Antidiarrhoeic Effect of Plants Used in Popular Medicine

7/27/2019 Antidiarrhoeic Effect of Plants Used in Popular Medicine

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Analysis of antidiarrhoeic effect of plants used inpopular medicine*C y b e l e E , A l m e i d a , M a r g G . O , K a r n i k o w s k i , R e j a n e F o l e t o a n d B e r n a rd o B a l d i s s e r o t t o

D e p a r t a m e n t o d e F i s i o l o g i a , U n i v e r s i d a d e F e d e r a l d e S a n t a M a r i a - S a n t a M a r ia , R S - B r a s i l

People customarily use the extracts of plants known to have antidiarrhoeal effects without any scientific base to explainthe action of the extract. For this reason, an investigation was undertaken with a view to determining the efficacy ofthe effects of the brute aqueous extract (BAE) of the leaves of Psidium guajava (guava), Stachytarpheta cayenensis(bastard vervain), Polygonum punctatum (water. smartweed), Eugenia uniflora (Brazil or Surinam cherry) and Astersquamatus (z-da-silva) on the intestinal transport of water in rats and on the gastrointestinal propulsion in mice. Withthe exception of the BAE of S. cayenensis, all other BAE's have increased the absorption of water in one or moreintestinal portion in relation to the control group. All tested BAE, except that of P. punctatum, reduced thegastrointestinal propulsion in relation to that of the control group. The results indicate that the BAE of the leaves of P.guajava, S. cayenensis, P. punctatum, E. uniflora and A. squamatus have a potential antidiarrhoeic effect to beconfirmed by additional investigations in animals infected with enteropathogenic agents.Diarrhea, therapy. Plant extracts, pharmacology. Plants, medicinal.

IntroductionIn the Third World, diarrhoeal diseases areresponsible for the deaths of millions of peopleeach year22 and it is, thus, a serious public healthproblem. Most persons who suffer from this prob-lem are socially underprivileged individuals, an dconsequently, almost without access to alopathicmedicine. Fo r this reason, an investigation wasmade with a view to determining the efficacy ofthose plants comm only used in Southern Brazil formedical diarrhoeic care: Psidium guajava L. var.

pommiferum (guava/goiabeira), Stachytarphetacayenensis (L.C. Rich) Vahl. (bastardvervain/gervo), Polygonum punctatum Elliot,(water smartweed/polgono or pimenta d'gua),Eugenia uniflora L. (Brazil or Surinamcherry/pitangueira) and Aster squamatus (Spreng.)Hieron (z-da-silva). The leaves, roots and flo-wers of P. guajava are customarily used in tropi-

cal and subtropical regions4,5,16,17,18,28. The roots andleaves of S. cayenensis are utilized in NorthernBrazil1. A plant of the same genus, Stachytarphetajamaicensis, found in tropical and subtropicalregions is also used to treat dysentery an d intesti-nal worms24,30.The entire P. punctatum plant isused to treat dysentery in Central and SouthAmericas10,28. The leaves of E. uniflora are used intropical and subtropical regions1,30. The aerial por-tion of A. squamatus is used in Southern Brazil** .Material and Method

The plants were collected between September1991 and January 1992, after which the leaveswere dried at room temperature and the BAE pre-pared by an infusion of 16.67 g of dried leaves inone litre of Tyrode solution or water (similar to theinfusion used by people). Adult male Wistar rats

*Presented in the "III Jornada de Pesquisa of the Universidade Federal de Santa Maria, Santa Maria (September 93) and "XVII ICongreso Latinoamericano de Ciencias Fisiolgicas, Montevideo " (April 94).**A.M. V, Lopes et al "Plantas usadas na medicina popular em Santa Maria, Rio Grande do Sul, Brasil" [unpublished].Reprints: Cybele E. Almeida - Departamento de Fisiologia, Universidade de Santa Maria - 97119-900 - Santa Maria, RS - BrasilFa x (055) 226.24.23- E.mail - CYBELE@SUPER. UFSM.BRReceived in 1.19.1995. Approved in 10.2.1995.


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(150 - 200g) in fasting (24 h) were used to inves-tigate the transport of water, and were sacrificedby cerebral concu ssion. The abdomen was opened,and the intestine separated in the following por-tions: duodenum, j e junum, ileum and colon. Theseportions were everted an d washed with Tyrodesolution. The flow of water was determined asdescribed by Baldisserotto et al. 2 To verify the "invitro" effect of the plants the BAE was placed inth e infusion, in contact with th e intestinal mucosa.The flow of water was expressed as ml of watertransferred from mucosa to serosa (negative val-ues) or serosa to mucosa (positive values) in func-tion of the weight of the tissue (duodenum,je junum, ileum or colon) in g during l h (ml/g tis-sue.h). An adaptation of the method described byJanssen and Jageneau 15 was used to investigate thegastrointestinal propulsion. Mice (15 - 45 g) infasting (24 h) were fed a solution of 0.1 ml BAEpe r lO g live weight, that contained a 10% char-coal suspension as an indicator of gastrointestinalpropulsion, by gastric intubation. The controlgroup received the same treatment, but the BAEwas su bstituted for water. Forty-five m inutes later,the mice were sacrificed, the gastrointestinal tractexcised, from cardia to anus, an d carefully laid ou tfor measurement of the distances travelled by thecharcoal. The gastrointestinal propulsion wasexpressed as fractional values of the distance tra-velled by the charcoal in relation to the total lengthof the intestine. These fractional values were usedbecause the total length of the intestines of micewas variable.All values are expressed as the mean SE, andthe t-Student Test w as used to verify the statisticalsignificance of the difference between means(control and with BAE).Results

The flow of water was from serosa to mucosa(secretion) in the control group. The BAE of P.guajava increased the absorption of water in thecolon, bu t there was no alteration of the flow ofwater in the other portions. The BAE of S.cayenensis did not change the transport of water inrelation to the control group in the portionsanalysed. The BAE of E. uniflora increased theabsorption of water in all portions, except theje junum. The absorption of water increased in allportions when the BAE of A. squamatus wasused. The BAE of P. punctatum increased theabsorption of water in the ileum, but there was no

change in the flow of water in other portions(Figure 1A and B, Table 1).All BAE tested, except that of P. punctatum,reduced the gastrointestinal propulsion in relationto that of the control group (Figure 2 and Table 2).

DiscussionThe viscosity of the faecal bolus basicallydepends on the absorption of water and the inten-sity of the gastrointestinal propulsion. A decreasein the absorption or hypersecretion of water and ahigher intestinal motility which decreases the soli-dity of the faeces was observed in diarrhoea 12. This

change in the flow of water is due to an increase inthe secretion of Cl- or HCO 3- and an inhibition of9the absorption of Na+ and Cl- . To be considered ashaving an antidiarrhoeic effect, a drug must producean inverse diarrheal effect, i.e., it must decrease the


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secretion (or increase the absorption) of water andreduce the intestinal motility.Field studies of the World H ealth O rganizationhave demonstrated that the oral rehydration thera-py (ORT) is effective in the treatment of all diar-rhoeas19 . However, the availability of ORT, espe-cially in poor Third World countries, is low. By1989, the number of countries that used the ORTwas 60. Poorer countries, where the diarrhoeas arethe main cause of mortality, may not be able toproduce th e oral rehydration salts or distributethem18 . On the other hand, th e medicinal plantsthat could be used to treat diarrhoea (for example,all the plants utilized in this experiment) ar e fre-quently of easy access and can be obtained free ofcharge.The leaves of the guava, P. guajava, have beenused as folk remedies in the areas where it grows.In some places th e leaves are chewed for the reliefof discomfort and pain associated with the gas-

troenteritis of diarrhoea, as well as for stopping it.The same effect can be obtained using a decoctionof the leaves, bark of the stem or root17 . In South-East Asia, the leaf is given to the giant thorny stickinsect, Hepteropteryx dilata or other insects, andthe faeces are collected in dry pellet form. Thesepellets are mixed with hot water to make a plea-santly flavoured wine-coloured drink, which isclaimed to be efficacious in the treatment of acutediarrhoeas17 .The leaf of this plant contains approximately10% tannin7,20,21 and also quercetin26 . Plants thathave tannins in their composition ca n present ananti-diarrhoeic effect, since these substances pre-cipitate th e proteins of the enterocytes, reducingthe peristaltic movem ents and the intestinal secre-tions. The layer formed by the precipitate of pro-teins on the mucosal surface of the enterocytesalso inhibit the development of micro-organisms,thus explaining the antiseptic action of the tannins,which contributes to the treatment of diarrhoea8.Quercetin is the most frequent of all flavonoids13 ,an d inhibits the release of acetylcholine in theguinea-pig 's i leum and the synthesis ofprostaglandins2 9. In man, prostaglandins cause


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intestinal cramps and diarrhoea31 . Consequently, adrug that decreases the synthesis of prostaglandinscould be useful in the treatment of diarrhoea. Theextract of leaves of P. guajava also inhibits thespontaneous contractions in the ileum of theguinea-pig16,17 and the in vitro growth of threeenterobacteria (Escherichia coli, Salmonellaenteritidis and Shigella flexneri)4, 5. The antibioticactivity is attributed to two compounds of theextract, guajaverin and psidiolic acid3,5 .The chemical composition of the genusStachitarpheta has never been investigated.Another species of the genus Stachitarpheta (S.indica) is utilized in the treatment of diarrhoea inEastern Africa32. O ur results also confirm the pos-sibility of the existence of an antidiarrhoeic sub-stance in S. cayenensis, since its BAE reduces thegastrointestinal propulsion. The presence of activesubstances like tannins were also determined in E.uniflora32.Flavonoids were found in the flowers of A.squamatus25 . Another phytochemical study withthe leaves, stem and roots of this plant revealed thepresence of tannins15 . A. squamatus was the mostefficient among the plants studied, as regards itspossible antidiarrhoeic effect, since its BAEincreased the absorption of water in all portionsanalysed and reduced the intensity of the gastroin-testinal propulsion. These results justify the popu-lar use of A. squamatus in the treatment of diar-rhoeal diseases in infants in Southern Brazil .P. punctatum has been used in enemas as atreatment for dysentery10 . Several species of thegenus Polygonum, including P. punctatum, con-tain great amounts of tannins14 . Quercetin andsesquiterpenoids (with antimicrobian activity)were also isolated from the extract of this

species11,34. Aqueous an d alcoholic extracts ofthis plant reduced the effect of ocitocin andacetylcholine in the rat's uterus. This reductionwas not observed if the extracts were tannin-free23 However, Chagas et al6 did not find anyeffect of the aqueous extract of P. acre in thesame organ.In the present study, the BAE analysed (exceptthat of 5. cayenensis) reduced the secretion ofsome po rtions of the intestine. It is possible that itseffect is due to the presence of tannins in the BAEof P. guajava, E. uniflora, A. squamatus an d P.punctatum. The reduction of the gastrointestinalpropulsion observed with the use of the BAE of P.guajava, E. uniflora and A. squamatus could alsobe due to the tannins. This effect of the BAE of P.guajava is in agreement with the fact that a similarextract of this plant inhibited the spontaneous con-tractions in the ileum of the guinea-pig17,18. Sincethe chemical composition of S. cayenensis is notknown, it is not possible to explain its effect ongastrointestinal propulsion.The results of this study indicate that the plantsanalysed have a potential antidiarrhoeic effect.However, more studies must be undertaken on infect-ed animals with varying doses of the same extract.Further pharmacological, toxicological and clinicalwork on these plants is needed before they can beused as an alternative treatment for diarrhoeas.Acknowledgement

To Prof. Amelia Moema Lopes of the"Universidade Federal de Santa Maria" for herhelp in the collection and classification of theplants used in this experiment.

References1. ALBUQUERQUE, J .M. Plantas medicinais deuso popular. Braslia, Associao Brasileira deEducao Agrcola Superior/MEC, 1989.2 . BALDISSEROTTO, B.; M I M U R A, O.M..;SALOMO, L.C. Effect of pH on ion andwater transport in the gut of the freshwaterteleost, Synbranchus marmoratus. Cinc.Cult., 45:396-8, 1993.3. B E R D Y , J.; ASZALOS, A.; BOSTIAN, M..; McNITT,

K . L . Hand book of antibiotic compounds.Boca Raton, CRC Press, 1982.V.8, pt.l: 410an d pt.2:429.4. CACERES, A . ; C A N O , O.; SAMAYOA, B . ;AGUILAR,L. Plants used in Gua temalafor the treatment of gastrointestinal disorders.

1. Screening of 84 plants against ente-robacteria .J.Etbnopbarmacol., 30:55-73, 1990.5 . C AC E R E S , A .; FLETES, L. ; A G U I L A R , L.;RAMIREZ, O .; FIGUEROA, L . ; TARACENA,M.A.; SAMAYOA, B. Plants used inGuatemala for the treatment of gastrointesti-nal disorders. 3.Confirmation of activityagainst enterobacteria of 16 plants . J.Etbnopbarmacol. , 38:31-8, 1993.6. CHAGAS, A.M.; TEIXEIRA, A .H.; DALOSTO, C;BOLASSE, C.; BORTOLUZZI, M.A.M.; JU -CHEM, W.R. Efeito protetor de Polygonumacre H.B.K. sobre as hemorragias artificiaisem camundongos. Sade, 15 :105-16, 1989.7 . CORRA, M.P. Diccionrio da s plantas teis doBrasil e das exticas cultivadas. Braslia,Ministrio da Agricultura/IBDF, 1984.


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8. COSTA, A.F. Farmacognosia. 3th ed. Lisboa,Fundao Calouste Gulbenkian,1975, v. l .9. FIELD, M. & SEMRAD, C.E .Toxigenic diarrheas,congenital transport. Annu. Rev. Physiol.,55 :631-55, 1993.10 . FONT-QUER, P. Plantas medicinales. 2th ed.Barcelona, Ed. Labor, 1973.

11 . FU K U Y AM A, Y ,; SATO, T. ; ASAKAWA, Y. ;T A K E M O T O , T. A potent cytotoxic warbur -ganal and related drimane-type sesquiterpe-noids from Polygonum hidropiper. Phyto-chemistry, 21 :2895-8, 1982.12 . G U Y T O N , A.C. Tratado de fisiologia mdica.7 th ed. Rio de Janeiro, G uanabara Koogan,1989.13 . HAVSTEEN, B. Flavonoids, a class of naturalproducts of high pharmacological potency.Biochem. Pbarmacol. , 32 :1141-2, 1983.14 . H E GN A UE R, R. Chemotaxonomie de r pflanzen.Stuttgart, Birkhauser, 1962-1973.

1 5 - KARNIKOWSKI, M. G. O. ; BALDISSEROTTO, B. ;BORTOLUZZI, M.A.M. Screening do extratoaquoso bruto (EAB) de Aster squamatus(Spreng) Hieron, In : Encontro de CinciasFisiolgicas do Cone Sul, 1o, Santa Maria,1994. Anais, 1994, p.34 .16 . L O Z O Y A , X.; BECERRIL, G .; MARTINEZ, M.Modelo de perfusin in tralumina l del ileon de lcobayo in vitro en el estudio de las pro-priedades antidiarricas de la guajaba (Psidiumguajava). Arch. Invest. Mx., 21 :155-62, 1990.17 . LUTTERODT, G.D. Inhibit ion of gastrointesti-na l release of acetylcholine byquercetin as apossible mode of action of Psidium guajavaleaf extracts in the t reatment of acute diar-rhoeal disease. J. Ethnopharmacol. , 25 :235-47, 1989.18. LUTTERO DT, G .D. Inhibition of Microlax*-induced experimental diarrhoea with narcoti-clike extracts of Psidium guajava leaf in rats.J.Ethnopharmacol., 37 :151-7, 1992.19 MARTINEZ, C.A. ; BARUA, D.; MERSON, M. H.Control of diarrhoeal diseases. World HealthStat. Q., 41 :74-81, 1988.20. MISRA, K . & SESHADRI, T.R. Chemical compo-nents of the fruits of Psidium guajava.Phytochemistry, 7: 641-5, 1968.21. O K U D A , T.; YOSHIDA, T . ; HATANO , T.; YAZA-K I, K .; IKEGAMI, Y.; SHINGU, T. Guavins A, Can d D, complex tannins from Psidium guaja-va . Chem. Pharm. Bull. Tokyo, 35 :3-6, 1987.22. POWELL, D.W. Ion and water transport in theintestine. In : Andreoli, T.E.; Hoffman, J .F. ;Faunstial , D . O . ; Schultz, S . G . Membranetransponprocesses in organized systems. NewYork, Plenum M edical Book C ompany , 1987.p. 175-212.

23. RIBEIRO-do-VALLE, R.M.R.; SIMES, C.M.O.;POLI, A. ; NICOLAU, M. ; ZANIN, M. Efeito do sextratos de Polygonum acre H.B.K. , FamPolygonaceae (Erva-de-bicho) sobre osefeitos contrateis induzidos pela acetilcolinae ocitocina no tero isolado de rata. Efeitoda presena de taninos.In: Reunio Anual daFederao das Sociedades de BiologiaExperimenta l , 3a Caxambu, 1988. Anais,Caxambu, 1988. p.200.2 4. R O B I N S O N , R. D .; WILLIAMS, L. A. D .; L I N D O ,J. F. ; TERRY, S . I ; MANSINGH, A. Inactivationof strongyloides filariform larvae in vitro bysix Jamaic an plant ex tracts and three com-mercial antihelmintics. West Indian Med. J .,39 :213-17, 1990.25 . ROSS, S.A.; SAYED, H. M .; EL-SAYYAD, S. M.Phytochemical studies on Aster squamatus LPart II : Sesquiterpene lactones, triterpenesand sterol present in the flowers. Bull.Pharm. Sci., 7 : 389-97, 1984.26. SESHADRI, T.R . ; VASISHTA, K . Polyphenols ofthe leaves of Psidium guajava - Quercetin,guijaverin, leucocyanidin and amritoside.Phytochemistry, 4:989-92, 1965.27. SIMES, C.M.O. Investigao qumico-farma-colgica de Achyroline satureoides (Lam.)D.C. Compositae (Marcela). Porto Alegre,1984. [Tese de Mestrado - UFRGS].28 . SIM ES, C . M . O . ; M E N T Z , LA.; S C HE NK E L, J. R . ;I R G A N G , B.E.; STEHMANN, J .R . Plantas damedicina popular no Rio Grande do Sul.Porto Alegre, Editora da Universidade Federaldo Rio Grande do Sul, 1986.2 9. SWEIS, J .; R O B A K , J . ; D AB R O WS KI , L; D U N I C Z ,S.; MICHALSKA, Z.; GRY GL ENSKI , R. J.Antiaggregatory effects of flavonoids in vitroan d their influence on lipoxygenase an dcyclooxygenase in vitro. Pol. J. Pharmacol.Pharm., 36:455-63, 1984.30 . USHER, G . A dictionary of plants used by man.London, Oxley Printing G roup, 1974.31. VERMIS, B.; FARKAS,L; NORG RADI, M. Synthesisof natural diglucosides of quercetin. In: Farkas,L ; Gabor , M.; Kallay, F. (Eds)., Topics in f l a -vonoid chemistry and biochemistry. In : Hun-garian Bioflavonoid Symposium, 4th, K eszthely,1973, Proceedings. Amsterdam, ElsevierScientific Publishing Company, p. 162-70.32 . WATT, J.M. & BREYER-BRANDWIJK, M . G . Th emedicinal and poisonous plants of southernan d eastern Africa. 2th ed. Edinburgh , E. &S. Livingstone, 1962.33 . YUSIF, K. S. & BLINOVA, K. F. Flavonol agly-cons of Polygonum hidropiper. khim. Prir.Soedin., 5: 658-9. [Abstract in: Chem. Absts.,102: 42886y, 19853.


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ResumoPara combater a diarria muitas vezes as pessoas utilizam extratos de plantas conhecidas popularmente como anti-diarricas, mesmo sem base cientfica. Em razo disto, verificou-se o efeito do extrato aquoso bruto (EAB) das folhasda Psidium guajava (goiabeira), Stachytarpheta cayenensis (gervo), Polygonum punctatum (polgono ou pimentad'gua), Eugenia uniflora (pitangueira) e Aster squamatus (z-da-silva) no transporte intestinal de gua em ratos e napropulso gastrointestinal em camundongos. Co m exceo do EAB de S. cayenensis, os demais aumentaram aabsoro de gua em uma ou mais pores do intestino em relao ao grupo-controle. Todos os EAB testados, comexceo do P. punctatum, reduziram o trnsito intestinal em relao ao grupo-controle. Com base nos resultadosobtidos conclui-se que os EAB das folhas de P. guayava, S. cayenensis, P. punctatum, E. uniflora e A. squamatustm potencial ao anti-diarrica, a ser confirmada em novas investigaes em animais infectados po r agentesenteropatognicos.Diarria, terapia. Extratos vegetais, farma cologia. Plantas medicinais.

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Antidiarrhoeic Effect of Plants Used in Popular Medicine