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      Hot-water extract of the branches of Hovenia dulcis Thunb. (Rhamnaceae) ameliorates low-fiber diet-induced constipation in rats

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          Abstract

          Hovenia dulcis Thunb. (Rhamnaceae), also known as oriental raisin tree, is used in traditional herbal medicine. Its extracts have been reported to show various pharmacological effects such as hepatoprotection, antitumor, antiatopic dermatitis, antilipid peroxidation, anti-steatotic, anti-inflammatory, and antiallergic activities. However, there have been no reports on the effect of H. dulcis extracts in relieving constipation so far. The aim of this study was to investigate the effects of a hot-water extract of the branches of H. dulcis (WEHD) on low-fiber diet-induced constipation in Sprague Dawley rats. The in vivo laxative activity of WEHD was assessed by measuring the intestinal transit of charcoal meal and stool parameters. Furthermore, the in vitro spasmogenic activity of WEHD was evaluated by monitoring the temporal profiles of contraction of rat colon in the absence or presence of WEHD. In addition, constituent profiling was conducted using high-performance liquid chromatography analysis. Pretreatment with WEHD significantly enhanced the intestinal transit of charcoal meal and increased the frequency and weight of stools in rats. In addition, the frequency and amplitude of contractile responses of isolated rat colon were markedly enhanced by WEHD. Two organic phenolic acids, ferulic and vanillic acids, were identified in WEHD, of which vanillic acid exhibited spasmogenic activity. To the best of our knowledge, this is the first study to report the laxative and spasmogenic activities of H. dulcis and its constituents, suggesting that WEHD can serve as a complementary and/or alternative laxative in alleviating chronic constipation.

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          Potential applications of ferulic acid from natural sources

          Ferulic acid (FA), a ubiquitous natural phenolic phytochemical present in seeds, leaves, bothin its free form and covalently conjugated to the plant cell wall polysaccharides, glycoproteins,polyamines, lignin and hydroxy fatty acids. FA plays a vital role in providing the rigidity to the cell wall and formation of other important organic compounds like coniferyl alcohol, vanillin, sinapic, diferulic acid and curcumin. FA exhibits wide variety of biological activities such as antioxidant, antiinflammatory, antimicrobial, antiallergic, hepatoprotective, anticarcinogenic, antithrombotic, increase sperm viability, antiviral and vasodilatory actions, metal chelation, modulation of enzyme activity, activation of transcriptional factors, gene expression and signal transduction.
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            Review article: therapeutic roles of acupuncture in functional gastrointestinal disorders.

            Acupuncture has been practiced empirically in China for several millennia, and is being increasingly accepted by practitioners and patients worldwide. Functional gastrointestinal disorders are common in clinical gastroenterology. The prevalence of one or more functional gastrointestinal disorders is estimated to be as high as 70% in general population using Rome diagnostic criteria. Since functional gastrointestinal disorders are diagnosed based on symptoms and the exact aetiologies for most of functional gastrointestinal disorders are not completely known, it is not unusual that the treatment for these disorders is unsatisfactory and alternative therapies are attractive to both patients and practitioners. During the latest decades, a considerable number of studies have been performed on acupuncture for the treatment of functional gastrointestinal disorders and underlying mechanisms. In this article, we reviewed available data in the literature on the applications and mechanisms of acupuncture for the treatment of functional gastrointestinal disorders, including functional oesophageal disorders, nausea and vomiting, functional dyspepsia, irritable bowel syndrome, constipation, etc. A summary is provided based on the quality and quantity of published studies regarding the efficacy of acupuncture in treating these various disorders. In addition, the methodology of acupuncture is also introduced.
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              Laxative abuse: epidemiology, diagnosis and management.

              Laxatives have been used for health purposes for over 2000 years, and for much of that time abuse or misuse of laxatives has occurred. Individuals who abuse laxatives can generally be categorized as falling into one of four groups. By far the largest group is made up of individuals suffering from an eating disorder such as anorexia or bulimia nervosa. The prevalence of laxative abuse has been reported to range from approximately 10% to 60% of individuals in this group. The second group consists of individuals who are generally middle aged or older who begin using laxatives when constipated but continue to overuse them. This pattern may be promulgated on certain beliefs that daily bowel movements are necessary for good health. The third group includes individuals engaged in certain types of athletic training, including sports with set weight limits. The fourth group contains surreptitious laxative abusers who use the drugs to cause factitious diarrhoea and may have a factitious disorder. Normal bowel function consists of the absorption of nutrients, electrolytes and water from the gut. Most nutrients are absorbed in the small intestine, while the large bowel absorbs primarily water. There are several types of laxatives available, including stimulant agents, saline and osmotic products, bulking agents and surfactants. The most frequently abused group of laxatives are of the stimulant class. This may be related to the quick action of stimulants, particularly in individuals with eating disorders as they may erroneously believe that they can avoid the absorption of calories via the resulting diarrhoea. Medical problems associated with laxative abuse include electrolyte and acid/base changes that can involve the renal and cardiovascular systems and may become life threatening. The renin-aldosterone system becomes activated due to the loss of fluid, which leads to oedema and acute weight gain when the laxative is discontinued. This can result in reinforcing further laxative abuse when a patient feels bloated and has gained weight. Treatment begins with a high level of suspicion, particularly when a patient presents with alternating diarrhoea and constipation as well as other gastrointestinal complaints. Checking serum electrolytes and the acid/base status can identify individuals who may need medical stabilization and confirm the severity of the abuse. The first step in treating laxative misuse once it is identified is to determine what may be promoting the behaviour, such as an eating disorder or use based on misinformation regarding what constitutes a healthy bowel habit. The first intervention would be to stop the stimulant laxatives and replace them with fibre/osmotic supplements utilized to establish normal bowel movements. Education and further treatment may be required to maintain a healthy bowel programme. In the case of an eating disorder, referral for psychiatric treatment is essential to lessen the reliance on laxatives as a method to alter weight and shape.
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                Author and article information

                Journal
                Drug Des Devel Ther
                Drug Des Devel Ther
                Drug Design, Development and Therapy
                Drug Design, Development and Therapy
                Dove Medical Press
                1177-8881
                2018
                03 April 2018
                : 12
                : 695-703
                Affiliations
                [1 ]Department of Natural Medicine Research, Jeonnam Institute of Natural Resources Research, Jangheung-gun
                [2 ]Department of Pharmacy, College of Pharmacy and Natural Medicine Research Institute, Mokpo National University, Muan-gun, Jeonnam
                [3 ]Department of Manufacturing Pharmacy, College of Pharmacy, Pusan National University, Geumjeong-gu, Busan, South Korea
                Author notes
                Correspondence: In-Soo Yoon, College of Pharmacy, Pusan National University, 2 Busandaehak-ro 63beon-gil, Geumjeong-gu, Busan 46241, South Korea, Tel +82 51 510 2806, Email insoo.yoon@ 123456pusan.ac.kr
                Seung-Sik Cho, Department of Pharmacy, College of Pharmacy, Mokpo National University, 1666 Youngsan-ro, Muan-gun, Jeonnam 58554, South Korea, Tel +82 61 450 2687, Email sscho@ 123456mokpo.ac.kr
                Article
                dddt-12-695
                10.2147/DDDT.S150284
                5892967
                71159384-1e7f-493c-bb8b-92d0087d9679
                © 2018 Choi et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Original Research

                Pharmacology & Pharmaceutical medicine
                hovenia dulcis,constipation,low-fiber diet,charcoal meal,vanillic acid,laxative

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