carbohydrates, Tannins, Phenols. Methanolic extract Ethanol induced ulcer 21
0.0.3 AlstoniaScholaris0.0.3 Apocyanaceae Blackboard tree Bark Alkaloids, coumarins, flavonoids, phlobatannin, reducing sugars, simple phenolic, steroids, saponins and tannins Ethanolic extract Pylorus ligation model 22
Asparagus Racemosus

Asparagaceae

Asparagus fern Roots

Fresh Juice

Shatavarin Methanolic extract Indomethacin treated 23
AzadirachtaIndica

Meliaceae

Neem Leaves Flavonoids, tannins, carbohydrates and proteins. Aqueous extract, Methanolic extract Indomethacin treated, ethanol and histamine 24
Bauhinia Variegata

Fabaceae

Orchid tree Leaves Flavonoids Aqueous extract, ethanolic extract Aspirin induced 25
ButeaFoandosa

Fabaceae

Palas Leaves Butrin, flavonoids and steroids Petroleum ether, chloroform, ethanol and water extracts HCl induced ulcer 26
Carica Papaya

Caricaceae

Papita Fruit and seeds Papain, chymopapain, pectin, carposide, carpaine, pseudocarpaine, dehydrocarpines, carotenoids, crypto glavine, cis-violaxanthin and antheraxanthin. Aqueous extract Aspirin induced ulcer 27
AnnonaSquamoza

Annonaceae

Guma, Seetha Leaves, fruit, seeds, bark. Alkaloids, flavonoids, saponins, and tannins Aqueous extract Indomethacin induced ulcer 28
AdansoniaDigitata

Malvaceae

Dead rat tree Leaves Wax, glucose, salts, gum, and albuminoids Aqueous extract Ethanol induced ulcer 29
AegleMarmelos

Rutaceae

Bael tree Fruits Flavonoids, tannins, and saponins Aqueous extract, Methanolic extract Indomethacin induced ulcer 30
Allium Sativm

Amaryllidaceae

Garlic Seeds Alliin, allicin, starch, mucilage, albumen, and sugar Methanolic extract Stress-induced gastric ulcers 31
Aloe Vera

Liliaceae

Gritkumari Leaves Barbaloin, Iso- Barbaloin, saponins Hydroalcoholic extract Indomethacin induced ulcer 32
CareyaArborea

Myrtaceae

Slow match tree Bark Tannin, Saponins Ethanolic extract Ethanol induced ulcer, Pylorus ligation 33
Euphorbia Nerifolia

Eurphorbiaceae

Common milk hedge leaf Resin, gum, caoutchouc, malate of calcium, Hydro-alcoholic extract Pylorus ligation 34
FicusReligiosa

Urticaceae

Sacred fig Bark Tannin, caoutchouc (cochtone), and wax, flavonoids, saponins, and tannins Ethanolic extract Pyloric ligation 35
Hibiscus Rosa Sinensis

Malvaceae

Changing rose Leaves Flavonoids, anthocyanins, quercetin, cyanidin, kaempferol, and hydrocitric acid Methanolic extract Pyloric ligation 36
IndigoferaTinctoria

Papilionaceae

True indigo Leaves Indican (a glucoside) Petroleum ether, chloroform, ethanolic and aqueous extracts Aspirin plus pylorus ligated model 37
Lawsoniainermis

Lythraceae

Henna Leaves Hanno, tannic acid Ethanolic extract Ethanol induced ulcer 38
MagniferaIndica

Anacardiaceae

Mango tree Leaves, flower Alkaloids, sterols, saponins, tannins, and flavonoids Petroleum ether and ethanol extracts Aspirin-induced ulcer 39
Mimosa Pudica

Fabaceae

Touch me not Leaves Flavonoids, quercitin, naringin, saponins, tannins, gums, and mucilage Alcoholic extract Aspirin, Alcohol and pyloric ligation 40
MomordicaCharantia

Cucurbitaceae

Bitter gourd Fruits Glucoside, yellow acid, resin Methanolic extract Acetic acid induced gastric ulcer, pyloric ligation induced ulcer 41
MoringaOleifera

Moringaceae

Drum-stick, horse radish tree Leaves Alkaloids, flavonoids, saponin, tannins, zeatin, quercetin, kaempferom, and terpenoids Alcoholic extract Aspirin and ethanol induced 42
MyrtusCommunis

Myrtaceae

Myrtle Berries Resin, tannin, citric acid, malic acid, and sugar Aqueous extracts Ethanol, indomethacin and pyloric ligation induced models 43
Ocimum Sanctum

Lamiaceae

Holy basil Leaves Alkaloids, tannins, saponins, flavonoids, and sterols Ethanolic extract Methanol

induced ulcer

44
PhyllanthusNiruri

Euphorbiaceae

Stonebreaker or seed-under-leaf Roots Alkaloids, saponins, tannins, flavonoids, carbohydrates, and glycosides Aqueous extract Ethanol induced ulcer 45
PsidiumGugava

Myrtaceae

Guava Bark, leaves Resin, crystals of calcium oxalate, fat, cellulose, tannin alcoholic extract,

ethyl acetate fraction

Ethanol and pylorus ligature model 46
RhusCoriaria

Anacardiaceae

Sumach Fruits Flavonoids and tannins Hydroalcoholic extract Ethanol induced 47
Sesbaniagrandiflora

Fabaceae

Basna Leaves Saponins, tannins, and triterpenes Ethanolic extract Aspirin, ethanol and indomethacin induced ulcer 48
Shorea Robusta

Dipterocarpaceae

Sal tree Resin Ursolic acid, tri and tetrehydroxyursenoic acid, Asiatic acid alpha and beta amyrin, and mangiferonic acid uvaol Resin Ethanol and pyloric ligation 49
SolanumNigrum

Solanaceae

Black nightshade berries Fruits Alkaloids, saponins, flavonoids, and phytosterols Fruit extract Cold restraint stress, indomethacin, pyloric ligation and ethanol and acetic acid induced ulcer 50
TerminaliaChebula

Combretaceae

Handa Seed Tannins, gallic acid, chebulinic acid, sorbitol Methanolic extract Pylorus

ligation and ethanol induced ulcer

51

Bauhinia variegata Linn.

Description

Bauhinia variegata is a medium-sized tree. The bark of the plant is grey and the leaves are sub-coriaceous and deeply cordate. The flowers are variously colored and the pods are long, hard, flat, and glabrous [24].

Active constituents

The seeds and bark yields fatty oil and fiber respectively. Flavonoids isolated from the different organs of B. variegata were identified as Quercetin, rutin, Quercetin, apigenin and apigenin 7-O-glucoside. Saponins, steroids, flavonoids, alkaloids, tannins, sugars are also present.

Uses

The bark is astringent, tonic and anthelmintic and useful in skin diseases, ulcers and leprosy. It is used to remove intestinal worms and to prevent the decomposition of the blood in tumors. The root is carminative, and is used in dyspepsia and flatulence.

Buteafrondosa Roxb

Description

It is a species of Butea, native to tropical southern Asia, from India, Pakistan, Bangladesh, Nepal, Myanmar, Sri Lanka, Thailand and western Indonesia. It is used for resin, timber, fodder, dye and medicine. The wood is dirty white and soft and, being durable under water, is used for well-curbs and water scoops [25].

Active constituents

The main constituent of the flower is butrin besides buteinand butin. It also contains flavonoids and steroids. Other than these in flowers, coreopsis, isocoreopsin, sulfuring (glycoside) and other two with monospermoside and isomonospermoside structures are also identified. Roots containglucose, glucosideglycine, and aromatic compounds. Tetramers of leucocyanidin are isolated from gum and stem bark.

Uses

The fresh juice is usedin ulcers. The gum is a powerful astringent given internally for diarrhea and dysentery, and hemorrhage from stomach and the bladder. The bark is reported to possess astringent bitter, pungent, alliterative, aphrodisiac and anthelmintic properties. It is useful in tumors, bleeding piles and ulcers. Roots are useful in elephantiasis and in curing night blindness and other eyesight defects. It is applied in sprue, piles, ulcers, tumors.

Carica papaya L.

Description

Papaya is a fast-growing, semi-woody tropical herb. The stem is single, straight and hollow and contains prominent leaf scars. The skin is waxy and thin but fairly tough. It is then juicy, sweetish and somewhat like a cantaloupe in flavor but some types is quite musky. Mature fruits contain numerous grey-black ovoid seeds attached lightly to the tannin [26].

Medicinal properties

Papaya latex is very much useful for curing dyspepsia and is externally applied to burns and scalds. It contains many biologically active compounds. Two important compounds are papain and chymopapain, which are widely known as being useful for digestive disorders and disturbances of the gastrointestinal tract.

Active constituents

Main chemical components are pectin, papain, chymopapain, carposide, carotenoids, carpaine, pseudocarpaine, dehydrocarpines, cis-violaxanthin, crypto glavine, and antheraxanthin.

Uses

Papaya is basically an agent that helps in the digestive process. The leaves of the tree as well as the fruit, both ripe and raw, are used medicinally to aid digestion. The papaya seeds are also useful as when ingested they help in throwing out worms from the body. The latex or the white sap produced by the papaya tree trunk is also effectual in this manner, but comparatively more aggressive. On the other hand, an infusion prepared with the flowers of the plant may be used to stimulate menstruation. While the raw papaya contains a white milky substance called papain, the ripe fruit is moderately laxative and helps in the movement of bowels.

Annonasquamoza

Description

A tree growing to a height of 5 to 10 m. Leaves are alternate, ovate to oblong-ovate or elliptic-ovate, with entire or undulate margins, pointed tip and with pointed, rounded or heart-shaped base. Flowers are stalkless, white or yellowish-white. The calyx is ovoid. Throat of the corolla and stamens are hairy. Fruit is a drupe, yellowish white or pinkish, ovoid, long with a rather scanty pulp and a hard stone [27].

Active constituents

Chemical constituents in this plant are alkaloids, saponins, flavonoids, and tannins. Seeds yield oil and resin, leaves, seeds and immature fruit contain an acrid principle. Bark contains a large amount of tannic acid. Fruit pulp contains sugar, extractive matters, gum, and ash. Fruit is considered demulcent, the bark, astringent and tonic. Tannic acid is considered as active constituent.

Uses

The bark is moistened and applied to boils and tumors to hasten ripening. Also used for headaches and stomach aches. Bark is used as anti-dyspeptic. Powdered bark is used for mouth ulcers. Infusion of bark is used as gargle. The barks are used to strengthen teeth. Leaves are used for ulcers and headaches. The highly mucilaginous fruit is used for coughs and ailments of the chest, uterus and urethra. In large quantities, used as a laxative. stem-bark extract is used as aAntidiarrhoeal activity. In one of the study it was found that the aqueous leaf extract protected against ethanol induced and pylorus ligation induced gastric ulcer in rats [28].

Adansoniadigitata

Description

Adansoniadigitata is locally known as “paparapuli.” It is one of the largest and long-lived trees in the world and mainly found in Bombay, Gujarat and Ceylon [29].

Active constituents

In this plant, Pulps contains phobaphenes, mucilage and glucose, gum, tartrate and acetate of potash, and other salts. A leaf contains glucose, wax, gum, salts, and albuminoids. Bark contains acid gum, wax, soluble and insoluble tannin, albuminous carbonate and chloride of sodium and potassium, and a glucoside adansonin. Leaves are used as fomentations and poultices for irritable inflammatory ulcers [30].

Aeglemarmelos

Description

It is locally called as “vilvam.” This plant chiefly grows on throughout India [31].

Active constituents

Active constituents in this plant are tannins, flavonoids, and saponins. Luvangetin, isolated from the seeds, is considered. In one of the investigation it was found that ulcers are induced by aspirin plus pylorus ligated gastric ulceration in rats [32].

Allium sativum

Description

Allium sativum locally called as “vellapundu.” It is cultivated all over India [33]

Activeconstituents

In this plant area acrid volatile oil which is the active principle,alliin, allicin,mucilage, starch, sugar, albumen. Seeds yield aromatic oil. The juice, more particularly its oil constituents, is rich in organically bound sulphur, salicylic acid combinations, and iodine. It was found that the extract significantly increases healing of gastric ulcer and prevents the development of experimentally induced gastric and duodenal ulcers in rats [34].

Aloe vera

Description

It is locally called “kattalai” and it is found all over India.

Active constituents

In this plant are Aloin,Barbalin,isobarbaloin,saponins and emodin [35].

Antiulcer Activity

The extract of this plant showed significant anti-ulcer activity in indomethacin induced gastric ulcer [36].

Careyaarborea

Description

Careyaarborea is locally called “pailacputatammi.”

Active constituents

In this plant are thick red barks containing tannin. Liber contains calcium oxalate in large simple crystals. Saponins are also present [37].

Antiulcer Activity

The extract showed significantly increases healing of gastric ulcer [38].

Euphorbia neriifolia

Description

Euphorbia neriifoliais locally called “ilaikkalli.”

Active constituents

Euphorbia neriifoliaplants are Euphorbon, gum, resin, caoutchouc, malate of calcium, and so forth [39].

Ficusreligiosa

Description

Ficusreligiosais locally called “arasha-maram”. This sacred peepul is a large tree round wild and cultivated all over India by the Hindus [40].

Active constituents

Active constituents in this plant are bark containing caoutchouc (cochtone), tannin, and wax. Bioactive compounds like flavonoids, saponins, and tannins are considered.

Antiulcer Activity

In one of the investigation it was found that tshe hydro alcoholic extract leaves of F. religiosa significantly decreases the ulcer index value when compared to control [41].

Hibiscus rosasinensis

Description

It is locally called “chembaruthi.” It is native to China and grown widely as an ornamental plant through India [42]

Active constituents

Active constituents in this plant are flavonoids, anthocyanins, quercetin, cyanidin, kaempferol, and hydrocitric acid.

Antiulcer Activity

It was found that the aqueous and alcohol extracts ofH. rosasinensis roots possesses significant antiulcer activity[43].

Indigoferatinctoria

Description

It is locally called “neelum; avari.” This is cultivated extensively in Northern India, especially in Bengal, Orissa, Oudh, Southern India, Madras, and Bombay [44].

Active constituents

Active constituents in this plant are Indican (a glucoside).

Lawsoniaalba

Description

It is locally called “maruthoni.” It is common all over India.

Active constituent

Active constituents in this plant are leaves that yield a colouring matter (henna dye) 12 to 15% Hanno, tannic acid, a kind of tannin, and an olive green resin soluble in ether and alcohol. Seeds yield oil. There is also glucoside in the plant [45].

Antiulcer Activity

Leaves of this plant areused to cure wounds and ulcers.

Mangiferaindica

Description

It is locally called “mangaai.” It is cultivated throughout India

Active constituents

Chemical constituents in this plant are alkaloids, saponins, tannins, sterols, and flavonoids.

Antiulcer Activity [46].

The extract of this leaves significantly reduced the gastric juice volume and gastric acidity [47].

Mimosa pudica

Description

It is locally called “thottalsinungee.” It grows in all tropical countries and many subtropical regions of the world [48].

Active constituents

Active constituents in this plant are flavonoids, naringin, tannins, quercitin, saponins, gums, and mucilage.

Antiulcer Activity

Ethanolic extract of the leaves of Mimosa pudica have been investigated to possess antiulcer activity [49].

Momordicacharantia

Description

It is locally called as “pavakka-chedi.” This climbing plant is cultivated in gardens everywhere in India.

Active Constituents

Active constituents in this plant are bitter glucoside soluble in water and insoluble in ether, a yellow acid, resin, and ash. Flavonoids, sterols and saponins, are considered as active constituents.

Antiulcer Activity

Alcoholic and aqueous extract of M. charantia fruit are used against pylorus ligation, aspirin, and stress induced ulcer in rats. [51]

Moringaoleifera

Description

It is locally called “murungai.”

Active Constituents

Active Constituents in this plant are alkaloids,tannins, zeatin, flavonoids, saponin, quercetin, terpenoids, kaempferom, beta sitosterol, and beta carotene are considered [52].

Antiulcer Activity

The alcoholic leaves extract of M. oleiferahas been reported against pylorus ligation, ethanol, cold restraint stress, and aspirin induced gastric ulcer [53].

Myrtuscommunis

Description

It is cultivated in many parts of India.

Active constituents

Active constituents in this plant are ripe berries that contain an essential volatile oil (oil of Myrtle), malic acid, tannin, citric acid, resin, and sugar.

Antiulcer Activity

M. communis fruits protected against, indomethacin, pylorus ligation gastric ulcer.

Description

It is locally called “tulsi.” It grows throughout India. It is one of the sacred herbs for Hindus in the Indian subcontinent [54].

Active constituents

Active constituents in this plant are alkaloids, sterols tannins, flavonoids,saponins, and fixed oil eugenol is considered.

Antiulcer Activity

Plant extract showed aspirin, indomethacin, alcohol, and stress.

Phyllanthusniruri

Description

It is locally called “kizhkaynelli.” It is common in Central and Southern India, extending to Ceylon. Chemical constituents in this plant are alkaloids, saponins, tannins, flavonoids, carbohydrates, and glycosides.

Active Constituents

Alkaloids-4-methoxy-securinine, ellagic acid, beta sitosterol, gallic acid, and hypophyllanthin are considered.

Antiulcer Activity

The methanolic aerial part extract of P. niruri has been shown significant antiulcer activity [55].

Psidiumguyava

Description

Psidiumguyava is locally called “koyya”.

Active constituents

Active constituents in leaves contain resin, cellulose, flavonoids, fat, tannin, cellulose, tannin, volatile oil, chlorophyll, and mineral salts.

Antiulcer Activity

The methanol leaf extract of P. guyavahas been shown significant anti-ulcer against ethanol induced gastric ulcer [56].

Rhuscoriaria

Description

It is native to southern Europe.

Active constituents

Chemical constituents in this plant are ellagic acid, gallic acid, isoquercitrin, myricitrin, and tannic acid. Flavonoids and tannins are considered as active constituents.

Antiulcer Activity

The hydro alcoholic extract of R. coriaria showed significantly increased gastric ulcers healing activity [57].

Sesbaniagrandiflora

Description

It is locally called “akathi.” Active constituents

Active constituents

Active constituents in this plant are saponins, tannins, and triterpenes [58].

Antiulcer Activity

The ethanol leaf extract of S. grandiflora extract significantly inhibited gastric mucosal damage and reduced the basal gastric acid secretion [59].

Shorearobusta

Description

It is locally called “taloora; kungiliyam”

Active constituents

Active constituents in this plant are ursolic acid, tri and tetrehydroxyursenoic acid, Asiatic acid alpha and beta amyrin, and mangiferonic acid uvaol [60].

Antiulcer Activity

The extract of S. Robusta was significantly increases the gastroprotective activity as compared to control [61].

Solanumnigrum

Description

It is locally called “manathakkalikeerai.” It is cultivated throughout India.

Active constituents

Active constituents in this plant are alkaloids, flavonoids, saponins, and phytosterols [62].

Antiulcer Activity

Aqueous leaf extract of Solanumnigrum protected against pylorus ligation induced gastric ulcers in rats [63].

Terminaliachebula

Description

It is locally called “kaduk-kai.” This tree is wild in the forests of Northern India, Central Provinces, and Bengal and common in Madras, Mysore, and in the Southern parts of the Bombay Presidency.

Active Constituents

Active Constituents in this plant are tannins (tannic acid) and a large amount of gallic acid, sorbitol, a brownish yellow colouring matter, and chebulinic acid which when heated in water splits up into tannic and gallic acids [64].

Antiulcer Activity

The extract showed significant reduction in gastric volume, free acidity, and ulcer index as compared to control. [65]

CONCLUSION

From the present study, it is clear that various medicinal plants and plant extract have significant anti-ulcer activity in vivo experiments on animal models. It was also observed that limited clinical data are available to support these plants as gastroprotective agent thus; the data on efficacy and safety are limited. But inspite of this, there are several medicinal plants which possesses high efficacy and safety. Theanti ulcer activity is mainly due to the presence of flavonoids. It has gastric anti secretary, free radical scavenging property and mucoprotective activity when compared with the reference drugs. From this study, the above mentioned plants could prevent ulcer in a dose dependent manner in rats. The results of this study reveled that the plant extract of several medicinal plants have good potential for use in peptic ulcer disease. It is evident that experimental evaluation of herbal drugs for the treatment of gastric ulcer is rather promising but very few have reached clinical trials and still few have been marketed. This shows that the benefits of research are not reaching the people. Hence, pharmacologists need to take more interest in evaluation of herbal drugs for potential antiulcer activity and standardization of such herbal drugs to be clinically effective and globally competitive.

REFERENCES

  1. Bodhankar SL, Vyawahare NS. A Text book of Pathophysiology. 5th ed. Niraliprakashan;2004.
  2. Grossman M. Am J Pharm Toxicol. Peptic ulcer: a guide for the practicing physician;2009.
  3. Malfertheiner P, Chan FK, McColl KE. Peptic ulcer disease. The Lancet;2009.
  4. Debjit B, Chiranjib C, Tripathi KK, Sampath Kumar KP. Recent trends of treatment and medication peptic ulcerative disorder. Int J Pharm Tech Res 2010;2(1):970–80.
  5. Vyawahare NS, Deshmukh, Godkari MR, Kagathara VG. Plants with anti-ulcer activity. Pharmacogn Rev 2009;3:108–15.
  6. Brooks FP. The pathophysiology of peptic ulcer disease. Digestive Diseases Sci 1985;30(11):15S–29S.
  7. http://www.betttermedicine.com/article/peptic-ulcer-1/symptoms, October 2011.
  8. Hemamalini K, Suvidha S, Bharbav A, Vasireddy V. Evaluation of antiulcer activity of methanolic extracts of Kigelia Africana, Sophorainterrupta and Holopteleaintegrifolia leaves in experimental rats. Int J Curr Pharm Res 2012;4(4):61-6.
  9. Kumar R. A review on medicinal plants for peptic ulcer. Der Pharmacia Lettre 2011;3(3):414–20.
  10. Patel G, Jain S. Antiulcer activity of Neriutnindicum in rats. Res J Pharmaco 2010;4(3):66–8.
  11. Suerbaum S, Michetti P. Helicobacter pyloriinfection. N Engl J Med 2002;347:1175-86.
  12. Thamotharan G, Shekar G, Ganesh T. Anti ulcerogenic effects of Lanatacamara Linn leaves on in vivo test models in rats. Asian J Pharm Clinical Res 2010;3(3):57-60.
  13. Goodman, Gilman. The pharmacological basis of therapeutics. 9th ed. New York: Mc Graw-Hill;1996.
  14. Vinod N, Albina A, Gopalakrishna HN, Dorababu P. Evaluation of the anti-ulcer activity of NR-ANX-C (a polyherbal formulation) in aspirin & pyloric ligature induced gastric ulcers in albino rats. Indian J Med Res 2010;132:218-1223.
  15. Al-Yahya MA, Rafatullah S, Mossa JS, Ageel AM. Gastric Anti-Secretory, Antiulcer and Cytoprotective Properties of Ethanolic Extract of Alpiniagalanga Willd in Rats. Phytotherapy Res 1990;4(3):112-4.
  16. Rang HP. Pharmacology: Churchill Livingstone Elsevier; 2009.
  17. Kokate CK, Purohit AP, Gokhale SB. Pharmacognosy. 13th ed. Pune: Nirali Prakashan Publisher; 2007.
  18. Warrier PK, Nambiar VP, Raman KC. Indian medicinal plants: A compendium of 500 species. Hyderabad: Orient Longman Publisher; 1994.
  19. Parmar NS, Parmar S. Anti-ulcer potential of flavonoids. Indian J Physiol Pharmacol 1998;42:343–51.
  20. Marslin G, Vithalrao KP, Franklin G, Kalaichelavan V. Anti-Ulcer Activity of Ficusarnottiana Miq. (Moraceae) Leaf Methanolic Extract. Am J Pharmacol Toxico 2009;4(3):89-93.
  21. Arulmozhi S, Papiya MM, L Sathiyanarayananand Prasad A. Thakurdesai, Analgesic, Anti-inflammatory and Anti-ulcerogenic Activities of Fractions from Alstoniascholaris. Pharmacologia 2012;3:132-7.
  22. Bhatnagar M, Sisodia SS, Antisecretory and antiulcer activity of Asparagus racemosus against indomethacin plus phyloric ligation-induced gastric ulcer in rats. J Herb Pharmacother 2006;6(1):13-20.
  23. Chattopadhyay I, Nandi B, Chatterjee R, Biswas K, Bandyopadhyay U, Banerjee RK. Mechanism of antiulcer effect of Neem (Azadirachtaindica) leaf extract: effect on H+-K+-ATPase, oxidative damage and apoptosis. Inflammo Pharma 2004;12(2):153-76.
  24. Rajkapoor B, Jayakar B, Anandan R, Kavimani S. Anti-ulcer effect of Bauhinia variegate Linn in rats. J Nat Rem 2003;3(2):215-7.
  25. Ramesh L, Ranirukmini RK. Antiulcerogenic study of different extracts of Buteafrondosa Roxb in albino mice. J Pharmacog 2010;1(1):6-9.
  26. Kottaimuthu R. “Ethnobotany of the Valaiyans of Karandamalai, Dindigul District, Tamil Nadu, India,” Ethnobotanical Leaflets 2009;12:195–203.
  27. Dinesh KY, Singh N, Sharma R, Sahai M, Palit G, Mourya R. Anti-ulcer constituents of Annonasquamosa twigs. Fitoterpia 2011;82(4):666-75.
  28. Saleem TSM, Kumar RP, Priyanka N, Madhuri M, Sravanti V, Sarala K. Anti-ulcerogenic effect of aqueous extract of Annonasquamosa (Linn). Int J Res Phytochem Pharmacol 2012;2(3):157–9.
  29. Nadkarni's KM. Indian Materia Medica. Popular Prakashan, Mumbai, India 1976;1:680–2.
  30. Nadkarni's KM, Indian Materia Medica, Popular Prakashan, Mumbai, India 1976;1:38-9.
  31. Ilavarasan JR, Monideen S, Vijayalakshmi M. Antiulcer activity of Aeglemarmelos. Ancient Sci Life 2002;21(4):23–6.
  32. Kumari T, Subitha M, Ayyanar M, Udayakumar M, Sekar T. Ethnomedicinal plants used by kanitribals in pechiparai forests of southern western ghats, tamilnadu, india. Int Res J Plant Sci 2011;2(12):349–54.
  33. Nadkarni's KM, Indian Materia Medica, Popular Prakashan, Mumbai, India 1976;1:65-71.
  34. Azamthulla M, Asad M, Prasad VS. Antiulcer activity of Allium sativum bulb juice in rats. Saudi Pharm J 2009;17(1):70–7.
  35. Nadkarni's KM, Indian Materia Medica, Popular Prakashan, Mumbai, India 1976;1:76-7.
  36. Borra SK, Lagisetty RK, Mallela GR. Anti-ulcer effect of Aloe vera in non-steroidal anti-inflammatory drug induced peptic ulcers in rats. African J Pharm Pharmacol 2011;5(16):1867–71.
  37. Nadkarni's KM. Indian MateriaMedica, Popular Prakashan; 1976.
  38. Kumar K, Kengaora M, Kumar S, Mythreyi R. Antiulcer activity of ethanol extract of the stem bark of CareyaarboreaRoxb. Int Current Pharm J 2013;2(3):78-82.
  39. Nadkarni's. KM. Indian Materia Medica, Popular Prakashan; 1976.
  40. Divya B, Palanivel V, Kumar KLS. Study of antiulcer activity of Ficusreligiosa leaf extract on experimentally induced gastric ulcer in rats. Int J Pharm Chem Sci 2012;1(3):713-9.
  41. Gregory M, Divya B, Mary RA, HipolithViji MM, Kalaichelvan VK, Palanivel V. Anti-ulcer activity of Ficusreligiosa leaf ethanolic extract Asian Pacific J Tropical Biomedicine 2013;3(7):554–6.
  42. Srivastava S, Jiaswal J, Gautam H, Sharma S, Rao CHV. Antiulcer activity of methanolic extract of Hibiscus Rosa Sinensis leaves. Int J Pharm Pharm Sci 2013;5(3):829-30.
  43. Srivastava S, Jaiswal J, Gautam H, Sharma S, Rao CV. Anti-ulcer activity of methanol extract of Hibiscus rosasinensis leaves. Int J Pharm Pharm Sci 2013;5(3):829–30.
  44. Umarani N, Ilango K, Valentina P, Sunitha PG, Anandarajagopal K. Antiulcer activity of various extracts of leaves of Indigoferatinctoria. Int J Chem Sci 2008;1:281-4.
  45. Goli V, Macharla SP, Bhaskar KV, Gowrish SNL, Bhaskar J, Dhanlakshmi Ch. Antiulcer activity of leaf extract Lawsoniainermis in albino rats. Res J Pharm Technol 2011;4(9):1436-8.
  46. Neelapu M, Muvvala S, Mrityunjaya BP, Lakshmi BVS. Antiulcer activity of HPTLC analysis of Mangiferaindica L. Leaves. Int J Pharm Phytopharm Res 2012;1(4):146-55.
  47. Neelima N, Sudhakar M, Patil MB, Lakshmi BVS. Anti-ulcer activity and HPTLC analysis of Mangiferaindica leaves. Int J Pharm Phytopharm Res 2012;1(4):146–55.
  48. Vinothapooshan G, Sundar K. Antiulcer activity of Mimosa pudica leaves against gastric ulcer in rats. Res J Pharm Biol Chem Sci 2010;1(4):606-14.
  49. Vinothapooshan G, Sundar K. Anti-ulcer activity of Mimosa pudica leaves against gastric ulcer in rats, Res J Pharm Biol Chem Sci 2010;1(4):606–16.
  50. Alam S, Asad M, Asdaq SM, Prasad VS. Antiulcer activity of methanolic extract of Momordicacharantia L in rats. J Ethanopharmacol 2009;123(3):464-9.
  51. Rao NV, Venu K, Sowmya U, Reddy GJ, Anirudan K. Evaluation of antiulcer activity of Momordicacharantia in rats. Int J Pharm Biol Sci 2011;1(1):1–16.
  52. Verma VK, Singh N, Saxena P, Singh R. Antiulcer and Antioxidant activity of Moringaoleifera (Lam) leaves against Aspirin and ethanol induced gastric ulcer in rats. Int J Pharm 2012;2(2):46-57.
  53. Verma VK, Singh N, Saxena P, Singh R. Anti-ulcer and anti-oxidant activity of Moringaoleifera (Lam) leaves against aspirin and ethanol induced gastric ulcer in rats. Int Res J Pharm 2002;2:46–57.
  54. Nadkarni's KM, Indian Materia Medica, Popular Prakashan; 1976.
  55. Okoli CO, Ezike AC, Akah PA, Udegbunam SO, Okoye TC, Mbanu TP, Ugwu E. Studies on wound healing & antiulcer activities of extract of aerial parts of Phyllanthusniruri L.(Euphorbiaceae). Am J Pharmacol Toxicol 2009;4(4):118-26.
  56. Jayakumari S, Anbu J, Ravichandiran V, Anjana A, Kumar GMS, Maharaj S. Antiulcerogenic and free radical scavenging activity of flavonoid fraction of Psidium Guajavalinn. leaves. Int J Pharm Pharm Sci 2012;4(1):170-4.
  57. Ahmad H, Wadud A, Jahan N, Khazir M, Sofi G. Evaluation of anti-ulcer activity of hydro alcoholic extract of Post Sumaq (Rhuscoriaria Linn.) in Ethanol induced Gastric ulcer in experimental rats. Int Res J Med Sci 2013;1(10):7–12.
  58. Ganesan S, Pandi NR, Banumathy N. Ethanomedicinal survey of Alagarkoil Hills, Tamilnadu. India E J Indian Med 2008;1:1–18.
  59. Rasika DB, Mahendra A, Gairi Sneha JA, Subodhc P. Anti-ulcer activity of the ethanol extract of leaves of Sesboniagrandiflora L. Int J Pharm Pharm Sci 2010;2(4):206-8.
  60. Nadkarni's KM. Indian Materia Medica,Popular Prakashan; 1976.
  61. Muthu SK, Nagarajan Anusuya, Palanisamy B. Antiulcerogenic effect of resin from Shorea Robusta on experimentally induced ulcer models. Int J Pharm Pharm Sci 2013;5(1):269-72.
  62. Jainu M, Devi CS. Antiulcerogenic ulcer healing effects of Solanumnigrum (L.) on experimental ulcer model: possible mechanism for the inhibition of acid formation. J Ethanopharmcol 2006;104(1-2):156-63.
  63. Kavitha Shree GG, Parvathi S, Ramkumar PSS, Priya SS. Pharmacological and phytochemical evaluation of anti-ulcerogenic potential of Solanumnigrum. Indian J Pharm Sci Res 2012;3(8):2837–40.
  64. Nadkarni's KM. Indian Materia Medica, Popular Prakashan;1976.
  65. Raju D, Ilango K, Chitra V, Ashish K. Evaluation of anti-ulcer activity of methanolic extract of methanolic extract of Terminaliachebula fruits in experimental rats. J Pharm Sci Res 2009;1(3):101-7.