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      Ginger in gastrointestinal disorders: A systematic review of clinical trials

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          Abstract

          Ginger, the rhizome of Zingiber officinale, which is used as a spice globally has a long history of medicinal use that stimulates investigators to assess its potential roles as an adjuvant therapy or alternative medicine in a range of diseases. Anti‐inflammatory, antioxidant, antitumor, and antiulcer effects of ginger have been proven in many scientific studies, and some of the ancient applications of ginger as a home remedy has been confirmed in human. In this review, we summarized the current evidence on the effects of ginger consumption on gastrointestinal disorders based on clinical trials. Our data indicate that divided lower daily dosage of 1500 mg ginger is beneficial for nausea relief. Because of limited number of studies on some other gastrointestinal disorders, the results may not be as much powered as to find significant results. Therefore, more extensive and well‐controlled human studies of ginger or its standard extracts are required to demonstrate its efficacy as a gastroprotective agent. Dose‐finding studies should be undertaken to accurately determine the effective dose and preparation of ginger in further clinical trials protocol.

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          Some phytochemical, pharmacological and toxicological properties of ginger (Zingiber officinale Roscoe): a review of recent research.

          Badreldin Ali, Gerald Blunden, Musbah Tanira … (2008)
          Ginger (Zingiber officinale Roscoe, Zingiberacae) is a medicinal plant that has been widely used in Chinese, Ayurvedic and Tibb-Unani herbal medicines all over the world, since antiquity, for a wide array of unrelated ailments that include arthritis, rheumatism, sprains, muscular aches, pains, sore throats, cramps, constipation, indigestion, vomiting, hypertension, dementia, fever, infectious diseases and helminthiasis. Currently, there is a renewed interest in ginger, and several scientific investigations aimed at isolation and identification of active constituents of ginger, scientific verification of its pharmacological actions and of its constituents, and verification of the basis of the use of ginger in some of several diseases and conditions. This article aims at reviewing the most salient recent reports on these investigations. The main pharmacological actions of ginger and compounds isolated therefrom include immuno-modulatory, anti-tumorigenic, anti-inflammatory, anti-apoptotic, anti-hyperglycemic, anti-lipidemic and anti-emetic actions. Ginger is a strong anti-oxidant substance and may either mitigate or prevent generation of free radicals. It is considered a safe herbal medicine with only few and insignificant adverse/side effects. More studies are required in animals and humans on the kinetics of ginger and its constituents and on the effects of their consumption over a long period of time.
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            Ginger--an herbal medicinal product with broad anti-inflammatory actions.

            Reinhard Grzanna, Lars Lindmark, Carmelita Frondoza (2005)
            The anti-inflammatory properties of ginger have been known and valued for centuries. During the past 25 years, many laboratories have provided scientific support for the long-held belief that ginger contains constituents with antiinflammatory properties. The original discovery of ginger's inhibitory effects on prostaglandin biosynthesis in the early 1970s has been repeatedly confirmed. This discovery identified ginger as an herbal medicinal product that shares pharmacological properties with non-steroidal anti-inflammatory drugs. Ginger suppresses prostaglandin synthesis through inhibition of cyclooxygenase-1 and cyclooxygenase-2. An important extension of this early work was the observation that ginger also suppresses leukotriene biosynthesis by inhibiting 5-lipoxygenase. This pharmacological property distinguishes ginger from nonsteroidal anti-inflammatory drugs. This discovery preceded the observation that dual inhibitors of cyclooxygenase and 5-lipoxygenase may have a better therapeutic profile and have fewer side effects than non-steroidal anti-inflammatory drugs. The characterization of the pharmacological properties of ginger entered a new phase with the discovery that a ginger extract (EV.EXT.77) derived from Zingiber officinale (family Zingiberaceae) and Alpina galanga (family Zingiberaceae) inhibits the induction of several genes involved in the inflammatory response. These include genes encoding cytokines, chemokines, and the inducible enzyme cyclooxygenase-2. This discovery provided the first evidence that ginger modulates biochemical pathways activated in chronic inflammation. Identification of the molecular targets of individual ginger constituents provides an opportunity to optimize and standardize ginger products with respect to their effects on specific biomarkers of inflammation. Such preparations will be useful for studies in experimental animals and humans.
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              Zingiberis rhizoma: a comprehensive review on the ginger effect and efficacy profiles.

              S Chrubasik, M H Pittler, B D Roufogalis (2005)
              Zingiberis rhizoma is used as a broadspectrum antiemetic. We, therefore, conducted a comprehensive review of the literature to summarize the pharmacological and clinical effects of this popular plant material. Although clinical and experimental studies suggest that ginger has some antiemetic properties, clinical evidence beyond doubt is only available for pregnancy-related nausea and vomiting. Meta-analyses could not demonstrate the postoperative antiemetic effectiveness, and effect in motion sickness or nausea/vomiting of other ethiology. It also remains to be confirmed that proprietary ginger preparations are clinically useful to alleviate osteoarthritic or other pain, although there is no doubt that ginger constituents interfere with the inflammatory cascade and the vanilloid nociceptor. Ginger exerts in vitro antioxidative, antitumorigenic and immunomodulatory effects and is an effective antimicrobial and antiviral agent. Animal studies demonstrate effects on the gastrointestinal tract, the cardiovascular system, on experimental pain and fever, antioxidative, antilipidemic and antitumor effects, as well as central and other effects. The most relevant human pharmacological studies require a confirmatory study to exclude interaction of ginger preparations with platelet aggregation. Pharmacokinetic data are only available for [6]-gingerol and zingiberene. Preclinical safety data do not rule out potential toxicity, which should be monitored especially following ginger consumption over longer periods.
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                Author and article information

                Contributors
                Azita Hekmatdoost: Azita.Hekmatdoost@cw.bc.ca , a_hekmat2000@yahoo.com
                Journal
                Journal ID (nlm-ta): Food Sci Nutr
                Journal ID (iso-abbrev): Food Sci Nutr
                Journal ID (doi): 10.1002/(ISSN)2048-7177
                Journal ID (publisher-id): FSN3
                Title: Food Science & Nutrition
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2048-7177
                Publication date (Electronic): 05 November 2018
                Publication date Collection: January 2019
                Volume: 7
                Issue: 1 ( doiID: 10.1002/fsn3.2019.7.issue-1 )
                Pages: 96-108
                Affiliations
                [ 1 ] Student Research Committee Faculty of Nutrition and Food Technology Shahid Beheshti University of Medical Sciences Tehran Iran
                [ 2 ] Gut and Liver Research Center Mazandaran University of Medical Sciences Sari Iran
                [ 3 ] Department of Clinical Nutrition and Dietetics Faculty of Nutrition Sciences and Food Technology National Nutrition and Food Technology Research Institute Shahid Beheshti University of Medical Sciences Tehran Iran
                Author notes
                [*] [* ] Correspondence

                Azita Hekmatdoost, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

                Emails: Azita.Hekmatdoost@ 123456cw.bc.ca , a_hekmat2000@ 123456yahoo.com

                Article
                Publisher ID: FSN3807
                DOI: 10.1002/fsn3.807
                PMC ID: 6341159
                PubMed ID: 30680163
                SO-VID: d20629b6-8614-4396-a19e-ad0f05fd506b
                Copyright © © 2018 The Authors. Food Science & Nutrition published by Wiley Periodicals, Inc.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 12 April 2018
                Date revision received : 03 July 2018
                Date accepted : 04 July 2018
                Page count
                Figures: 0, Tables: 4, Pages: 13, Words: 10452
                Categories
                Subject: Review Article
                Subject: Review Article
                Custom metadata
                source-schema-version-number 2.0
                component-id fsn3807
                cover-date January 2019
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.5.6 mode:remove_FC converted:22.01.2019

                Keywords: dyspepsia,fatty liver,gastrointestinal cancer,gastrointestinal mucosa,gastroprotective,ginger,gingerol,irritable bowel syndrome,nausea,shogaol,swallowing,vomiting gastric emptying,zerumbone,zingiber
                Data availability:
                Keywords: dyspepsia, fatty liver, gastrointestinal cancer, gastrointestinal mucosa, gastroprotective, ginger, gingerol, irritable bowel syndrome, nausea, shogaol, swallowing, vomiting gastric emptying, zerumbone, zingiber

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