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Anti-Ulcer Activities of Medicinal Plants and Natural Products

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Chapter 6
Anti-Ulcer Activities of
Medicinal Plants and
Natural Products
Madhu Rani
https://orcid.org/0000-0001-8759-6852
Deshbandhu College, University of Delhi, India

Rubina Chongtham
Deshbandhu College, University of Delhi, India

Ajeet Singh
https://orcid.org/0000-0002-4393-8889
National Dairy Research Institute, India

ABSTRACT
The peptic ulcer is a widespread and common health problem around the world.
The major causes include generation of free radicles, decrease in mucosal defense
factor, or increase in mucosal injurious factors. Various plants and their products
have been known to prevent or reduce peptic ulcers. Natural products from plants
are a rich resource used for centuries to cure different ailments. The use of phyto-
constituents as drugs has proved to be clinically effective and less toxic than existing
drugs. An attempt has been made to review some plant species and their products
as phytomedicines showing promising results in prevention and treatment of peptic
ulcers.

DOI: 10.4018/978-1-7998-2094-9.ch006

Copyright © 2020, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited.
Anti-Ulcer Activities of Medicinal Plants and Natural Products

INTRODUCTION

Peptic ulcer is very frequent gastrointestinal disorder stemming from an insufficient

gastric mucosal guard. Many medications are accessible in the market as remedy for
this disease; though, these medications are linked with troubling side effects. Peptic
ulcer disease is represented by the disruption of the mucosal layer of the digestive
tract. This term is encompassing a diverse group of conditions with ulcerations. It
is amongst the most common gastrointestinal ailment affecting about 10-15% of the
population. Ulcers primarily results from an imbalance among several endogenous
antagonistic and defensive factors in the stomach, acid-pepsin secretion, like blood
flow, mucus secretion, integrity of the mucosal barrier, cellular regeneration, growth
factors and prostaglandins (Paguigan et. al., 2014). Other factors associated with
occurrence of peptic ulcer include intake of alcohol, traumatic lifestyle, consumption
of steroidal and non-steroidal anti-inflammatory medicines, bacterial infections (such
as Helicobacter pylori), smoking, inferior socio-economic status and, occasionally,
family history. Though, ulcer is not a fatal disease, it can be attributed to more severe
complications as gastrointestinal perforations, internal bleeding, infiltration of
ulcer into adjoining organs and gastric outlet impediment. Treatments available for
peptic ulcer disease heal ulcerations, ease the pain and delay relapse of ulcerations.
Generally, the medicines include antacids, antibiotics and proton pump inhibitors.
Though different categories of medicines are used in the therapy of peptic ulcer,
most of the drugs show significant side effects like arrhythmias, hypergastrinemia,
haemopoetic changes, impotence, gynaecomastia and arthralgia. Medicaments from
Ayurvedic or traditional medicinal system are an alternative approach.
This chapter aims to explore the anti-ulcer properties of some medicinal plants.
A number of investigations have verified the efficacy of medicinal plants for the
cure of peptic ulcer disease. The detected activity in such plants is accredited with
the presence of various secondary metabolites including phenolic acids, terpenoids,
flavonoids, tannins, alkaloids, and saponins. Studies revealed anti-ulcer activity of
extract from numerous plants belonging to different families. Some of these plants
are Bauhinia spp., Eruca sativa (Linn.) Cav. (Brassicaceae), Gynura procumbens,
Ocimum tnuiflorum, Toona ciliat, Diospyros spp., Symplocos spp., Chionanthus
spp., Voacanga africana Stapf (Apocyanaceae), Palaquium ellipticum Blanco
(Sapotaceae), Musa paradisiaca Linn. (Musaceae), Swietenia mahagoni (Linn.)
Jacq. (Meliaceae), Wilbrandia ebracteata Cong. (Curcubitaceae), Xantolis tomentosa
Roxb. Raf. (Sapotaceae), Calligonum somosum Linn. (Polygonaceae) and Pedalium
murex Linn. (Pedaliaceae). In this study, some of these plants are assessed for their
anti-ulcer properties described in table 1 (Kokate et al., 2007).

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MEDICINAL PLANTS AND NATURAL PRODUCTS

WITH ANTIULCER ACTIVITIES

Gynura Procumbens (Lour.) Merr. (Asteraceae)

The genus Gynura comprises of around 44 species. G. procumbens is traditionally

used in many regions for the treatment of ailments like rashes, eruptive fever,
migraines, kidney diseases, hypertension, viral skin diseases, diabetes mellitus,
constipation, rheumatism and urinary tract infection (Afandi et al., 2014). A few of
these traditional prerogatives have been corroborated in pharmacological studies,
including use as anti-inflammatory, anti-hypertensive, anti-hyperglycemic, anti-
herpes virus and anti-hyperlipidemic medicines. G. procumbens leaves extract
showed a number of active chemical constituents including terpenoids, flavonoids,
sterol glycosides, saponins and tannins. Mahmood et al., (2010) demonstrated anti-
ulcerogenic activity by ethanolic extract of its leaves. They emphasized that it gave
a gastro-protective effect in adult rats used in their study. Leaves of G. procumbens
have shown to protect the gastric mucosa significantly against ethanol-induced
injuries. The protection was found to be dose dependent, most prominent protection
at a dose of 400 mg/kg as established by the reduction of ulcer zones in the gastric
wall, reduction in the inhibition of edema and reduced leukocytes infiltration in the
sub-mucosal layers (Mou & Dash, 2016).

Diospyros Malabarica (Desr.) Kostel. (Ebenaceae)

D. malabarica grows well all over India and other humid regions of the world. It
is an evergreen tree with extensively branched, expanding crown. The bark, leaves,
flowers and fruits of D. malabarica are used as ayurvedic herbal medicine to pacify
burning sensation, diarrhea, inflammations, scalds, diabetes, hemorrhoids, skin
diseases, leucorrhea, fever, kapha, vitiated pitta, splenomegali, anemia, burns and
urinary tract infections. Young fruits contain tannin that are used for dyeing. Seeds
are also used as medicine for curing chronic dysentery and diarrhea. In the indigenous
system of medicine (Ayurveda), bark of D. malabarica is stated to be effective in the
cure of gastric ulcers. Preliminary phytochemical investigations by Gopalakrishna
et al., (2014) showed the presence of flavonoids, carbohydrates, proteins, steroids,
tannins and glycosides in chloroform extract. Ande et al., (2012) postulated that
flavonoids reduce histamine secretion from the mast cells. The reduction of histamine
secretion may be attributed to inhibition of histidine decarboxylase enzyme and
promoting biosynthesis of prostaglandin, which may be related to the anti-ulcer
activity of flavonoids.

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Anti-Ulcer Activities of Medicinal Plants and Natural Products

Musa Paradisiaca Linn. (Musaceace)

M. paradisiaca is a hybrid obtained by crossing M. accuminata and M. balbisiana. M.

paradisiaca (banana) is the oldest cultivated plant with a wide range of therapeutic
value. Its flowers are known to be used in therapy of dysentery, bronchitis, ulcers
and diabetes. The sap of M. paradisiaca is used for the treatment of diseases like
leprosy, epilepsy, hysteria, hemorrhage, fever, insect bites and digestive disorders.
The seeds and roots are used for the treatment of digestive troubles. The pulp and
peel of M. paradisiaca contain antifungal and antibiotic principles. It also contains
norepinephrine, serotonin, and dopamine. Norepinephrine and dopamine results
in blood pressure elevation, while serotonin prevents gastric secretion. Banana has
been used as an antacid in the treatment of peptic ulcer because they protect the
stomach from ulcers and ulcer damage. Banana forms a thick mucus barrier that
protects from stomach acids and contains protease inhibitors that remove bacteria
causing stomach ulcers. The active chemical constituents of M. paradisiaca include
phytochemicals like flavonoids, phenols and glycosides. Different investigations
reported various phytochemicals in different sections of banana. Many flavonoids
and their related compounds have been isolated from the raw banana fruit, known as
“plantain”, like- leucocyanidin was isolated from the unripe pulp of plantain (Ragasa
et al., 2007). Other compounds including tannin, norepinephrine, crystallizable
and non-crystallizable sugars, tryptophan, indole compounds, starch, vitamin C,
B-complex vitamins, iron, fats and mineral salts were also detected in the pulp of
M. paradisiaca var. sapientum fruit by Ghani (2003).
Ehiowemwenguan et al., (2014) observed presence of certain secondary
metabolites like saponins, glycosides, tannins alkaloids, volatile oil and flavonoids
in the preliminary phytochemical screenings carried out on M. paradisiaca var.
sapientum peels. The phytochemical screening with ethanol and methanol extracts
of M. paradisiaca substantiated the occurrence of several secondary metabolites.
Mallikarjuna et al., (2012) found alkaloids, steroids, tannins, glycosides, flavonoids,
etc. in ethanolic extract, and xantho-proteins, alkaloids, saponins, and glycosides
in methanol extracts.
Mahadeva et al., (2016) also reported presence of alkaloids, glycosides, flavonoids,
saponins in M. paradisiaca tepal and skin extract. Aucubin, a glycoside present in M.
paradisiaca possess antihistaminic activity and prevent the advancement of the ulcer.

Ocimum Tenuiflorum Linn. (Lamiaceae)

O. tenuiflorum (also known as O. sanctum) is a sacred plant and used in the therapy
of a variety of ailments such as asthma, bronchitis, diarrhea, malaria, dysentery, skin
diseases, arthritis, eye diseases, insect bites etc. It is used in preparation of many

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delicacies around the world. Its dried leaves have been used as insect repellent in
grain storages. The aromatic leaves and flowers are used in various forms including,
decoction, tea and tincture. The infusions and decoction are considered to be stomachic
and expectorant. The decoctions are used in common ailments like- bronchitis,
coughs, diarrhea and skin diseases. These preparations are considered as prophylactic
against epidemics like cholera, malaria and influenza. The seeds are considered as
nourishing, antioxidant, mucilaginous and demulcent when taken with cow’s milk,
juice or water. They are used in treating lethargy, ulcers, weakness, vomiting and
diarrhea. O. sanctum is considered as an overall tonic. The dried root powder taken
in milk, ghee or as a decoction, is advocated for the treatment of malarial fever, as
an analgesic, application to the insect bites and also to enhance sexual stamina and
prevent premature ejaculation. Singh & Majumdar (1999) conducted a study on
fixed oil of O. sanctum for the evaluation of the antiulcer activity. They concluded
that it may possess significant ulcer protective activity. The ulcer protective effect
may be attributed to the anti-secretory, anti-lipoxygenase and anti-histamine effect
of the oil. The oil significantly reduces ulcer index in a dose related fashion. They
also ascribed the inhibitory impact of fixed oil on gastric ulcer by 5-lipoxygenase
pathway inhibition or leukotriene antagonistic action. Histamine-induced gastric
ulcer occurs due to its vasospastic action and increased gastric acid secretion. The
fixed oil of O. sanctum was reported to suppress histamine-induced vasospastic
impact as well as gastric secretions.

Swietenia Mahagoni (Linn.) Jacq. (Meliaceae)

Many components of S. mahagoni tree have been utilized as traditional medication

for the cure of various ailments including hypertension, malaria, cancer, amoebiasis,
chest aches, fever, anemia diarrhea, dysentery and intestinal parasites (Maiti et al.,
2007).
A number of phytochemical studies on S. mahagoni have managed to the extraction
of more than 45 compounds belonging to the limonoids including the mexicanolide,
andirobin, tetranortriterpenes, triterpens, gendunin, phragmalin and chlorgenic acid.
Saad et al., (2003) isolated eighteen tetranotriterpenoids from S. mahagoni, reported
the presence of known fatty acids and terpenoids.

Eruca Sativa Mill. (Brassicaceae)

E. sativa is considered as medicinal plant with many reported properties like, tonic,
laxative, digestive, anti-phlogistic, astringent, diuretic, emollient, rubefacient,
stimulant, stomachic and anti-inflammatory for colitis. Young leaves are found to
possess stimulant, diuretic, antiscorbutic and stomachic activity. E. sativa oil is used

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to get rid of lice and dandruff, and against itching, urticaria (red weals on the skin
which itch intensely), chilblains and scalds. It is also used in the lotion used to boost
hair growth. It is sometimes used as antibiotic to treat infection of the respiratory and
urinary tracts. Aqueous extracts of the plant tissues have shown herbicidal activity
(Marwat et al., 2016; Nail et al., 2017).
E. sativa plant has 67 volatile compounds, signifying 96.52% of the total oil
components. The oil contains both saturated and unsaturated fatty acids. Like other
cruciferous vegetables, E. sativa contains health supporting phytochemicals involving
flavonoids, isoflavonoids, polyphenols carotenoids and glucosinolates. Saleh et al.,
(2016) observed in their study conducted on rats that ethanol leaf extract of E. sativa
triggered increase of pH of gastric content and also production of mucus. Therefore,
they determined that E. sativa exhibits an anti-ulcer activity by sustaining the acid-
base balance of gastric contents. Similar observations were made by Bozokalfa et
al., (2011) in their study, sowing that E. sativa leaves possess a great quantity of vital
mineral elements for human nutrition, primarily potassium, phosphorus and calcium.
Some of these elements are believed to be involved in the anti-ulcer ability. Kim et
al., (2012) established in their study on role of selenium against gastric ulceration
that it constrains the construction of ethanol-induced gastric mucosal lesions through
the inhibition of lipid peroxidation and stimulation of enzymatic radical scavenging.
Likewise, Chai (2011) inferred that bismuth containing compounds are frequently
incorporated in the drug treatment programs for gastric ulcer and they are believed
to damage the cell walls of ulcer causing bacteria Helicobacter pylori.

Adansonia Digitata Linn. (Malvaceae)

The chemical constituents of pulp of this plant contains phobaphenes, mucilage and
gum, glucose, tartrate and acetate of potash, and other salts. The leaf contains wax,
glucose, salts, gum, and albuminoids. The bark of this plant contains wax, soluble
and insoluble tannin, acid gum, albuminous carbonate and chloride of sodium and
potassium, and a glucoside adansonin.
Fresh juice of the leaves mixed with powdered ginger together with the expressed
juice of the fresh root of Salvadora indica is applied with significant advantage to
slothful syphilitic ulcer. Leaves of this plant are used as fomentations and poultices
for irritable inflammatory ulcers (Nadkarni, 1976).

Allium Sativum Linn. (Liliaceae)

Mustard or coconut oil in which A. sativum has been fried is an excellent application
for maggots infesting ulcers, ulcerated surfaces, and wounds. The juice of A. sativum

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mixed with 3 or 4 portions of water has been used as a lotion for washing wounds
and as well as foul ulcers (Nadkarni, 1976).

Aloe Vera (Linn.) Burm.f. (Liliaceae)

Leaves are being used successfully in America in the treatment of chronic ulcers.
First the pain diminishes and after a few weeks the ulcers heal (Nadkarni, 1976). A.
vera powder was mixed with gum acacia; the solution was administered orally in rats
at dose of 200mg/kg against indomethacin induced gastric ulcer (Borra et al., 2011).

Annona Squamosa Linn. (Annonaceae)

A. squamosa is commonly known as “custard apple.” It is cultivated in gardens all

over India. Chemical constituents in this plant are alkaloids, flavonoids, saponins, and
tannins. Seeds yield oil and resin; seeds, leaves, and immature fruit contain an acrid
principle. Leaves made into a paste without adding water are applied to unhealthy
ulcers (Nadkarni, 1976). The aqueous leaf extract protected against pylorus ligation
and ethanol induced gastric ulcer in rats (Saleem et al., 2012).

Azadirachta Indica A. Juss. (Meliaceae)

A poultice of leaves mixed with sesamum seeds is useful in morbid ulcerations

(Nadkarni, 1976). A. indica leaf extract protected against pylorus ligation and cold
restraint stress induced gastric ulcer in rats (Divakar et al., 2001).

Balsamodendron Mukul (Arn.) Bhandari (Burseraceae)

B. mukul gum is mixed with lime juice or coconut oil; it is applied as a plaster
or in the form of a lotion in indolent ulcers. Gum obtained from other species, B.
pubescens found in Sind, Karachi, and Baluchistan, is used as ointment in bad ulcers
such as Delhi sores, combined with sulphur, catechu, and borax (Nadkarni, 1976).

Bauhinia Variegata (Linn.) Benth. (Caesalpiniaceae)

The ethanolic and aqueous extract of root of B. variegate was administered at the
doses of 200 and 400mg/kg orally, in rats against pylorus ligation, ethanol, and
aspirin induced gastric ulcer. The extract significantly inhibited gastric mucosal
damage and reduced the basal gastric acid secretion (Kumar & Rajani, 2011).

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Berberis Aristata DC. (Berberidaceae)

Chemical constituents reported in the roots and wood of B. aristata are rich in a
yellow alkaloid “berberine” bitter substance, which dissolves in acids and forms
salts of the alkaloid; root contains two more alkaloids. The crude extracts known
as rasaut (in Hindi) are prepared from the root; bark mixed with honey is useful to
ulcerations of the skin (Nadkarni, 1976).

Beta Vulgaris Linn. (Chenopodiaceae)

Chemical constituents in B. vulgaris are an active principle “betin”. A decoction

of the root with a little vinegar is excellent for all kinds of ulcers and running sores
(Nadkarni, 1976).

Carica Papaya Linn. (Caricaceae)

The ripe fruit is edible and unripe can be eaten cooked for indolent ulcer. The unripe
fruit can be cooked as parts of salads, jellies, and stews although the ripe fruits are
frequently eaten raw without the skin or seed. Intake of the unripe fruit of the plant
has been linked with an antiulcer activity (Kottaimuthu, 2008). The aqueous seed
extract of C. papaya was administered in rats against ethanol induced gastric ulcer
(orally at the doses of 50 and 100mg/kg). The extract protected the gastric mucosa
against ethanol effect. C. papaya extract significantly reduced the gastric juice
volume and gastric acidity (Indran et al., 2008).

Euphorbia Neriifolia Linn. (Eurphorbiaceae)

E. neriifolia is commonly known as “common milk hedge” found in Central India and
cultivated in Bengal (India). Chemical constituents in E. nerrifolia are euphorbon,
resin, gum, caoutchouc, malate of calcium, and so forth. The plant juice is largely
used with clarified or fresh butter as an application to unhealthy ulcers and scabies
(Nadkarni, 1976).

Ficus Religiosa Linn. (Moraceae)

Chemical constituents of F. religiosa are bark containing tannin, caoutchouc and

wax. Bark of this plant is useful in ulcers in decoction (simple kashayam) with a
little honey (Nadkarni, 1976). The hydro alcoholic leaves extract of F. religiosa were
studied at two dose levels (250 and 500 mg/kg, oral) in rats against absolute ethanol,

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aspirin, and pylorus ligation induced gastric ulcer and significantly decreases the
ulcer index value (Gregory et al., 2013).

Galega Purpurea (Linn.) Pers. (Papilionaceae)

G. purpurea is commonly known as “purple tephrosia.” It is found throughout India,

especially in Southern India. It grows on hard stony ground too difficult to be rooted.
Chemical constituents of G. purpurea yields gum, a trace of albumen and colouring
matter, ash containing a trace of manganese, brown resin and chlorophyll and a
principle allied to quercetin or querritrin, and glucoside rutin (Nadkarni, 1976).

Hibiscus Rosa Sinensis Linn. (Malvaceae)

The root of H. rosa sinensis is traditionally used for the treatment of ulcer among
the kani tribes in Kanyakumari district, Tamil Nadu, India (Subitha et al., 2011).
The aqueous and alcohol extracts of H. rosa sinensis roots possessed significant
antiulcer activity in pylorus ligated rats (at the doses of 250 and 500mg/kg) and
precisely proven that these extracts possess enough potential as an anti-ulcerogenic
agent (Srivastava et al., 2013).

CONCLUSION

The plants and phytomedicines are important choice to treat peptic ulcer. Various
phytochemicals including flavonoids, tannins, saponins, terpenoids showed their
antiulcer activity. The activity is imparted due to their property as cryoprotection,
antisecretory and antioxidants. The phytoconstituents also provide an insight in
drug designing and biochemical action against ulcer causing conditions. We need
to explore unapproached promising medicinal plants with the purpose to provide
novel efficient and less toxic medicines for peptic ulcer.

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Anti-Ulcer Activities of Medicinal Plants and Natural Products

Table 1. Medicinal plants with antiulcer activity

Extract/
Sr. No. Botanical name Family Parts used References
phytochemical
Gynura procumbens Mahmood et
1. Asteraceae Leaves Ethanolic extract
(Lour.) Merr. al., (2010)
Diospyros
Fruits and Gopalakrishna
2. malabarica (Desr.) Ebenaceae Tannins
Seeds et al., (2014)
Kostel
Musa paradisiaca Tepal and Alkaloids, Mahadeva et
3. Musaceae
Linn. skin glycosides al., (2016)
Singh &
Ocimum tenuiflorum
4. Lamiaceae Fixed oil - Majumdar,
Linn.
(1999)
Saleh et al.,
5. Eruca sativa Mill. Brassicaceae Leaves Ethanol extract
(2016)
Adansonia digitata
6. Malvaceae Leaves Juice Nadkarni, 1976
Linn.
Aegle marmelos Subitha et al.,
7. Rutaceae Fruit -
(Linn.) Correa (2011)
Allium sativum
8. Liliaceae Fruit Aqueous juice Nadkarni, 1976
(Linn.) Fam.
Plant powder
Aloe vera (Linn.)
9. Liliaceae Whole plant mixed with gum Nadkarni, 1976
Burm. f.
acacia
Annona squamosa
10. Annonaceae Leaves Paste Nadkarni, 1976
Linn.
Azadirachta indica Divakar et al.,
11. Meliaceae Leaves Aqueous extract
A. Juss. (2001)
Balsamodendron
Nadkarni,
12. mukul (Arn.) Burseraceae Gum -
(1976)
Bhandari
Bauhinia variegata Ethanolic and Kumar &
13. Caesalpiniaceae Roots
Linn. (Benth.) aqueous extracts Rajani, (2011)
Berberis aristata Nadkarni,
14. Berberidaceae Root and bark Alkaloids
DC. (1976)
Nadkarni,
15. Beta vulgaris Linn. Chenopodiaceae Root Decoction
(1976)
Ethanolic and Indran et al.,
16. Carica papaya Linn. Cariacaceae Seeds
Aqueous extract (2008)
Euphorbia neriifolia Nadkarni,
17. Euphorbiaceae Whole plant Juice
Linn. (1976)
Hydro-alcoholic Gregory et al.,
18. Ficus religiosa Linn. Urticaceae Leaves
extract (2013)
Hibiscus rosa- Aqueous and Srivastava et
19. Malvaceae Roots
sinensis Linn. alcohol extract al., (2013)

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