Herbal Approaches to Gastrointestinal Disorders: Integrating Tradition and Science

doi:10.14218/JTG.2025.00030

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Herbal Approaches to Gastrointestinal Disorders: Integrating Tradition and Science

Acharya Balkrishna^1,2,
Deepika Srivastava¹,
Razia Parveen¹,
Ankita Kukreti¹ and
Nidhi Sharma^1,*

Author information

Journal of Translational Gastroenterology 2025

doi: 10.14218/JTG.2025.00030

Abstract

Gastrointestinal (GI) health is essential for maintaining systemic balance, influencing digestion, immunity, and neuroendocrine signaling. However, GI disorders such as irritable bowel syndrome, inflammatory bowel disease, gastroesophageal reflux disease, peptic ulcers, and constipation are increasingly prevalent, significantly affecting global health and healthcare economics. Although conventional pharmacological treatments offer symptomatic relief, their long-term use is often associated with adverse effects, resistance, and limited efficacy, prompting a shift toward alternative and complementary therapies. Traditional systems of medicine, such as Ayurveda, Traditional Chinese Medicine, Unani, and Siddha, emphasize holistic approaches, including herbal formulations that target underlying causes rather than just symptoms. This review provides a comprehensive analysis of the role of natural products and traditional herbals in GI health. It discusses key bioactive constituents, flavonoids, alkaloids, terpenoids, and polyphenols, known for their anti-inflammatory, antimicrobial, gastroprotective, and prebiotic properties. Widely used herbal remedies such as Triphala, licorice root, peppermint oil, turmeric, and psyllium are highlighted for their proven therapeutic actions. Additionally, the review documents more than 300 medicinal plants traditionally used in diverse cultures worldwide for managing GI conditions, based on ethnopharmacological evidence. While the therapeutic promise is substantial, challenges such as formulation standardization, herb-drug interactions, and limited clinical data remain. The review underscores the need for integrating traditional wisdom with modern scientific validation, offering a path forward for safe, effective, and personalized GI healthcare.

Graphical Abstract

Keywords

Gastrointestinal disorders, Herbal medicine, Traditional systems, Natural products, Ethnopharmacology, Integrative therapy

Introduction

The gastrointestinal (GI) system plays a central role in human health as the primary site for digestion and nutrient absorption, while also influencing immunity, endocrine signaling, and mental well-being through the gut–brain axis. A balanced and healthy GI tract is vital for maintaining metabolic homeostasis and overall physiological harmony.^1,2 Recent research has highlighted the gut’s influence on systemic functions such as hormone regulation, immune system activity, and even mental health, with over 70% of immune cells located in the GI tract.^3,4 Dysfunctions in this system contribute not only to digestive disorders but also to obesity, diabetes, autoimmune conditions, and neuropsychiatric diseases, underscoring the profound importance of GI health in both preventive and therapeutic medicine.^5,6

Globally, GI disorders such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), gastroesophageal reflux disease (GERD), constipation, dyspepsia, and peptic ulcers represent a major health burden.⁷ According to the Rome Foundation Global Study, over 40% of people meet the criteria for functional gastrointestinal disorders, with IBS alone affecting 10–15% of the global population.⁸ GERD affects nearly 20% of adults weekly, and constipation prevalence reaches up to 75% in individuals over 45 years. The prevalence of IBD continues to rise, particularly in industrialized nations, with direct healthcare costs in the U.S. exceeding $6 billion annually.⁸ Apart from this, peptic ulcers, often linked to Helicobacter pylori infection or non-steroidal anti-inflammatory drug use, continue to pose significant clinical challenges in both developing and developed nations.⁹ These chronic conditions typically manifest as abdominal pain, bloating, altered bowel movements, and diarrhea, reducing productivity and inflating healthcare costs. In 2021 alone, GI-related healthcare expenditure was estimated at $111.8 billion, reflecting both clinical and economic challenges.¹⁰ The growing prevalence and burden of GI disorders highlight the urgent need for effective, safe, and sustainable treatment approaches.

Limitations of conventional therapies

Modern pharmacological strategies for GI disorders rely on drugs such as antacids, proton pump inhibitors (PPIs), H₂ receptor antagonists, anti-inflammatory agents, antibiotics, and laxatives. While effective for short-term relief, these treatments frequently fail to provide lasting solutions or to address underlying causes of disease. Moreover, long-term use is often associated with safety concerns. For example, PPIs are linked to nutrient deficiencies,¹¹ bone demineralization,¹² and higher susceptibility to infections, including Clostridium difficile.^13–15 Corticosteroids and immunosuppressants used in IBD increase risks of infections and hormonal imbalances.¹⁶ Non-steroidal anti-inflammatory drugs elevate the risk of GI bleeding,¹⁷ while anticholinergic and sedative drugs add further complications.^18,19

The multifactorial nature of GI diseases, including altered motility, microbial dysbiosis, and visceral hypersensitivity, makes single-target therapies insufficient. Relapse after drug discontinuation, development of tolerance, and drug resistance further limit effectiveness.^20,21 Collectively, these drawbacks emphasize the need for integrative and holistic strategies, spurring renewed interest in natural products and traditional medicine systems as complementary or alternative therapies.

Renewed interest in natural and traditional approaches

In response to the limitations of conventional therapies, there is renewed interest in natural products and traditional medicine for GI disorders. Systems such as Ayurveda, Traditional Chinese Medicine (TCM), and Unani emphasize medicinal plants and dietary regulation, offering holistic approaches that address physical, dietary, emotional, and environmental factors. Herbal medicines, central to these traditions, are increasingly supported by scientific evidence. Natural products from plants, fungi, and marine sources show diverse bioactivities, while phytochemicals including flavonoids, alkaloids, terpenoids, polyphenols, tannins, and glycosides demonstrate anti-inflammatory, antioxidant, antimicrobial, immunomodulatory, and mucosal-protective effects.^22,23 Notable examples include licorice (Glycyrrhiza glabra) with mucoprotective and anti-ulcer activity^24,25; peppermint (Mentha piperita) oil for IBS via antispasmodic effects^26,27; turmeric (Curcuma longa), with curcumin’s anti-inflammatory effects in IBD^28,29; and Triphala, an Ayurvedic formulation for bowel regulation and detoxification.^30,31 Many formulations also act as prebiotics or modulators of gut microbiota. The herbal medicine market reflects this demand, with revenues of USD 199.07 billion in 2023 projected to reach USD 417.99 billion by 2033.³²

Advances in analytical chemistry, pharmacology, molecular biology, and systems biology are enabling evidence-based validation of traditional remedies. However, challenges remain, including standardization, herb-drug interaction studies, large-scale clinical trials, and regulatory harmonization. This review will examine natural products and traditional herbals in GI disorders such as IBS, IBD, GERD, peptic ulcers, and constipation, highlighting mechanisms, efficacy, safety, and the clinical relevance of traditional concepts. It will also discuss challenges like formulation variability and regulatory gaps, and explore future directions involving omics technologies, microbiome research, and personalized medicine.

By bridging traditional wisdom with modern science, this review aims to support the evidence-based integration of natural products into comprehensive GI care.

Method of literature search

A comprehensive literature search was conducted to gather relevant information on herbal and traditional medicinal approaches to GI disorders. The databases searched included PubMed, Scopus, Web of Science, and the Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) Research Portal. The search strategy employed a combination of keywords and Boolean operators such as “gastrointestinal disorders,” “herbal medicine,” “natural products,” “traditional medicine,” “ethnopharmacology,” “Ayurveda,” “TCM,” “Unani,” and “Siddha.”

The inclusion criteria comprised studies and reviews focusing on herbal medicines, natural products, and traditional therapeutic practices related to GI health. Publications reporting experimental, clinical, and ethnopharmacological evidence were also considered. Exclusion criteria involved non-peer-reviewed sources, articles lacking primary data or mechanistic insights, and studies unrelated to GI health. The timeframe of the search extended up to July 2025, ensuring incorporation of the most recent evidence. Additional references were identified from the bibliographies of selected articles to strengthen comprehensiveness.

Traditional systems of medicine in gastroenterology

Traditional systems of medicine, rooted in centuries of empirical observations and holistic health philosophies, have provided effective GI remedies long before the advent of modern pharmacology. These approaches, such as Ayurveda, TCM, Unani, Siddha, and various indigenous folk practices, offer distinctive paradigms in understanding and managing digestive health. Collectively, these medical systems view the GI tract not just as a site of digestion but as a central hub for maintaining systemic health. The approaches adopted in these traditions often emphasize dietary regulation, the use of polyherbal formulations, seasonal detoxification, and the balance of internal energies or humors, aligning with modern understandings of the gut as a complex, integrative organ with profound systemic influence.^33,34 With growing evidence of the limitations of conventional pharmacological agents and a surge in functional GI disorders, there is renewed interest in these systems.^35,36 Modern scientific advancements have increasingly begun to validate the efficacy of traditional herbal treatments, uncovering mechanisms that act on sensory receptors, motility, inflammation, and neuromuscular regulation in the GI tract.^37–39

Ayurveda

In Ayurveda, GI health is central to overall well-being, governed by the concept of Agni, or digestive fire, which is responsible for the transformation of food into nourishment. Agni is classified into different types: Jatharagni (digestive fire in the stomach), Bhutagni (digestive processes at the elemental level), and Dhatvagni (tissue-level metabolism). A balanced Agni is considered crucial for proper digestion, absorption, assimilation, and elimination. Conversely, impaired Agni is believed to result in the accumulation of Ama (toxic undigested material), leading to GI and systemic diseases.⁴⁰ According to Ayurvedic theory, the three Doshas—Vata, Pitta, and Kapha—regulate all physiological processes, including those of the GI tract. Pitta, associated with enzymatic and metabolic activities, is particularly significant in digestion. Imbalances in these Doshas manifest in various GI conditions. For instance, increased Pitta is linked to hyperacidity and ulcers,^41,42Vata imbalance is often associated with constipation and bloating,^43,44 and Kapha predominance may result in sluggish digestion and mucus accumulation in the GI tract.⁴⁵ Treatments focus on restoring Agni and Dosha balance through diet, lifestyle, and herbs tailored to an individual’s constitution.⁴⁶

Ayurveda offers a wealth of formulations specifically designed to enhance digestive health, manage dyspepsia, relieve constipation, and reduce inflammation. One of the most extensively studied and widely used preparations is Triphala, a synergistic blend of three fruits—Emblica officinalis (Amla), Terminalia chebula (Haritaki), and Terminalia bellirica (Bibhitaki). Triphala exhibits antioxidant, anti-inflammatory, and laxative properties, and studies have shown its ability to regulate gut motility and modulate intestinal microbiota.^39,47 Another important polyherbal formulation is Avipattikar Churna, traditionally used for hyperacidity and constipation, which contains a combination of cooling and digestive herbs including Trikatu (a mixture of ginger, black pepper, and long pepper), Amla, Haritaki, and Licorice.^48,49 These formulations not only provide symptomatic relief but also work to restore the functional balance of Agni and Doshas. Ayurvedic detoxification therapies like Panchakarma also aim to cleanse the GI tract and restore physiological homeostasis, often combined with dietary regimens and Rasayana (rejuvenative) therapies.⁵⁰

TCM

TCM approaches GI health by focusing on the harmonious flow of Qi, the dynamic balance between Yin and Yang, and the functional integrity of organ systems, especially the Spleen and Stomach. Qi, which flows through meridians, must be abundant and unobstructed for optimal digestive function. GI disorders in TCM are considered consequences of disrupted Qi flow, accumulation of dampness or heat, or deficiencies in Yin.⁵¹ Various Chinese herbs have been identified to target these imbalances. TCM diagnoses GI diseases based on complex syndromes, such as “Spleen Qi Deficiency” or “Stomach Heat,” each requiring a specific therapeutic approach. TCM treatments aim to regulate Qi, harmonize Yin-Yang, and strengthen the spleen-stomach system using herbs, acupuncture, and dietary adjustments.^52,53

A variety of herbs are utilized in TCM to treat GI conditions, often in sophisticated combinations tailored to the individual’s constitution and symptoms. Licorice (Glycyrrhiza uralensis), known as Gan Cao, is a harmonizing herb frequently used to soothe the stomach, reduce inflammation, and alleviate spasms. Ginger (Zingiber officinale), or Sheng Jiang, is employed to warm the digestive tract, dispel cold, and stimulate digestion, especially in cases of nausea or poor appetite.⁵⁴ Baikal Skullcap (Scutellaria baicalensis), known for its flavonoid content, is used for its anti-inflammatory and antimicrobial effects, particularly in cases of gut inflammation and dysentery.^55–57 Moreover, Chinese herbal formulas like Tong-Xie-Yao-Fang and Tong-Xie-Ning, composed of Atractylodis macrocephalae, Paeoniae alba, Citrus reticulata, and Saposhnikoviae, have shown significant efficacy in randomized controlled trials (RCTs) for treating diarrhea-predominant IBS, reducing pain frequency and improving stool consistency.^58,59 Likewise, TCM decoctions such as Ban Xia Xie Xin Tang and Xiang Sha Liu Jun Zi Tang are prescribed for conditions like gastritis, bloating, and diarrhea.^60,61 The personalized and adaptive nature of TCM interventions, along with increasing evidence from pharmacological studies, supports their potential integration into gastroenterological practice.

Unani and siddha systems

The Unani system, rooted in Greco-Arabic medicine, conceptualizes GI health through the humoral theory, which posits that the body is governed by the balance of four humors: Dam (blood), Balgham (phlegm), Safra (yellow bile), and Sauda (black bile).⁶² GI disorders are attributed to humoral imbalances, particularly involving Safra (linked to bile and liver function) and Balgham (associated with mucus and cold conditions).⁶³ The stomach and liver are considered key sites for digestion and transformation, with dysfunction leading to diseases such as indigestion, flatulence (Tabkheer-i-Meda), and ulcers (Quroh-e-Ma’ida). According to Unani scholars, it is caused by Ghadha-i-Ghalizkham (foods that are partially cooked and hard to digest), disturbance in Quwwat-i-Hadm,⁶⁴ stomach weakness, Fudlat (waste product), intake of spicy foods, rotten fruits, hard fibrous diets, alcoholism, indigestion, gastric secretions, prolonged stress, and strain.^65–67

Unani practitioners frequently prescribe herbal remedies to address symptoms such as bloating, acidity, constipation, and indigestion. Prominent medicinal plants used in this tradition include Zanjabeel (Zingiber officinale, Ginger), known for its carminative and digestive-stimulating properties; Aslussoos (Glycyrrhiza glabra, Licorice), valued for its soothing effect on the gastric mucosa and its role in reducing inflammation; and Sana Makki (Cassia angustifolia, Senna), a well-recognized laxative used to soften stools and relieve constipation.^37,68

Additionally, Asgandh (Withania somnifera, Ashwagandha) and Aslussoos (Licorice) are widely employed in Unani formulations to strengthen digestive function and regulate metabolism. These herbs support the body’s ability to efficiently absorb nutrients and maintain internal equilibrium, thus contributing to overall health and vitality. In cases of gastritis and hyperacidity, Unani prescriptions often include mucosal-protective agents such as Aslussoos and Teel Khushk (Ulmus rubra, Slippery Elm), which help soothe gastric lining inflammation. For irregular bowel movements, personalized polyherbal solutions are administered to restore GI homeostasis. Such therapeutic practices exemplify the individualized and holistic nature of Unani medicine in managing digestive ailments through evidence-informed traditional knowledge.^37,68

The Siddha system, predominantly practiced in South India, also adheres to a humoral theory, focusing on the equilibrium among three fundamental humors: Vali (air), Azhal (fire), and Iyyam (water). GI diseases are typically understood as disturbances in Azhal, which is closely associated with the digestive fire and metabolic activities.⁶⁹ Siddha medicine aims to restore internal balance through a combination of herbs, minerals, and dietary modifications, tailored to the individual’s humoric constitution and the nature of the ailment. A variety of herbal formulations are traditionally employed to improve digestion and alleviate digestive discomfort. Kadukkai (Terminalia chebula, Haritaki) and Thippili (Piper longum, Long pepper) are among the most frequently used agents for their digestive and carminative actions.⁷⁰

Other widely used Siddha formulations include Triphala Chooranam, a classical combination of Amla (Emblica officinalis), Bibhitaki (Terminalia bellirica), and Haritaki, which promotes digestive regularity and bowel health.⁷¹Milagu Chooranam, composed primarily of Milagu (black pepper), is taken with warm water to stimulate the digestive fire and relieve bloating. Omam Chooranam, derived from Omam (carom seeds or ajwain), is valued for its effectiveness against indigestion and flatulence. Chitrakadi Vati, another important preparation, enhances appetite and supports metabolic processes. In addition, Kabasura Kudineer, though widely known for managing respiratory ailments, is also used to support digestive health and systemic immunity. Thaaleesathi Chooranam, containing Thippili, Sathi Vidhai (Hedychium spicatum), and Milagu, offers relief from various GI disturbances. Dadimashtaka Churna, made from pomegranate seeds and other digestive herbs, is employed to manage acidity and strengthen digestion. Chukku Malli Kashayam, a decoction of Chukku (dry ginger) and Malli (coriander seeds), helps stimulate the digestive system and reduce GI sluggishness. Similarly, Sitharathai Chooranam, prepared from the rhizomes of Alpinia galanga, is indicated for indigestion and bloating.^72,73 These Siddha remedies are typically used under the supervision of trained practitioners as part of a holistic regimen that may include diet, lifestyle changes, and detoxification. While these formulations are rooted in traditional knowledge and are widely practiced in Southern India, integrating them responsibly with modern healthcare advice is essential for the safe and effective treatment of persistent or chronic digestive disorders.

Other folk and ethnomedicinal practices

Beyond classical traditional systems, folk medicine and ethnoveterinary practices in various rural and tribal communities offer a rich repository of plant-based treatments for GI ailments. These remedies are typically passed down through generations via oral traditions and are shaped by local flora, cultural beliefs, and ecological knowledge. In many parts of Africa, South America, and India, communities rely on locally available plants such as Neem (Azadirachta indica) for stomach infections, Bael (Aegle marmelos) for diarrhea and dysentery, and Castor (Ricinus communis) for constipation and colic. One traditional African remedy, Garcinia buchananii bark extract, has shown spasmolytic and motility-inhibitory effects on colonic tissue in preclinical studies, suggesting a plausible mechanism for its antidiarrheal action.³⁷ These practices, though under-researched, reflect a deep ecological understanding and offer cost-effective, culturally accepted solutions that warrant systematic scientific investigation.

In sum, traditional systems of medicine offer a multidimensional understanding of GI health, rooted in philosophical paradigms and centuries of clinical experience. These systems emphasize restoring physiological balance, enhancing digestive strength, and preventing disease progression through a combination of herbal remedies, dietary regulation, and lifestyle modification.⁷⁴ With growing scientific interest and the global resurgence of integrative medicine, there is a renewed impetus to explore and validate these age-old practices through modern research methodologies. Their incorporation into contemporary gastroenterological care holds promise for safer, holistic, and patient-centered therapeutic strategies. An overview of the major traditional systems of medicine and their approaches to GI health is summarized in Figure 1.

Fig. 1 Traditional systems of medicine in gastroenterology.

Classification of natural products used in GI disorders

Natural products have been at the forefront of traditional and integrative approaches to GI care. Owing to their diverse phytochemical composition, plant-based remedies offer therapeutic benefits in the management of functional GI disorders such as dyspepsia, constipation, diarrhea, indigestion, IBS, GERD, and peptic ulcers. Based on their primary mechanisms and therapeutic actions, natural products can be broadly classified into the following categories. These categories and their representative examples are illustrated in Figure 2.

Fig. 2 Classification of natural products used in gastrointestinal (GI) disorders.

Laxatives and carminatives

Laxatives and carminatives are widely used to regulate bowel movements and relieve flatulence or bloating. Plantago ovata (Psyllium husk), also known as Isabgol, is a well-recognized bulk-forming laxative and demulcent, used in IBDs, chronic constipation, and colitis. Its mucilage content helps absorb water in the intestine, softening the stool and easing its passage. It is also useful in GERD and diverticulitis.^75–77Cassia angustifolia (Senna), referred to as Sana Makki in Unani medicine, is an anthraquinone-rich herb commonly used for its stimulant laxative effect, particularly effective in treating acute constipation.^78,79Aloe vera, another potent laxative, contains aloin, which stimulates peristalsis and improves bowel evacuation. Additionally, it exhibits anti-inflammatory and healing properties, making it useful in colitis and other mucosal inflammatory conditions.⁸⁰Foeniculum vulgare (Fennel) is a gentle carminative often used to alleviate gas, flatulence, and infantile colic. Its essential oil relaxes GI smooth muscles and inhibits intestinal spasms. Fennel seeds are often consumed post-meal in traditional settings to aid digestion and prevent bloating.⁸¹Pimpinella anisum (Anise) and Illicium verum (Star anise) are other well-known carminatives traditionally consumed as teas to relieve indigestion, promote digestion, and reduce gas formation.^81,82

Antiemetic and antispasmodic herbs

Herbs with antiemetic and antispasmodic properties play a critical role in managing symptoms such as nausea, vomiting, bloating, and abdominal cramps. Among the most thoroughly researched is Zingiber officinale (Ginger), used widely in Asian and Western medicine to treat nausea, dyspepsia, and IBS. Gingerols and shogaols, its active constituents, enhance gastric motility, accelerate gastric emptying, and reduce visceral hypersensitivity. Clinical studies confirm its efficacy in nausea of various etiologies, including motion sickness and postoperative recovery.^81,83,84Mentha piperita (Peppermint) is a powerful spasmolytic agent. Its essential oil contains menthol, which acts on calcium channels and TRPM8 receptors, relaxing smooth muscles in the GI tract. It is used in both traditional and modern medicine to manage IBS, flatulence, dyspepsia, and abdominal cramps.^81,85,86Matricaria recutita (German chamomile) is another popular herb with spasmolytic, anti-inflammatory, and mild sedative properties. Chamomile tea is used for abdominal cramps, GI spasms, anxiety-related IBS, and flatulence. Its flavonoids (like apigenin) interact with benzodiazepine receptors, and its antispasmodic action helps relieve colicky pain.^81,82

Antiulcer and gastroprotective agents

Herbs with gastroprotective and antiulcer properties offer significant advantages over synthetic agents, particularly for long-term use in GERD, gastritis, and peptic ulcer disease. Glycyrrhiza glabra (Licorice), known in Ayurveda and Unani as Aslussoos, exerts mucosal protective, anti-inflammatory, and demulcent actions. Deglycyrrhizinated licorice enhances mucus production and promotes ulcer healing in GERD and gastritis patients.^81,82

Curcuma longa (Turmeric), rich in curcumin, is another extensively researched gastroprotective herb. Curcumin suppresses prostaglandin synthesis and downregulates pro-inflammatory cytokines (interleukin (IL)-1, IL-6, tumor necrosis factor (TNF)-α), providing relief in IBD and gastritis.⁸⁷ Similarly, Aegle marmelos (Bael), used in Ayurveda and Unani, demonstrates antidiarrheal, mucosal healing, and antimicrobial properties, especially useful in treating dysentery, IBS, and ulcers.⁸⁸ Mucilage-rich herbs such as Ulmus rubra (Slippery elm), Althaea officinalis (Marshmallow root), and Plantago ovata also protect the mucosal lining by forming a viscous barrier that reduces irritation and inflammation. These are commonly used in managing GERD, peptic ulcers, and esophagitis.⁸¹

Other notable herbs with gastroprotective potential include Cynara scolymus (Artichoke), which improves bile flow, relieves IBS symptoms, and exhibits hepatoprotective effects; Taraxacum officinale (Dandelion) for improving digestion and bile production.⁸⁹Silybum marianum (Milk thistle), whose seed extract (silymarin) supports liver detoxification, is traditionally used to improve dyspepsia and gastric inflammation.^90,91 Several ethnobotanical reports also document lesser-known species used by tribal populations for GI care, such as Ardisia solanacea, Psidium guajava, Achyranthes bidentata, Turnera diffusa, and Phoradendron californicum-employed in forms like leaf juice or infusions for treating ulcers, acidity, diarrhea, and dysentery.^92–95

Antimicrobial natural products for GI infections

Natural antimicrobials play a crucial role in eradicating GI pathogens like Helicobacter pylori, E. coli, Salmonella, and Shigella.⁹⁶Berberis vulgaris (Barberry), containing the alkaloid berberine, has potent antimicrobial activity against H. pylori, which is implicated in peptic ulcers and gastric cancer.⁹⁷Thymus vulgaris (Thyme) and Allium sativum (Garlic) are also effective against a wide spectrum of GI pathogens. Allicin in garlic demonstrates broad-spectrum activity and is beneficial in infections and dysbiosis.^98,99

Traditional tribal remedies include Achyranthes bidentata, Ardisia solanacea, Flourensia cernua, and Phoradendron californicum, which have been used for centuries to treat stomach infections, diarrhea, and dysentery through antimicrobial and anti-inflammatory actions.^92–95

Hepatoprotective and bile-modulating herbs

Several GI disorders, particularly those affecting fat digestion and bile flow, are linked to liver function. Silybum marianum (Milk Thistle) has hepatoprotective, anti-inflammatory, and antioxidant properties and is approved by the German Commission E for the treatment of dyspepsia and liver disorders.^90,91

Cynara scolymus (Artichoke) leaf extract improves bile production, supports liver detoxification, and reduces symptoms of IBS, including bloating and gas. It also inhibits cholesterol biosynthesis and LDL oxidation, promoting digestive efficiency.^100–103Taraxacum officinale (Dandelion root) stimulates bile flow and aids in treating sluggish digestion and hepatic insufficiency.⁸⁹

Prebiotics and gut microbiota modulators

Some natural products act as prebiotics, promoting the growth of beneficial gut microbiota and enhancing mucosal immunity. Plantago ovata (Psyllium) not only serves as a bulk laxative but also helps nourish commensal gut flora. Triphala, a traditional Ayurvedic formulation containing Terminalia chebula, Terminalia bellirica, and Emblica officinalis, has been shown to modulate gut microbiota, improve gut barrier integrity, and reduce colonic inflammation. Fermentable fibers and mucilage from herbs such as Ulmus rubra, Althaea officinalis, and Marshmallow root support the mucosal environment, enhance probiotic survival, and are useful in IBS and ulcerative colitis.¹⁰⁴

In addition to the pharmacological classification and mechanistic insights into natural products used in GI health, numerous ethnobotanical and ethnopharmacological surveys across the globe provide compelling evidence of traditional plant use in treating a wide range of GI disorders. These practices, often passed down orally through generations, reflect the cultural, geographical, and ecological diversity of medicinal knowledge systems. The following Table 1 compiles representative examples of such medicinal plants traditionally employed by local communities and indigenous tribes for GI issues such as ulcers, diarrhea, dyspepsia, constipation, gastritis, and colic, offering a practical overview of their cross-cultural relevance and therapeutic diversity.^{75,81,82,90,92,97,105–161}

Table 1

Plants traditionally used in the management of gastrointestinal disorders

S. N.	Plants	Part used	Prepration	Traditional use/proerties	Used in country	References
1	Abelmoschus esculentus (L.) Moench	Aerial parts		Peptic Ulcers	North Africa	¹⁰⁵^,¹⁰⁶
2	Abutilon indicum (L.) Sweet	Leaves	Decoction, Powder or Juice	Constipation, Peptic ulcers	Lakki Marwat, Khyber Pakhtunkhwa province of Pakistan, Kattunaika Tribe of Wayanad district, Kerala (India)	⁹²^,¹⁰⁷
3	Acacia karroo Hayne (syn. of Vachellia karroo (Hayne) Banfi & Galasso)	Bark, Gum and Leaves	Infusion	Dysentery, Diarrhoea	Eastern Cape Province, South Africa	¹⁰⁸
4	Acacia mearnsii De Wild.	Bark and Leaves	Infusions, Concoction, Decoction	Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
5	Acacia modesta Wall (syn. of Senegalia modesta (Wall.) P.J.H.Hurter)	Bark	Decoction	Flatulence	Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
6	Acacia nilotica (L.) Delile	Bark and Pods	Decoction, Pods powder mixed with sugar or honey	Diarrhea, Dysentery	Kohat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
7	Acacia senegal (L.) Willd. (syn. of Senegalia senegal (L.) Britton)	Roots and Bark		Peptic Ulcers	North Africa	¹⁰⁵^,¹⁰⁹
8	Achillea millefolium L.	Aerial parts and Flowers	Decoction or Infusion	Anorexia, Dyspepsia	Urmia, Iran	¹¹⁰^,¹¹¹
9	Achyranthes aspera L	Roots	Decoction, Juice	Abdominal Pain, Dysentery, Cholera, Constipation, Diarrhea, Anorexia, Nausea, Vomiting	Bannu, Khyber Pakhtunkhwa province of Pakistan, and Nepal, Mandai tribe of Bangladesh	¹⁰⁷^,¹¹²^,¹¹³
10	Acorus calamus L.	Rhizomes and Leaves	Juice, Decoction	Abdominal Pain, Diarrhoea, Anthelmintic, Cholera, Colic, Dysentery, Dyspepsia, Constipation	Kuruma, kurichia Tribe of Wayanad district, Kerala (India) and Karen people of northern Thailand and Nepal, Chakma tribe of Bangladesh	⁹²^,¹¹²^–¹¹⁵
11	Adenostemma lavenia (L.)O.Ktze.var.lavenia	Whole plant	Decoction	Ulcers	Kuruma Tribe of Wayanad district, Kerala (India)	⁹²
12	Adiantum philippense L.	Leaves		Dysentery	Chakma tribe of Bangladesh	¹¹³
13	Aegle marmelos (L.) Corr. Serr.	Root, Dried Bark, Leaves and Fruit	Juice, dried bark along with curd drinking	Dysentery, Vomiting, Abdominal disorders, Colic, Constipation, Diarrhea, Gastritis, Indigestion, Stomach-ache	Kuruma, kattunaika, kurichia, paniya, adiya Tribe of Wayanad district, Kerala (India) and Nepal, North Africa	⁹²^,¹⁰⁵^,¹¹²
14	Aerva persica (Burm.f.) Merr. (syn. of Aerva javanica (Burm.f.) Juss. ex Schult.)	Roots		Peptic ulcers	North Africa	¹⁰⁵
15	Ageratum conyzoides L.	Leaves		Acidity	Kuruma, kurichia Tribe of Wayanad district, Kerala (India)	⁹²
16	Agrimonia eupatoria L.	Aerial Part and Inflorescence	Decoction Or Infusion	Diarrhoea, Stomach ulcers and Gastritis	Urmia, Iran	¹¹⁰^,¹¹⁶
17	Alangium salvifolium (L.f.) Wang.	Whole plant	Fried	Heartburn	–	⁹²
18	Albizia lebbeck (L.) Benth	Bark	Decoction	Diarrhea	Bannu, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
19	Alchemilla vulgaris L.	Leaves	Decoction	Diarrhea	Setifian High Plateau, Algeria	¹¹⁷
20	Alepidea amatymbica Eckl. & Zeyh.	Roots/Rhizome	Decoction	Abdominal cramps	Eastern Cape Province, South Africa	¹⁰⁸
21	Alhagi camelorum Fisch (syn. of Alhagi maurorum var. maurorum)	Aerial parts	Decoction Or Infusion	Intestinal infection, Peptic ulcer	Urmia, Iran, North Africa	¹¹⁸^,¹¹⁹
22	Allium cepa L.	Bulb	Raw, Mixed Equal Amounts Of Extract Of Onion Bulb And Mint	Diarrhoea, Dysentery, Vomiting, Cholera, Colic, Constipation, Dyspepsia, Indigestion, Stomach disorders, Stomachache	Nyamwezi THPs, Tabora region, Tanzania, and Khyber Pakhtunkhwa province of Pakistan and Nepal	¹⁰⁷^,¹¹²^,¹²⁰
23	Allium sativum L.	Bulb	Chew or the bulb mix with honey or sugar and ingest a half teaspoon a day	Laxative	Nyamwezi THPs, Tabora region, Tanzania, Algeria, North African regions	¹⁰⁵^,¹¹⁷^,¹²⁰
24	Allophylus cobbe (L.) Raeusch.	Roots and Leaves	Juice	Stomach ulcers	Kuruma Tribe of Wayanad district, Kerala (India)	⁹²
25	Allophylus serratus (Roxb.) Kurz	Leaves	Juice	Stomach ulcers	Kuruma Tribe of Wayanad district, Kerala (India)	⁹²
26	Aloe barbadensis (Aloes) (syn. of Aloe vera (L.) Burm. f.)	Leaves	Juice or Decoction	Constipation, Gastric ulcer, Dysentery, Indigestion, Intestinal Worms, Stomach-ache	United States, Nyamwezi THPs, Tabora region, Tanzania, Nepal, and North Africa	⁸²^,¹¹⁰^,¹¹²
27	Aloe ferox Mill.	Leaves	Juice	Constipation, Peptic ulcer	North Africa	¹⁰⁵^,¹¹⁰
28	Aloysia citrodora Paláu (syn. Lippia citrodora (Paláu) Kunth)	Leaves	Decoction	Gastrointestinal disorders	Setifian High Plateau, Algeria	¹¹⁰^,¹¹⁷
29	Alpinia malaccensis (Burm.f.) Rosc.	Roots	Paste	Abdominal problems	Kuruma, Kurichia Tribe of Wayanad district, Kerala (India)	⁹²
30	Alstonia scholaris (L.) R.Br.	Plant		Constipation, Diarrhoea, Dysentery, Dyspepsia, Intestinal Worms	Nepal	¹¹²
31	Althaea officinalis L.	Roots, Leaves, and Flowers		Peptic ulcers	North Africa	¹²¹
32	Althaea officinalis L.	Roots		Dyspepsia		¹¹⁰
33	Althea hirsute L. (syn. of Malva setigera K.F.Schimp. & Spenn.)	Roots	Decoction or Infusion	Constipation	Urmia, Iran	¹²²
34	Amaranthus spinosus L.	Leaves	Leaves paste along with lemon juice	Stomach ulcer	Adiya, Tribe of Wayanad district, Kerala (India)	⁹²
35	Amorphophallus paeoniifolius (Dennst.) Nicols.var. paeoniifolius (syn. of Amorphophallus paeoniifolius (Dennst.) Nicolson)	Stem and Leaves	Juice	Stomach ulcer	Kurichia, Tribe of Wayanad district, Kerala (India)	⁹²
36	Amygdalus communis L. (syn. of Prunus amygdalus Batsch)	Unripe Fruits and Seed	Decoction or Infusion	Constipation	Urmia, Iran, and Izmir province, Turkey	¹²³^,¹²⁴
37	Anacyclus clavatus (Desf.) Pers.	Leaves	Decoction	Indigestion, Flatulence	Setifian High Plateau, Algeria	¹¹⁷
38	Andrographis paniculata (Burm.f.) Wall. ex Nees	Stem and Leaves	Leaves of this plant mixed with Psidium guajava, Clerodendron, Olea, Breynia, and Ludwegia leaves, ground well and drink the juice	Ulcer, Intestinal Worms, Acidity	Kuruma, kattunaika, kurichia, Tribe of Wayanad district, Kerala (India)	⁹²
39	Anethum graveolens L.	Seeds	Tea, Chew	Digestive Problems (Bloating), Flatulence	Mexican Traditional Medicine, Izmir province, Turkey, and Kurichia, Tribe of Wayanad district, Kerala (India)	⁸²^,¹²⁴
40	Anthemis tinctoria L. (syn. of Cota tinctoria (L.) J.Gay)	Floral Branches	Decoction or Infusion	Stomach-ache, Gastritis	Urmia, Iran	¹²⁵
41	Apium graveolens L.	Leaves	Tea or Decoction	Digestive problems (Bloating), Flatulence	Mexican Traditional Medicine, in the Setifian High Plateau, Algeria	⁸²^,¹¹⁷
42	Arachis hypogaea L.	Seeds	Decoction	Dysentery, Gastric ulcer	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
43	Arctium lappa L. (Arctium major Gaertn.)	Roots		Anorexia		¹¹⁰
44	Arctium minus (Hill) Bernh.	Roots		Anorexia		¹¹⁰
45	Arctium tomentosum Mill.	Roots		Anorexia		¹¹⁰
46	Argyrolobium roseum (Cambess.) Jaub. & Spach	Whole plant		Diarrhoea	Bannu, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
47	Aristolochia tagala Cham. (syn. of Aristolochia acuminata Lam)	Whole plant	Paste	Abdominal Pain	Paniya, Kattunaika, Kurichia Tribe of Wayanad district, Kerala (India)	⁹²
48	Artemisia absinthium L.	Aerial Part and Leaves	Boiled	Anorexia, Dyspepsia, Intestinal Worms, Indigestion, Diarrhoea, Vomiting	Kohat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷^,¹¹⁰
49	Artemisia dracunculus L.	Twig and Leaves	Decoction	Anorexia	Urmia, Iran	¹¹⁶
50	Artemisia herba-alba Asso.	Aerial parts and Leaves	Decoction	Gastralgia, Gastritis, Ulcer	Setifian High Plateau, Algeria, and other North African regions	¹¹⁷
51	Artemisia nilagirica (C.B.Clarke) Pamp.	Leaves	Juice	Abdominal pain	Kuruma, kattunaika, kurichia, paniya, Tribe of Wayanad district, Kerala (India)	⁹²
52	Artemisia vulgaris L.	Branches and Fruit	Decoction Or Infusion	Intestinal Worm	Urmia, Iran	¹¹⁶
53	Artocarpus hirsutus Lam.	Leaves	Burned and ash taken	Abdominal problems	Kurichia, Tribe of Wayanad district, Kerala (India)	⁹²
54	Arundinaria densifolia Munro (syn. of Kuruna densifolia (Munro) Attigala, Kaththr. & L.G.Clark)	Leaves	Juice	Stomach problems	Kuruma, paniya, kattunaika, adiya, Tribe of Wayanad district, Kerala (India)	⁹²
55	Aspalathus linearis (Burm.f.) R.Dahlgren	Plant		Diarrhoea		¹²⁶
56	Asparagus adscendens Roxb.	Roots (Ground Roots)		Flatulence	Karak, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
57	Asparagus filicinus Buch.-Ham. ex D.Don	Roots	Decoction	Gastric ulcer, Flatulence	Karen people of northern Thailand	¹¹⁵
58	Asparagus racemosus Willd.	Plant		Constipation, Diarrhoea, Dysentery, Dyspepsia, Flatulence, Stomach-ache	Nepal	¹¹²
59	Asystasia gangetica (L.) T.Anderson	Whole plant	Paste	Gastric ulcer	Kuruma, Tribe of Wayanad district, Kerala (India)	⁹²
60	Atalantia racemosa Wight var. racemose (syn. of Atalantia racemosa Wight ex Hook.)	Leaves	Juice	Acidity	Kurichia, Tribe of Wayanad district, Kerala (India)	⁹²
61	Avena sativa L	Seeds	Decoction	Gastralgia	Setifian High Plateau, Algeria	¹¹⁷
62	Azadirachta indica A. Juss	Roots and Leaves	Decoction	Digestive and Gastric Problems, Stomachache	Nyamwezi THPs, in the Tabora region, Tanzania, and Lakki Marwat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷^,¹²⁰
63	Benincasa hispida (Thunb.) Cogn.	Seeds		Stomach-ache, Flatulence	Santal tribe of Bangladesh	¹¹³
64	Berberis vulgaris L.	Aerial parts		Peptic ulcers	North Africa	¹⁰⁵
65	Bergenia ciliata (Haw.) Sternb.	Plant		Diarrhoea, Dysentery, Gastritis, Indigestion, Stomach-ache, Vomiting	Nepal	¹¹²
66	Bidens pilosa L	Whole plant	Decoction	Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
67	Bistorta amplexicaulis (D. Don)Greene	Whole plant		Constipation	Bannu, Kohat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
68	Boerhavia diffusa L.	Roots	The Plant Is Pasted With Cumin	Flatulence, Digestive problems	Karak, Khyber Pakhtunkhwa province of Pakistan, and Kurichia Tribe of Wayanad district, Kerala (India)	⁹²^,¹⁰⁷
69	Boesenbergia rotunda (L.) Mansf.	Rhizome	Decoction (Potion)	Flatulence	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
70	Bombax ceiba L.	Plant		Abdominal pain, Colic, Constipation, Diarrhoea, Dysentery, Stomach disorders, Stomach-ache, Intestinal worms	Nepal	¹¹²
71	Brachylaena ilicifolia (Lam.) E.Phillips & Schweick.	Leaves	Infusion And Decoction	Diarrhoea	Eastern Cape Province, South Africa	¹⁰⁸
72	Brachystegia spiciformis Benth.	Roots	Crushed Then Decocts	Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
73	Brassica oleracea var. botrytis L. (syn. of Brassica cretica subsp. cretica)	Aerial parts		Peptic ulcer	North Africa	¹⁰⁵
74	Brassica oleracea var. capitate L. (syn. of Brassica oleracea L.)	Leaves		Peptic ulcer	North Africa	¹⁰⁵
75	Bryonia dioica Jacq. (Bryonia cretica subsp. dioica (Jacq.) Tutin)	Roots and Fruit	Decoction, Powder	Indigestion, Intestinal infection	Urmia, Iran	¹¹⁶
76	Bulbine abyssinica A.Rich.	Roots and Leaves	Decoctions	Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
77	Bulbine asphodeloides (L.) Spreng.)	Tuber	Decoctions	Diarrhoea, Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
78	Bulbine latifolia (L.f.) Spreng.	Roots	Decoctions	Diarrhoea	Eastern Cape Province, South Africa	¹⁰⁸
79	Cajanus cajan (L.) Huth	Leaves	Powder mixed with hot water or tea	Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
80	Camellia sinensis (L.) Kuntze	Leaves	Tea	Gastric Infection, Indigestion, Nausea, Diarrhoea	Bannu, Lakki Marwat, Khyber Pakhtunkhwa province of Pakistan, and Izmir province, Turkey	¹⁰⁷^,¹²⁴^,¹²⁶
81	Carica papaya L	Fruit		Constipation	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
82	Carissa opaca Stapf. ex Haines (syn. of Carissa spinarum L.)	Roots, Leaves and Fruit		Dysentery	Karak, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
83	Carlina acanthifolia All.	Roots		Peptic ulcers	North Africa	¹²⁷
84	Carum carvi L.	Fruit, Seed and Essential Oil	Decoction	Dyspepsia, Flatulence, Diarrhoea	Setifian High Plateau, Algeria	¹¹⁰^,¹¹⁷
85	Carum copticum (L.) Benth. &Hook.f. ex C.B. Clarke	Seed		Diarrhoea, Dysentery, Vomiting	Kohat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
86	Cassia abbreviata Oliv	Leaves	Powder mixed with hot water	Stomach-ache	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
87	Cassia fistula L.	Fruit With Seeds	Decoction	Dysentery	D. I. Khan,Bannu, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
88	Cassia sophera L. (syn. of Senna sophera (L.) Roxb.)	Leaves		Constipation	Santal tribe of Bangladesh	¹¹³
89	Cassipourea mollis (R.E. Fries) Alston	Roots	Chew then swallow the fluid	Diarrhoea, Stomach-ache, Gastric ulcer	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
90	Catunaregam spinose (Thunb.) Tirveng.	Plant		Colic, Diarrhoea, Dysentery, Gastritis, Indigestion, Peptic ulcer, Stomach-ache	Nepal	¹¹²
91	Cedrus deodara (Roxb. ex D.Don) G. Don	Whole plant		Flatulence	Karak, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
92	Celastrus paniculatus Willd.	Bark	Decoction (Potion)	Diarrhoea	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
93	Centaurea chamaerhaponticum Ball (syn. of Centaurea acaulis L.)	Aerial parts		Peptic ulcers	North Africa	¹⁰⁵
94	Centaurea solstitialis L.	Inflorescence	Decoction	Diarrhoea	Urmia, Iran	¹²⁵
95	Centaurium erythraea Rafn (syn. Erythraea centaurium (L.) Pers.	Aerial Part	Powder	Dyspepsia, Diarrhoea, Peptic ulcer	Setifian High Plateau, Algeria and other North African regions	¹⁰⁵^,¹¹⁰^,¹¹⁷
96	Centaurium majus (Hoffmanns. & Link) Zeltner (syn. of Centaurium erythraea subsp. majus (Hoffmanns. & Link) M.Laínz )	Aerial Part		Dyspepsia		¹¹⁰
97	Centaurium suffruticosum (Griseb.) Ronniger (syn. of Centaurium erythraea subsp. suffruticosum (Griseb.) Greuter)	Aerial Part		Dyspepsia		¹¹⁰
98	Centella asiatica (L.) Urb.	Roots and Leaves	Raw, Infusion, Decoction or Concoction	Gastric ulcer, Stomach disorders, Dysentery, Diarrhoea	Karen people of northern Thailand and Eastern Cape Province, South Africa	¹⁰⁸^,¹¹⁵
99	Cerasus avium (L.) Moench (syn. of Prunus avium (L.) L.)	Fruit Peduncle	Fruit stalk is boiled and the stock is drunk	Diarrhoea	Izmir Province, Turkey	¹²⁴
100	Ceratonia siliqua L.	Fruit	Chewed	Stomachic, Laxative, Diarrhoea	Izmir Province, Turkey, in the Setifian High Plateau, Algeria	¹¹⁷^,¹²⁴
101	Ceratonia siliqua L.	Leaves, Pods, and Seeds		Peptic ulcers	North Africa	¹²⁸
102	Chamaemelum nobile (L.) All.	Flowers		Dyspepsia		¹¹⁰
103	Chenopodium album L.	Leaves	Leaves are boiled and the stock is drunk	Constipation, Dysentery, Dyspepsia, Gastritis, Intestinal worms, Peptic ulcer	Izmir Province, Turkey and Nepal	¹¹²^,¹²⁴^,¹²⁹
104	Chrysophyllum bangweolense R. E. Fries (syn. of Donella bangweolensis (R.E.Fr.) Mackinder)	Roots	Decoction Drunk	Constipation	Nyamwezi THPs, in the Tabora region, Tanzania	¹²⁰
105	Cichorium intybus L.	Roots, Leaves and Flowers	Decoction	Anorexia, Dyspepsia, Stomachic, Laxative	Urmia, Iran, and Izmir province, Turkey	¹¹⁰^,¹²⁹^,¹³⁰
106	Cichorium intybus L.	Roots and Leaves		Peptic ulcers	North Africa	¹⁰⁵
107	Cinnamomum aromaticum Nees	Bark	Tea, Powdered bark used as spice	Digestive problems (Bloating)	Mexican Traditional Medicine	⁸²
108	Cinnamomum tamala (Buch.-Ham.) T.Nees & C.H.Eberm.	Plant		Appetizer, Colic pain, Diarrhoea, Gastritis, Intestinal disorder, Nausea, Stomach-ache, Vomiting	Nepal	¹¹²
109	Cinnamomum verum J.Presl (syn. Cinnamomum zeylanicum Blume)	Bark and Essential Oil	Tea, Powdered, Essential Oil, Decoction	Peptic Ulcer, Bloating, Gastrointestinal disorder, Vomiting, Dysentery	Mexican Traditional Medicine, and other North African regions, Kohat, Khyber Pakhtunkhwa province of Pakistan	⁸²^,⁹⁷^,¹⁰⁵^,¹⁰⁷^,¹¹⁰
110	Cirsium arvense (L.) Scop.	Floral Branches	Raw Edible	Intestinal Worms	Urmia, Iran	¹²⁵
111	Cissampelos capensis L.f.	Roots and Leaves	Infusion	Diarrhoea	Eastern Cape Province, South Africa	¹⁰⁸
112	Cissus quadrangularis L.	Stem		Constipation	Chakma tribe of Bangladesh	¹¹³
113	Citrullus colocynthis (L.) Schrad	Fruit and Seed	Decoction, Murabba	Constipation, Abdominal disorders	Urmia, Iran and Bannu,Kohat,Lakki Marwat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷^,¹²²
114	Citrus limon (L.) Burm. f.	Roots and Fruit	Roots Juice mixed with Cordia africana leaves and taken orally, Fresh Fruit are boiled and the stock is drunk	Flatulence, Colic, Constipation, Dysentery, Diarrhoea, Dyspepsia, Intestinal Worms, Stomach-ache, Vomiting	Nyamwezi THPs, in the Tabora region, Tanzania and Izmir Province, Turkey and Nepal	¹¹²^,¹²⁰^,¹²⁴
115	Citrus medica L.	Plant		Colic, Constipation, Diarrhoea, Dysentery, Dyspepsia, Vomiting	Nepal	¹¹²
116	Clausena anisata (Willd.) Hook.f. ex Benth.	Roots, Bark and Fresh Leaves	Decoction	Gastrointestinal disorder	Eastern Cape Province, South Africa	¹⁰⁸
117	Clerodendrum myricoides (Hochst.) R.Br. ex Vatke (syn. of Rotheca myricoides (Hochst.) Steane & Mabb.)	Roots and Leaves	Decoction Drunk	Dysentery, Stomach-ache	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
118	Coffea arabica L.	Seeds	Turkish Coffee	Indigestion	Izmir Province, Turkey	¹²⁴
119	Combretum zeyheri Sond.	Roots and Leaves	powder of the dried parts is mixed with tea or porridge, then taken orally	Diarrhoea, Dysentery, Stomach-ache	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
120	Commiphora myrrha (T.Nees) Engl.	Plant		Diarrhoea, Irritable Bowel Syndrome, Gastric Infection		¹²⁶
121	Convolvulus arvensis L	Roots	Sap of fresh roots	Stomachic, Laxative	Izmir Province, Turkey	¹²⁴
122	Coriandrum sativum L.	Fruit and Seeds	Fruit crushed and mixed with salt	Flatulence, Indigestion, Gastralgia, Diarrhoea	Khyber Pakhtunkhwa province of Pakistan, in Setifian High Plateau, Algeria	¹⁰⁷^,¹¹⁵^,¹¹⁷
123	Crocus sativus L.	Flowers	Powder	Indigestion, Gastralgia	Setifian High Plateau, Algeria	¹¹⁷
124	Crotalaria burhia Buch.-Ham. ex Benth.	Whole plant	Dried plant is ground, mixed with water	Diarrhoea, Abdominal disorders	Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
125	Croton kongensis Gagnep.	Leaves	Decoction	Gastric ulcer, Diarrhoea	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
126	Cucurbita pepo L	Seeds	Infusion	Flatulence	Nyamwezi THPs, in the Tabora region, Tanzania	¹²⁰
127	Cuminum cyminum L.	Seeds	Decoction	Intestinal Inflammation, Flatulence, Diarrhoea	Urmia, Iran, in Setifian High Plateau, Algeria	¹¹⁶^,¹¹⁷
128	Cupressus sempervirens L.	Leaves	Powder	Diarrhoea	Setifian High Plateau, Algeria	¹¹⁷
129	Curculigo orchioides Gaertn.	Plant		Cholera, Diarrhoea, Digestive, Peptic ulcer, Stomach-ache	Nepal	¹¹²
130	Curcuma aromatica Salisb.	Rhizome		Stomach ache, Indigestion	Mandai tribe of Bangladesh	¹¹³
131	Curcuma longa L.	Rhizome	Powder, Decoction	Gastric ulcers, Dyspepsia, Stomach Cancer, Stomach Bleeding, Flatulence	Kohat, Khyber Pakhtunkhwa province of Pakistan, Karen people of northern Thailand, and North African regions	⁸¹^,⁹⁷^,¹⁰⁵^,¹¹⁰^,¹¹⁴^,¹¹⁵^,¹³¹
132	Curcuma zanthorrhiza Roxb.	Rhizome		Dyspepsia		¹¹⁰
133	Curtisia dentata (Burm.f.) C.A.Sm.	Bark	Decoctions	Stomach disorders	Eastern Cape Province, South Africa	¹⁰⁸
134	Cuscuta reflexa Roxb.	Roots and Leaves	Juice	Intestinal Worms,	Tribe of Wayanad district, Kerala (India)	⁹²
135	Cussonia spicata Thunb.	Leaves	Infusion	Stomach complaints	Eastern Cape Province, South Africa	¹⁰⁸
136	Cydonia oblonga Mill	Leaves and Fruit	Leaves Are Boiled And The Stock Is Drunk. Fruit Is Directly Eaten	Diarrhoea	Izmir Province, Turkey	¹²⁹
137	Cynara cardunculus L. (syn. Cynara scolymus L.)	Leaves		Dyspepsia, Digestive Stimulants, Gastrointestinal disorders		¹¹⁰^,¹³²^,¹³³
138	Cynodon dactylon (L.) Pers.	Roots	Infusion	Diarrhoea, Gastritis	Setifian High Plateau, Algeria	¹¹⁷
139	Cyperus articulatus L.	Roots	Decoction Drunk	Stomach-ache	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
140	Cyperus kyllingia Endl. (syn. of Rhynchospora colorata (L.) H.Pfeiff.)	Rhizome	The Rhizome Paste Mixed With Milk I	Dysentery	Tribe of Wayanad district, Kerala (India)	⁹²
141	Cyperus rotundus L.	Rhizome		Dyspepsia, Diarrhoea, Vomiting	Bannu, Kohat,Lakki Marwat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
142	Cyperus scariosus R.Br.	Roots		Dysentery	Santal tribe of Bangladesh	¹¹³
143	Dalbergia melanoxylon Guill. & Perr.	Roots	Infusion	Stomach-ache	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
144	Daphne mucronata Royle.	Aerial parts	Decoction or Infusion	Gastric acid	Urmia, Iran	¹¹⁶
145	Datura stramonium L	Seeds	Decoction or Poultice	Intestinal worms, Appetizer	Karak, Khyber Pakhtunkhwa province of Pakistan and Urmia, Iran	¹⁰⁷^,¹³⁴
146	Desmodium triquetrum (L.) DC. (syn. of Tadehagi triquetrum (L.) H.Ohashi)	Leaves		Dysentery	Chakma tribe of Bangladesh	¹¹³
147	Dillenia pentagyna Roxb.	Bark	Decoction	Gastric ulcers	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
148	Dioscorea bulbifera L.	Bulb	Boiled	Gastric ulcers	Kurichia, Tribe of Wayanad district, Kerala (India)	⁹²
149	Diospyros abyssinica (Hiern) F.White	Roots	Infusion	Constipation	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
150	Dipsacus laciniatus L.	Roots, Leave and Seeds	Decoction, Poultice	Constipation	Urmia, Iran	¹¹⁶
151	Ekebergia benguelensis Welw. ex C.DC.	Roots	Powder mixed with tea or porridge	Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
152	Ekebergia capensis Sparrm.	Bark	Decoction	Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
153	Elaeagnus angustifolia L	Fruit and Seed skin	Raw Edible, Decoction	Detoxification, Constipation	Urmia, Iran and Lakki Marwat, Khyber Pakhtunkhwa province of Pakistan	¹¹⁶^,¹²³^,¹⁰⁷
154	Elettaria cardamomum (L.) Maton	Fruit		Gastrointestinal disorders		¹³¹^,¹³⁵
155	Embelia sessiliflora Kurz	Fruit	Raw	Laxative	Karen people of northern Thailand	¹¹⁵
156	Engelhardia spicata var. colebrookeana (Lindl.) Koord. & Valeton (syn. of Engelhardia spicata var. integra (Kurz) W.E.Manning ex Steenis)	Bark	Decoction (Potion)	Gastric ulcers	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
157	Ensete glaucum (Roxb.) Cheesman	Leaves	Decoction (Potion)	Diarrhoea, Food poisoning	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
158	Entada abyssinica Steud. ex A.Rich.	Roots	Powder Mixed With Tea Or Porridge And Drunk	Gastritis	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
159	Ephedra gerardiana Wall. ex Klotzsch & Garcke	Shoot, Leaves and Fruit		Dyspepsia	Lakki Marwat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
160	Equisetum arvense L.	Leaves	Decoction	Diarrhoea	Lakki Marwat, Khyber Pakhtunkhwa province of Pakistan, in Setifian High Plateau, Algeria	¹⁰⁷^,¹¹⁷
161	Eucalyptus globulus Labill.	Leaves	Infusion	Diarrhoea	Setifian High Plateau, Algeria	⁹⁷^,¹¹⁷
162	Eucomis autumnalis (Mill.) Chitt.	Bulbs	Decoction	Stomach ache	Eastern Cape Province, South Africa	¹⁰⁸
163	Eugenia jambolana Lam. (syn. of Syzygium cumini (L.) Skeels)	Leaves and Seed	Powder or Infusion	Stomach problems, Gastric ulcer	Bannu, Khyber Pakhtunkhwa province of Pakistan, Nyamwezi THPs, in the Tabora region, Tanzania	¹⁰⁷^,¹²⁰
164	Euphorbia candelabrum Trémaux ex Kotschy (syn. of Euphorbia murielii N.E.Br.)	Twigs	Decoction mixed with chicken meat taken orally	Constipation	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
165	Euphorbia heterophylla L.	Leaves and Latex	Decoction	Constipation	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
166	Euphorbia hirta L.	Whole plant	Powder mixed with porridge or used as decoction	Stomach ache, Constipation, Gastric ulcer	LakkiMarwat, Khyber Pakhtunkhwa province of Pakistan, Nyamwezi THPs, in the Tabora region, Tanzania, Karen people of northern Thailand	¹⁰⁷^,¹¹⁵^,¹²⁰
167	Euphorbia royleana Boiss.	Plant		Constipation, Diarrhoea, Dysentery, Gastric problem, Indigestion	Nepal	¹¹²
168	Evolvulus nummularius (L.) L.	Roots and Rhizome	Mixed with Zingiber officinale and Alternanthera sessilis	Dysentery	Mandai tribe of Bangladesh	¹¹³
169	Ficus carica L.	Leave and Fruit	Decoction	Constipation	Urmia, Iran, in Setifian High Plateau, Algeria	¹¹⁷^,¹³⁶
170	Ficus religiosa L.	Bark	Burned Bark Powder	Diarrhoea	Bannu, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
171	Flacourtia indica (Burm.f.) Merr.	Roots	Decoction Drunk	Constipation	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
172	Flacourtia jangomas (Lour.) Raeusch.	Bark	Decoction (Hold In Mouth, Potion)	Gastric ulcer, Diarrhoea	Karen people of northern Thailand	¹¹⁵
173	Foeniculum vulgare Mill	Stem, Leaves, Fruit and Seeds	Tea, equal quantity of fennel fruit, coriander fruit and sugar are mixed and ground together to make powder	Gastralgia, Constipation, Irritable Bowel Syndrome, Dyspepsia, Acidity, Abdominal pain	Mexican Traditional Medicine, Khyber Pakhtunkhwa province of Pakistan, in Setifian High Plateau, Algeria and Eastern Cape Province, South Africa	⁸²^,⁹⁷^,¹⁰⁷^,¹⁰⁸^,¹¹⁷^,¹²⁶
174	Fragaria × ananassa (Duchesne ex Weston) Duchesne ex Rozier	Leaves		Diarrhoea		¹¹⁰
175	Fragaria moschata Duchesne ex Weston	Leaves		Diarrhoea		¹¹⁰
176	Fragaria vesca L.	Leaves		Diarrhoea		¹¹⁰
177	Fragaria viridis Weston	Leaves		Diarrhoea		¹¹⁰
178	Friesodielsia obovata (Benth.) Verdc. (syn. of Monanthotaxis obovata (Benth.) P.H.Hoekstra)	Roots	Decoction	Constipation	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
179	Fumaria indica (Hausskn.) Pugsley	Whole plant		Diarrhoea, Vomiting	Kohat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
180	Galium humifusum M.Bieb.	Aerial parts	Decoction	Parasitic Diarrhoea	Urmia, Iran	¹³⁷
181	Galium verum L.	Roots and Aerial parts	Decoction	Parasitic Diarrhoea	Urmia, Iran	¹³⁷
182	Gentiana lutea L.	Roots		Anorexia, Dyspepsia		¹¹⁰
183	Globularia alypum L.	Roots, Leaves and Flowers		Peptic Ulcers	North Africa	¹⁰⁵
184	Glycyrrhiza glabra L.	Roots, Rhizome and Aerial parts	Decoction, Licorice Candy that is produced from the roots is dissolved in water and drunk	Dyspepsia,Gastritis, Peptic Ulcer	Urmia, Iran and Izmir province, Turkey, in Setifian High Plateau, Algeria, and other North African regions	¹⁰⁵^,¹¹⁰^,¹¹⁶^,¹¹⁷^,¹²⁹
185	Glycyrrhiza inflata Batalin	Roots		Dyspepsia		¹¹⁰
186	Glycyrrhiza uralensis Fisch. ex DC.	Roots		Dyspepsia		¹¹⁰
187	Gmelina arborea Roxb. ex Sm.	Bark and Flowers	Decoction	Gastric ulcer, Constipation	Karen people of northern Thailand	¹¹⁵
188	Gomphostemma heyneanum Wall. ex Benth.	Leaves	Paste	Dysentery, Diarrhoea	kurichia, kuruma, kattunaika, Tribe of Wayanad district, Kerala (India)	⁹²
189	Grammosciadium daucoides DC.	Fresh Leaves	Decoction	Bloating, Stomach and Intestinal ulcers, Indigestion, Acidity	Urmia, Iran	¹³⁸^,¹³⁹
190	Gymnopetalum integrifolium (Roxb.) Kurz (syn. of Trichosanthes scabra var. scabra)	Stem and Leaves	Decoction	Flatulence	Karen people of northern Thailand	¹¹⁵
191	Harpagophytum procumbens (Burch.) DC. ex Meisn.	Roots		Anorexia, Dyspepsia		¹¹⁰
192	Harrisonia abyssinica Oliv.	Roots	Decoction Drunk	Stomachache	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
193	Helianthemum kahiricum Delile	Aerial parts		Peptic ulcers	North Africa	¹⁰⁵^,¹⁴⁰
194	Helianthemum lippii (L.) Dum.Cours.	Aerial parts		Peptic ulcers	North Africa	¹⁰⁵^,¹⁴¹
195	Helichrysum arenarium (L.) Moench.	Flowers		Dyspepsia		¹¹⁰
196	Hexalobus monopetalus (A.Rich.) Engl. & Diels	Leaves	Decoction	Gastric ulcer, Constipation	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
197	Holarrhena antidysenterica (G.Don) Wall. ex A.DC. (syn. of Holarrhena pubescens Wall. ex G.Don)	Stem Bark and Seed	Powder	Stomach problems, Dysentery	Kurichia, Tribe of Wayanad district, Kerala (India), Santal tribe of Bangladesh	⁹²^,¹¹³
198	Hydnora africana Thunb.	Whole plant	Infusion or Decoction	Diarrhoea, Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
199	Hymenocardia mollis Pax (syn. of Hymenocardia acida Tul.)	Roots	Decoction	Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
200	Hypericum perforatum L.	Aerial parts	Above ground parts are kept in olive oil for at least 3 months and then consumed on an empty stomach in the morning. Above ground parts are also boiled and the stock is consumed	Dyspepsia, Stomachic, Stomach Ulcer		¹¹⁰^,¹²⁴
201	Illicium verum Hook.f.	Plant	Tea	Bloating	Mexican Traditional Medicine	⁸²
202	Ipomoea crassipes Hook.	Whole plant	Infusions And Decoctions	Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
203	Jatropha gossypiifolia L.	Bark	Infusion Drunk	Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
204	Juniperus communis L.	Aerial parts, Fruit, and Essential oil		Dyspepsia, Peptic ulcer	North Africa	¹¹⁰^,¹⁰⁵
205	Juniperus indica Bertol.	Plant		Abdominal pain, Flatulence, Constipation, Diarrhoea, Indigestion	Nepal	¹¹²
206	Juniperus phoenicea L.	Leaves		Peptic ulcers	North Africa	¹⁰⁵^,¹⁴²
207	Kaempferia parviflora Wall. ex Baker	Rhizome	Decoction	Flatulence, Gastric ulcer	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
208	Lagenaria siceraria (Molina) Standl.	Aerial parts		Diarrhoea, Dysentery, Indigestion, Acidity, Peptic ulcer	Nepal, North Africa	¹¹²^,¹⁰⁵
209	Lannea schimperi (Hochst. ex A.Rich.) Engl.	Bark	Chew and swallow the fluids	Stomachache	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
210	Lannea stuhlmannii (Engl.) Eyles (syn. of Lannea schweinfurthii var. stuhlmannii (Engl.) Kokwaro)	Roots	Decoction	Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
211	Launaea cornuta (Hochst. ex Oliv. & Hiern) C.Jeffrey	Leaves	Infusion	Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
212	Laurus nobilis L.	Leaves	Boiled and the stock is drunk either plainly or mixed with honey	Indigestion	Izmir Province, Turkey	¹²⁴^,¹²⁹
213	Lavandula officinalis L.	Flowers	Infusion	Flatulence	Setifian High Plateau, Algeria	¹¹⁷
214	Lavandula stoechas L.	Leaves		Peptic ulcers	North Africa	¹⁰⁵^,¹⁴³
215	Lawsonia inermis L.	Leaves		Peptic ulcers	North Africa	¹⁰⁵
216	Leea indica (Burm. f.) Merr.	Roots and Stem	Decoction	Diarrhoea, Gastric ulcer	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
217	Leonotis leonurus (L.) R.Br.	Whole plant	Infusion or Decoction	Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
218	Linum usitatissimum L.	Seeds	Chewed	Dyspepsia, Constipation	IIzmir province, Turkey, Setifian High Plateau, Algeria	¹¹⁰^,¹¹⁷^,¹²⁴^,¹²⁹
219	Lupinus termis L.	Seeds	Powder	Constipation	Setifian High Plateau, Algeria	¹¹⁷
220	Lycium barbarum L.	Leaves	Extract	Bloody diarrhoea, Vomiting	Bannu, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
221	Malva neglecta Wallr.	Shoot, branches, Leaves and Seeds		Stomach Pain, Dyspepsia, Constipation	Lakki Marwat, Khyber Pakhtunkhwa province of Pakistan and Urmia, Iran	¹⁰⁷^,¹¹⁰^,¹¹⁶
222	Malva parviflora L.	Leaves	Decoction	Constipation	Karak, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
223	Malva sylvestris L.	Aerial part and Leaves	Decoction, Infusion	Dyspepsia, Gastralgia, Laxative	Izmir province, Turkey, Setifian High Plateau, Algeria	¹¹⁰^,¹¹⁷^,¹²⁴^,¹²⁹
224	Mangifera indica L.	Leaves		Peptic Ulcer, Abdominal Pain, Constipation, Diarrhoea, Dysentery, Flatulence, Gastritis, Gastropathy, Intestinal Spasm, Peptic Ulcer, Stomach Worms, Stomachache	Nepal, North Africa	¹⁰⁵^,¹¹²
225	Marrubium vulgare L.	Aerial parts	Decoction	Anorexia, Dyspepsia, Diarrhoea	Setifian High Plateau, Algeria	¹¹⁰^,¹¹⁷
226	Matricaria chamomilla L.	Flowers	Decoction	Dyspepsia, Gastrointestinal disorders, Diarrhoea, Constipation, Irritable Bowel Syndrome Symptoms, Dyspepsia, Indigestion, Acidity, Peptic ulcer	Izmir province, Turkey, North African regions	¹⁰⁵^,¹¹⁰^,¹²⁴^,¹²⁶
227	Melia azadirachta L. (syn. of Azadirachta indica A.Juss.)	Leaves and Fruit	Decoction	Intestinal Worms	Lakki Marwat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
228	Melissa officinalis L.	Leaves		Dyspepsia		¹¹⁰
229	Mentha × piperita L.	Leaves and Essential oil	Chewed, Decoction	Dyspepsia, Nausea, Indigestion, Gastric Infection, Flatulence,	Setifian High Plateau, Algeria, Eastern and Western traditional systems, Izmir province, Turkey	¹¹⁰^,¹¹⁷^,¹²⁶^,¹²⁴^,¹²⁹^,¹⁴⁴^,¹⁴⁵
230	Mentha aquatica L.	Leaves	Infusion	Stomach ache	Eastern Cape Province, South Africa	¹⁰⁸
231	Mentha longifolia (L.) L.	Aerial parts	Fresh leaves are boiled in water with green tea and sugar	Diarrhoea, Bloating Intestinal colic; Flatulence	Kohat, Lakki Marwat, Karak D. I. Khan, Khyber Pakhtunkhwa province of Pakistan and Urmia, Iran	¹⁰⁷^,¹⁴⁶
232	Mentha microphylla K.Koch (syn. of Mentha spicata subsp. condensata (Briq.) Greuter & Burdet).	Leaves		Peptic ulcers	North Africa	¹⁰⁵^,¹⁴⁷
233	Mentha pulegium L.	Plant	Tea	Bloating	Mexican Traditional Medicine	⁸²
234	Mentha spicata L.	Aerial parts and Leaves	Tea, Essential Oil, Decoction,	Digestive Problems (Bloating), parasitic Diarrhoea, Intestinal Colic; Duodenum And Ileum Muscle Relaxants, Flatulence Gastralgia, Peptic ulcer	Mexican Traditional Medicine, Urmia, Iran, Izmir province, Turkey and North African regions	⁸²^,¹⁰⁵^,¹²⁴^,¹⁴⁶^–¹⁵¹
235	Menyanthes trifoliata L.	Leaves		Anorexia, Dyspepsia		¹¹⁰
236	Momordica charantia L.	Fruit	Thinly sliced fruits are kept in honey or olive oil until completely dissolved and then consumed (1–2 tbsp) on an empty stomach in the mornings	Stomach ache, Gastritis, Peptic ulcer	Izmir Province, Turkey	¹²⁴^,¹²⁹
237	Moringa oleifera Lam	Fruit	Infusion	Stomachache, Gastric ulcer	Nyamwezi THPs, in the Tabora region, Tanzania	¹²⁰
238	Morus nigra L	Fruit	Fruits are boiled and the stock is drunk	Diarrhoea	Izmir province, Turkey	¹²⁴
239	Mundulea sericea (Willd.) A.Chev.	Roots	Decoction	Stomachache	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
240	Musa × sapientum L. (syn. of Musa × paradisiaca L.)	Fruit		Heartburn, Gastric Ulcer, Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania, Karen people of northern Thailand	¹¹⁴^,¹¹⁵^,¹²⁰
241	Mussaenda sanderiana Ridl.	Roots and Leaves	Decoction	Anorexia	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
242	Myristica fragrans Houtt.	Plant		Flatulence, Colic, Diarrhoea, Dyspepsia, Stomachache, Vomiting	Nepal	¹¹²
243	Myrtus communis L.	Leaves and Fruit	Decoction	Gastrointestinal disorders, Diarrhoea, Peptic ulcer	Izmir province, Turkey, Setifian High Plateau, Algeria, North African regions	¹⁰⁵^,¹¹⁷^,¹²⁴^,¹²⁹
244	Nardostachys grandiflora DC. (syn. of Nardostachys jatamansi (D.Don) DC.)	Plant		Flatulence, Colic, Constipation, Diarrhoea, Dysentery, Dyspepsia, Food poisoning, Gastritis, Indigestion, Intestinal parasites	Nepal	¹¹²
245	Nasturtium officinale W.T.Aiton	Leaves		Constipation	Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
246	Neopicrorhiza scrophulariiflora (Pennell) D.Y.Hong	Plant		Gastritis, Intestinal Worms, Stomachache	Nepal	¹¹²
247	Nigella sativa L.	Seeds	Powder	Acidity, Flatulence, Peptic ulcer	Setifian High Plateau, Algeria and other North African regions	¹⁰⁵^,¹¹⁷^,¹²⁶
248	Ochna integerrima (Lour.) Merr.	Leaves	Decoction	Diarrhoea, Constipation, Gastric ulcer	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
249	Ocimum basilicum L.	Aerial parts	Decoction	Anorexia, Digestive System Booster; Flatulence	Urmia, Iran	¹²²
250	Olea europaea L.	Leaves and Fruit		Peptic ulcers	North Africa	¹⁰⁵^,¹⁴⁸
251	Olea europaea subsp. africana (Mill.) P.S.Green	Roots, Bark and Leaves	Infusions or Decoctions	Diarrhoea	Eastern Cape Province, South Africa	¹⁰⁸
252	Opuntia dillenii (Ker Gawl.) Haw. (syn. of Opuntia tuna (L.) Mill.)	Leaves and Fruit	Ripened fruit is boiled in water with some sugar	Constipation	Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
253	Opuntia ficus-indica (L.) Mill.	Fruit and Seeds		Peptic ulcers	North Africa	¹⁰⁵
254	Opuntia monacantha Haw.	Whole plant		Indigestion	Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
255	Origanum compactum Benth.	Leaves		Peptic ulcers	North Africa	¹⁰⁵^,¹⁴⁹
256	Origanum dictamnus L.	Aerial parts		Dyspepsia	–	¹¹⁰
257	Origanum majorana L	Aerial parts	Decoction	Dyspepsia, Indigestion, Gastralgia	Setifian High Plateau, Algeria, Izmir province, Turkey	¹¹⁰^,¹¹⁷^,¹²⁴^,¹²⁶^,¹²⁹
258	Origanum majorana L.	Aerial parts		Peptic ulcers	North Africa	¹⁰⁵
259	Origanum onites L	Aerial part	Aerial parts are boiled and the stock is drunk	Gastralgia	Izmir province, Turkey	¹²⁴^,¹⁵¹
260	Origanum syriacum L.	Leaves		Peptic Ulcers	North Africa	¹⁰⁵
261	Oroxylum indicum (L.) Kurz	Plant		Anorexia, Dyspepsia, Flatulence, Constipation, Diarrhoea, Dysentery, Stomachache	Nepal	¹¹²
262	Osyris quadripartita Salzm. ex Decne. (syn. of Osyris lanceolata Hochst. & Steud.)	Roots, Stems, Bark and Leaves		Peptic ulcers	North Africa	¹⁰⁵^,¹⁵²
263	Oxalis corniculata L	Leaves	Decoction or Juice	Stomach problems, Dysentery	Bannu, Khyber Pakhtunkhwa province of Pakistan	⁹²^,¹⁰⁷
264	Oxalis corniculata L.	Plant		Anorexia, Biliousness, Constipation, Diarrhoea, Dysentery, Dyspepsia, Indigestion, Peptic Ulcer, Stomachache Vomiting	Nepal	¹¹²
265	Ozoroa insignis Delile.	Roots and Leaves	Decoction	Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
266	Paliurus spina-christi Mill.	Fruit	Fresh or dried fruits are boiled and the stock is drunk	Stomachic, Laxative	Izmir province, Turkey	¹²⁴^,¹²⁹
267	Papaver rhoeas L.	Flowers	Decoction	Indigestion	Setifian High Plateau, Algeria	¹¹⁷
268	Paronychia argentea Lam.	Aerial parts	Decoction	Diarrhoea	Setifian High Plateau, Algeria	¹¹⁷
269	Pelargonium reniforme (Andrews) Curtis	Roots	Decoction	Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
270	Persicaria lapathifolia (L.) Gray	Roots and Leaves	Infusion	Stomach complaints, Diarrhoea	Eastern Cape Province, South Africa	¹⁰⁸
271	Petroselinum crispum (Mill.) Fuss	Plant	Tea, Condiment	Digestive Problems (Bloating)	Mexican Traditional Medicine	⁸²
272	Peumus boldus Molina.	Leaves		Dyspepsia		¹¹⁰
273	Phoenix dactylifera L.	Palm sap and Pulp		Peptic Ulcers	North Africa	¹⁰⁵
274	Phragmites australis (Cav.) Trin. ex Steud.	Rhizome	Decoction	Gastritis, Intestinal Inflammation	Urmia, Iran	¹¹⁶
275	Phyllanthus emblica L.	Fruit		Diarrhoea Dysentery	Kohat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
276	Phyllanthus emblica L.	Plant		Acidity, Anthelmintic, Colic, Constipation, Diarrhoea, Dysentery, Dyspepsia, Gastric Trouble, Intestinal Spasm, Jaundice, Laxative, Stomachache, Stomatitis And Vomiting	Nepal	¹¹²
277	Phyllanthus engleri Pax	Roots	Decoction Drunk	Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
278	Pimpinella anisum L.	Fruit, Essential Oil and Seeds	Tea, Powder	Irritable Bowel Syndrome Symptoms, Gastric Infection, Gastric Acidity, Bloating, Dyspepsia, Flatulence	Mexican Traditional Medicine, in Setifian High Plateau, Algeria	⁸²^,¹¹⁰^,¹¹⁷^,¹²⁶
279	Piper longum L.	Plant		Cholagogue, Colic, Digestive, Dyspepsia, Indigestion, Laxative, Piles, Splenopathy, Stomachache And Vomiting	Nepal	¹¹²
280	Pistacia lentiscus L.	Aerial parts, Leaves, Gum and Oleoresin		Dyspepsia, Against Gastralgia, Peptic Ulcer	Izmir province, Turkey and North Africa	¹⁰⁵^,¹¹⁰^,¹²⁴
281	Pistacia terebinthus L.	Leaves	Leaves Are Boiled And The Stock Is Drunk	Stomachic, To Treat Gastritis And Ulcer	Izmir province, Turkey	¹²⁴
282	Plantago afra L.	Seeds		Constipation		¹¹⁰
283	Plantago indica L	Seeds		Constipation		¹¹⁰
284	Plantago lanceolate L.	Leaves	Infusion	Diarrhoea, Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
285	Plantago major L.	Roots, Leaves and Seeds	Decoction	Peptic ulcer, Gastritis, Gastralgia	Urmia, Iran and Izmir province, Turkey, in Setifian High Plateau, Algeria and other North African regions	¹⁰⁵^,¹¹⁶^,¹¹⁷^,¹²⁴^,¹²⁹
286	Plantago ovata Forssk.	Seed (Husk)		Diuretic, Cholinergic		⁷⁵^,¹¹⁰
287	Platanus orientalis L.	Bark	Decoction	Anorexia, Diarrhoea	Urmia, Iran	¹¹⁶
288	Plectranthus barbatus L	Roots	Infusion mixed with honey	Gastric ulcer, Flatulence	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
289	Polypodium vulgare L.	Rhizome		Constipation		¹¹⁰
290	Pongamia pinnata (L.) Pierre	Seeds	Powder	Kills Pinworm	Kurichia, kattunaika, Tribe of Wayanad district, Kerala (India)	⁹²
291	Portulaca oleracea L.	Aerial parts		Peptic ulcers	North Africa	¹⁰⁵
292	Potentilla erecta (L.) Raeusch.	Rhizome		Diarrhoea		¹¹⁰
293	Prunus kotschyi (Boiss. & Hohen. ex Spach) Meikle	Seeds	Decoction or Infusion	Constipation	Urmia, Iran	¹²³
294	Psidium guajava L	Leaves	Decoction	Dysentery, Diarrhoea, Abdominal Pain, Anthelmintic, Cholera, Colic	Nyamwezi THPs, Tabora region, Tanzania, Karen people of northern Thailand, Nepal	¹¹²^,¹¹⁴^,¹¹⁵^,¹²⁰
295	Psorospermum febrifugum Spanch	Roots	Powder mixed with hot water or tea	Worm Infections	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
296	Pterocarpus angolensis DC.	Bark	Decoction	Dysentery	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
297	Pterocarpus tinctorius Welw.	Roots and Bark	Decoction	Diarrhoea, Heartburn, Dysentery	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
298	Punica granatum L.	Roots, Leaves, Peel and Fruit	Decoction Infusion, Juice or Powder	Gastric ulcer, Diarrhoea, Gastritis	Nyamwezi THPs, Tabora region, Tanzania and Izmir province, Turkey and Khyber Pakhtunkhwa province of Pakistan and Karen people of northern Thailand, Setifian High Plateau, Algeria and other North African regions	¹⁰⁵^,¹⁰⁷^,¹¹⁴^,¹¹⁵^,¹¹⁷^,¹²⁰^,¹²⁴^,¹²⁹
299	Quercus ilex Lour. (syn. of Quercus helferiana A.DC.)	Fruit		Diarrhoea, Gastritis, ulcer	Setifian High Plateau, Algeria	¹¹⁷
300	Quercus ithaburensis subsp. macrolepis (Kotschy) Hedge & Yalt.	Fruit	Dried fruits are boiled; this stock is mixed with water and drunk	Stomachic, Against Diarrhoea	Izmir province, Turkey	¹²⁴^,¹²⁹
301	Quercus petraea (Matt.) Liebl.	Bark		Diarrhoea		¹¹⁰
302	Quercus pubescens Willd.	Bark		Diarrhoea		¹¹⁰
303	Quercus robur L.	Bark		Diarrhoea		¹¹⁰
304	Rhamnus alaternus L.	Seeds	Decoction	Gastralgia	Setifian High Plateau, Algeria	¹¹⁷
305	Rhamnus frangula L. (syn. of Frangula alnus Mill.)	Bark		Constipation		¹¹⁰
306	Rhamnus purshiana DC. (syn. of Frangula purshiana (DC.) A.Gray ex J.G.Cooper)	Bark	Tea or capsules made from the bark	Constipation		⁸²^,¹¹⁰
307	Rhaphidophora pertusa (Roxb.) Schott.	Stem	Juice	Abdominal pain	Tribe of Wayanad district, Kerala (India)	⁹²
308	Rheum palmatum L.	Roots		Constipation		¹¹⁰
309	Rheum rhaponticum L.	Roots		Constipation		⁸²
310	Rhus tripartita (Ucria) Grande (syn. of Searsia tripartita (Ucria) Moffett)	Roots, Stem, and Leaves		Peptic ulcers	North Africa	¹⁰⁵
311	Ricinus communis L.	Fruit, Seed and Virgin Oil	Chewed, Extract	Constipation, Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania, Setifian High Plateau, Algeria	⁸¹^,¹¹⁷^,¹²⁰
312	Rosa indica L.	Flowers	Flower mixed with sugar put in sun place take orally with water and fennel	Vomiting, Dyspepsia	Bannu, Kohat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
313	Rosmarinus officinalis L. (syn. of Salvia rosmarinus Spenn.)	Leaves and Essential oil	Decoction	Dyspepsia, Gastralgia	Setifian High Plateau, Algeria	¹¹⁰^,¹¹⁷
314	Rubia manjith Roxb.	Plant		Flatulence, Gastritis, Intestinal Spasm, Laxative, Stomach Worms, Vomiting	Nepal	¹¹²
315	Rubia petiolaris DC.	Roots and Leaves	Infusion, Decoction or Concoction	Stomach problems, Haemorrhagic diarrhoea, Amoebic Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
316	Rubus idaeus L.	Leaves		Diarrhoea	–	¹¹⁰
317	Rumex patientia L	Leaves	Decoction	Laxative	Izmir province, Turkey	¹²⁴^,¹²⁹
318	Ruta graveolens L.	Aerial parts	Decoction	Gastralgia	Setifian High Plateau, Algeria	¹¹⁷
319	Saccharum officinarum L.	Stem	Extract	Indigestion	D. I. Khan, Lakki Marwat Bannu, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
320	Salvia officinalis L.	Leaves	Decoction	Dyspepsia, Gastralgia	Izmir province, Turkey	¹¹⁰^,¹²⁴^,¹²⁹
321	Santolina chamaecyparissus L	Leaves	Extract	Indigestion, Gastralgia	Setifian High Plateau, Algeria	¹¹⁷
322	Sarcophyte sanguinea Sparrm	Whole plant	Infusion, Decoction	Diarrhoea, Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
323	Schizocarphus nervosus (Burch.) Van der Merwe	Roots	Decoction	Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
324	Schotia afra (L.) Thunb.	Roots and Bark	Decoction	Diarrheoa	Eastern Cape Province, South Africa	¹⁰⁸
325	Schotia brachypetala Sond.	Roots and Bark	Decoction	Dysentery, Diarrhoea	Eastern Cape Province, South Africa	¹⁰⁸
326	Schotia latifolia Jacq.	Roots and Bark	Decoction	Diarrheoa	Eastern Cape Province, South Africa	¹⁰⁸
327	Sclerocarya birrea (A.Rich.) Hochst.	Bark	Infusion	Constipation	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
328	Scorzonera cinerea Boiss. (syn. of Gelasia cinerea (Boiss.) Zaika, Sukhor. & N.Kilian)	Roots	Decoction	Laxative	Urmia, Iran	¹¹⁶
329	Securidaca longepedunculata Fresen.	Roots	Powder mixed with hot water and drunk	Stomachache, Gastric ulcer, Constipation	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
330	Senecio mollis Willd. (syn. of Jacobaea mollis (Willd.) B.Nord.)		Decoction	Diarrhoea	Urmia, Iran	¹³⁷
331	Senna alata (L.) Roxb.	Leaves	Decoction	Laxative	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
332	Senna alexandrina Mill. (syn. Cassia senna L.)	Leaflets, Leaves and Fruit	Tea, Capsules, Pills, Infusion	Constipation, Diarrhoea,	Setifian High Plateau, Algeria	⁸²^,¹¹⁰^,¹²⁹^,¹²⁰
333	Senna occidentalis (L.) Link	Leaves	Decoction	Laxative	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
334	Senna siamea (Lam.) H.S.Irwin & Barneby	Roots	Decoction Drunk	Stomachache, Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
335	Silybum marianum (L.) Gaertn.	Fruit and Seeds	Decoction	Indigestion, Dyspepsia	Basque people	⁹⁰^,¹¹⁰^,¹³¹^,¹⁵³^,¹⁵⁴
336	Sisymbrium irio L.	Leaves		Stomach Problems	Karak, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
337	Sisymbrium officinale (L.) Scop.	Seeds	Decoction	Laxative	Urmia, Iran	¹¹⁶
338	Smilax zeylanica L.	Roots		Stomach ache, Indigestion	Mandai tribe of Bangladesh	¹¹³
339	Solanum aculeastrum Dunal	Roots, Bark and Berries	Infusion, Decoction And Concussion	Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
340	Solanum incanum L.	Roots and Fruit	Decoction Drunk	Gastric ulcer, Constipation	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
341	Solanum nigrum L.	Roots, Stem, Leaves and Berries		Peptic ulcers	North Africa	¹⁰⁵^,¹⁵⁵
342	Solanum surattense Burm.f. (syn. of Solanum virginianum L.)	Fruit	Powder	Abdomen pain, Gastritis	Bannu, Kohat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
343	Solanum tomentosum L.	Roots, Bark and Berries	Infusion, Decoction And Concussion	Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
344	Sorghum bicolor (L.) Moench.	Leaves	Infusion Drunk	Flatulence	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
345	Stipa tenacissima L. (syn. of Macrochloa tenacissima (L.) Kunth)	Leaves	Decoction	Gastrointestinal disorders	Setifian High Plateau, Algeria	¹¹⁷
346	Streblus asper Lour.	Roots		Dysentery	Santal tribe of Bangladesh	¹¹³
347	Streblus asper Lour. With Hemidesmus indicus (L.) R.Br.	Gum and Roots		Stomach ache, Diarrhoea	Mandai tribe of Bangladesh	¹¹³
348	Strychnos henningsii Gilg	Stem Bark	Decoctions Of The Bark And Infusions Of The Leaves	Stomach ache	Eastern Cape Province, South Africa	¹⁰⁸
349	Strychnos heterodoxa Gilg (syn. of Strychnos potatorum L.f.)	Bark	Decoction Drunk	Dysentery	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
350	Strychnos innocua Delile.	Bark	Decoction Drunk	Gastric ulcer	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
351	Strychnos nitida G.Don	Whole plant	Decoction Drunk	Constipation	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
352	Syzygium aromaticum (L.) Merr. & L.M.Perry	Leaves	Decoction	Diarrhoea, Gastralgia, Flatulence	Setifian High Plateau, Algeria and other North African Regions	⁹⁷^,¹⁰⁵^,¹¹⁷^,¹²⁶
353	Syzygium cordatum Hochst. ex C.Krauss.	Roots, Bark and Leaves	Decoction or Concoction	Stomach complaints, Diarrhoea	Eastern Cape Province, South Africa	¹⁰⁸
354	Tamarindus indica L	Fruit		Constipation, Diarrhoea	Karen people of northern Thailand, Nyamwezi THPs, Tabora region, Tanzania	¹¹⁴^,¹¹⁵^,¹²⁰
355	Tanacetum parthenium (L.) Sch.Bip.	Leave and Flowers	Decoction	Gastritis	Urmia, Iran	¹¹⁶
356	Taraxacum officinale F.H.Wigg. (syn. of Taraxacum sect. Taraxacum F.H.Wigg.	Roots, Aerial parts, and Leaves		Gastrointestinal disorders, Anorexia, Dyspepsia		¹¹⁰^,¹⁵⁶
357	Terminalia bellirica (Gaertn.) Roxb.	Plant		Constipation, Diarrhoea, Dysentery, Dyspepsia, Gastritis, Gastrointestinal diseases, Indigestion, Stomachache, Vomiting	Nepal	¹¹²
358	Terminalia chebula Retz.	Plant		Flatulence, Constipation, Diarrhoea, Dysentery, Gastropathy, Indigestion, Stomachache, Vomiting	Nepal	¹¹²
359	Terminalia sericea Burch. ex DC	Roots	Infusion Drunk	Gastric ulcer, Stomachache,	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
360	Teucrium polium L.	Aerial part	Powder	Gastralgia	Setifian High Plateau, Algeria	¹¹⁷
361	Thespesia garckeana F.Hoffm.	Leaves	Decoction Drunk	Dysentery, Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
362	Thunbergia laurifolia Lindl.	Stem and Leaves	Decoction (Potion, Bath)	Gastric Ulcer Diarrhoea	Karen people of northern Thailand	¹¹⁵
363	Thymus kotschyanus Boiss. & Hohen.	Floral Branch	Infusion	Diarrhoea, Bloating, Indigestion	Urmia, Iran	¹⁵⁷
364	Thymus linearis Benth.	Plant		Anorexia, Diarrhoea, Digestive, Gastritis, Indigestion, Stomachache	Nepal	¹¹²
365	Thymus vulgaris L.	Plant	Tea, Essential Oil	Bloating, Diarrhoea, Constipation, Irritable Bowel Syndrome Symptoms, Gastric Infection, Gastric Acidity	Mexican Traditional Medicine	⁸²^,¹²⁶
366	Tordylium nodosum L. (syn. of Torilis nodosa (L.) Gaertn.)	Whole plant		Intestinal Worms	Bannu, Khyber Pakhtunkhwa province of Pakistan	¹¹⁰
367	Trachyspermum ammi (L.) Sprague	Plant		Flatulence, Cholera, Colic, Diarrhoea, Dyspepsia, Gastritis, Indigestion, Intestinal worms, Stomachache	Nepal	¹¹²
368	Tragopogon caricifolius Boiss.	Leave	Decoction	Constipation	Urmia, Iran	¹¹⁶
369	Trifolium pratense L.	Floral Branches	Decoction	Constipation	Urmia, Iran	¹¹⁶
370	Trigonella foenum-graecum L.	Seeds		Anorexia, Diarrhoea, Constipation, Dyspepsia, Gastric infection, Acidity, Peptic ulcer	North Africa	¹⁰⁵^,¹¹⁰^,¹²⁹
371	Typha capensis (Rohrb.) N.E.Br	Rhizomes	Decoction	Diarrhoea, Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
372	Urtica dioica L.	Leaves	Decoction	Diarrhoea	Setifian High Plateau, Algeria	¹¹⁷
373	Vaccaria oxyodonta Boiss. (syn. of Gypsophila vaccaria (L.) Sm.)	Flowers	Decoction	Constipation	Urmia, Iran	¹¹⁶
374	Valeriana jatamansi Jones ex Roxb.	Plant		Flatulence, Cholera, Diarrhoea, Dysentery, Gastrospasms, Indigestion, Stomachache	Nepal	¹¹²
375	Viscum album L	Leaves and Fruit	Decoction	Diarrhoea	Izmir province, Turkey	¹²⁴^,¹²⁹
376	Vitex mombassae Vatke (Vitex mombassae L.)	Leaves	Decoction Drunk	Dysentery	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
377	Vitis vinifera L.	Leaves, Fruit and Seeds		Peptic Ulcer	North Africa	⁸¹^,¹⁰⁵
378	Withania coagulans (Stocks) Dunal	Fruit and Leaves	Fruits Are Crushed, Mix With Salt, Extract	Gastric and Abdominal pain	Karak, Kohat, D. I. Khan, Lakki Marwat, Bannu, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
379	Woodfordia fruticosa (L.) Kurz	Flowers		Diarrhoea, Dysentery, Ulcers,	Kohat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
380	Xeroderris stuhlmannii Dunn ex Baker f. (or Xeroderris stuhlmannii (Taub.) Mendonça & E.P.Sousa syn. of Aganope stuhlmannii (Taub.) Adema	Roots	Powder Mixed With Hot Water Or Tea And Drunk	Stomachache	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
381	Ximenia americana L.	Roots	Infusion Drunk	Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
382	Xylopia antunensii L. (or Xylopia antunesii Engl. & Diels syn. of Xylopia odoratissima Welw. ex Oliv. )	Leaves	Decoction	Gastric Ulcer, Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
383	Zanthoxylum armatum DC.	Plant		Abdominal Pain, Anthelmintic, Anorexia, Flatulence, Cholera, Constipation, Diarrhoea, Dysentery, Dyspepsia, Flatulence, Gastritis, Indigestion,	Nepal	¹¹²
384	Zanthoxylum chalybeum Engl.	Roots	Decoction Drunk	Constipation, Gastric ulcer, Diarrhoea	Nyamwezi THPs, Tabora region, Tanzania	¹²⁰
385	Zingiber montanum (J.Koenig) Link ex A.Dietr.	Rhizome	Decoction	Flatulence, Gastric ulcer	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
386	Zingiber officinale Roscoe	Rhizome	Tea, Capsule, Powder	Diarrhoea, Dyspepsia, Nausea, Vomiting, Flatulence, Peptic ulcer	Asian medicine, Mexican Traditional Medicine and Nyamwezi THPs, Tabora region, Tanzania and North African regions	⁸²^,⁹⁷^,¹⁰⁵^,¹¹⁰^,¹¹⁵^,¹²⁰^,¹²⁶^,¹⁵⁸^–¹⁶⁰
387	Zingiber ottensii Valeton	Rhizome	Decoction	Flatulence, Flatulence	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
388	Ziziphora tenuior L.	Inflorescence	Decoction	Diarrhoea, Bloating, Gastritis	Urmia, Iran	¹⁶¹
389	Ziziphus cambodiana Pierre	Bark	Decoction	Gastric ulcers	Karen people of northern Thailand	¹¹⁴^,¹¹⁵
390	Ziziphus jujuba Mill.	Fruit	Roast the fruit and eat for the treatment of stomach problems. Take 5 gm of roots powder and 7 pieces of black pepper grind and mix	Diarrhoea and Abdominal pain	Bannu, LakkiMarwat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷
391	Ziziphus lotus (L.) Lam.	Bark, Leaves, Fruits and Seeds	Decoction	Gastralgia, Peptic ulcer	Setifian High Plateau, Algeria and other North African regions	¹¹⁷^,¹⁰⁵
392	Ziziphus mauritiana Lam.	Plant		Abdominal pain, Constipation, Diarrhoea, Dysentery, Dyspepsia, Indigestion, Peptic ulcer, Stomach disorders, Vomiting	Nepal	¹¹²
393	Ziziphus mucronata Willd.	Roots, Bark and Leaves	Decoction of the roots; concoction of bark and leaves	Diarrhoea, Dysentery	Eastern Cape Province, South Africa	¹⁰⁸
394	Ziziphus nummularia (Burm.f.) Wight & Arn.	Bark, Fruit and Leaves	Decoction	Dysentery	Bannu, D. I. Khan, Kohat, Khyber Pakhtunkhwa province of Pakistan	¹⁰⁷

THPs, traditional health practitioners.

Phytochemical and pharmacological basis of action

The therapeutic efficacy of herbal and natural products in managing GI disorders is largely attributed to the presence of diverse phytochemicals, including alkaloids, flavonoids, terpenoids, iridoids, tannins, and polysaccharides. These bioactive compounds modulate a variety of molecular targets and physiological pathways, contributing to their anti-inflammatory, antioxidant, mucosal protective, immunomodulatory, and microbiota-modulating effects.^162,163 The pharmacological basis of their action is increasingly being elucidated through both in vitro and in vivo experimental models, especially in conditions like IBS, peptic ulcers, GERD, and IBD, such as Crohn’s disease and ulcerative colitis.

Modulation of inflammatory signaling pathways

One of the most well-established mechanisms by which natural products exert therapeutic effects in GI disorders is the modulation of inflammatory signaling pathways, particularly the nuclear factor kappa B (NF-κB) and cyclooxygenase (COX) cascades. Chronic inflammation underlies many functional and structural GI conditions, including IBS, IBD, post-infectious IBS (PI-IBS), and peptic ulcers, making anti-inflammatory phytochemicals a vital area of investigation.

Oridonin, a diterpenoid compound isolated from Rabdosia rubescens, was shown to alleviate PI-IBS symptoms in rats by significantly inhibiting phosphorylation of NF-κB p65 and downregulating downstream inflammatory mediators such as inducible nitric oxide synthase (iNOS), COX-2, IL-1β, and IL-6. Furthermore, oridonin increased the expression of the pregnane X receptor, thereby upregulating CYP3A4 and P-glycoprotein—key elements in detoxification and mucosal barrier maintenance, thus offering a dual anti-inflammatory and barrier-protective effect.¹⁶⁴

Likewise, triptolide, an active diterpenoid triepoxide from Tripterygium wilfordii, demonstrated significant downregulation of IL-1, IL-6, TNF-α, and ornithine decarboxylase 1 expression in a chronic stress-induced IBS model. Its administration resulted in improved behavioral scores, reduced visceral hypersensitivity, and decreased intestinal inflammation, suggesting that triptolide modulates the gut-brain axis and inflammation in tandem.¹⁶⁵

Atractylenolide I, a bioactive component of Atractylodes macrocephala, also showed suppression of intestinal inflammation via inhibition of the JNK/iNOS signaling pathway. In PI-IBS models, this compound significantly decreased the expression of pro-inflammatory cytokines interferon-γ and TNF-α while restoring intestinal architecture and enhancing expression of tight junction proteins such as occludin and claudin-1.¹⁶⁶

Sakuranetin (SKN), a flavonoid compound, demonstrated anti-inflammatory and mucosal healing effects in GI inflammatory conditions. It significantly reduced colonic expression of iNOS and COX-2 while increasing the levels of endothelial nitric oxide synthase and peroxisome proliferator-activated receptor alpha, which are associated with vascular protection and anti-inflammatory responses. Histologically, SKN improved epithelial integrity and lowered inflammation scores, affirming its regulatory effect on inflammation signaling.¹⁶⁷

In another important study, galangin, a naturally occurring flavonoid, was shown to protect against ethanol-induced gastric mucosal injury. It significantly decreased levels of malondialdehyde (MDA), a marker of oxidative damage, while downregulating the expression of transient receptor potential vanilloid 1 (TRPV1), NF-κB, COX-2, and the pro-apoptotic protein Bax. Concurrently, galangin upregulated the expression of heat shock protein 70 (HSP70), B-cell lymphoma-2 (Bcl-2), and tight junction proteins such as claudin-1 and occludin, resulting in reduced mucosal inflammation and improved structural integrity.¹⁶⁸

Canolol, a phenolic compound derived from rapeseed oil, provided significant protection against ethanol-induced gastric damage by enhancing antioxidant defenses (elevating glutathione, catalase (CAT), and superoxide dismutase (SOD)) and inhibiting the activation of pro-inflammatory pathways, especially p38 MAPK and NF-κB. It also reduced pro-apoptotic protein Bax and increased Bcl-2 levels, thereby limiting mucosal cell apoptosis and improving overall tissue regeneration.¹⁶⁹

Finally, engeletin, a flavonoid isolated from Smilax glabra, was demonstrated to alleviate ulcerative colitis via inhibition of Toll-like receptor 4/NF-κB signaling. It significantly suppressed TNF-α, IL-1β, and IL-6 expression and inhibited polarization of macrophages to the M1 phenotype. Engeletin also promoted tight junction protein expression, such as occludin and claudin-1, which contributes to barrier restoration in colonic tissue.¹⁷⁰

These studies collectively illustrate that a wide range of phytochemicals, including terpenoids (oridonin, triptolide, atractylenolide I), flavonoids (SKN, galangin, engeletin), and phenolics (canolol), act through common and well-conserved inflammatory pathways. By suppressing NF-κB and COX-2 activity, reducing cytokine production, and restoring mucosal defense mechanisms, these compounds demonstrate promising therapeutic potential in the management of inflammation-associated GI disorders.

Antioxidant effects

Oxidative stress is a major contributor to the pathogenesis and progression of several GI disorders, such as peptic ulcers, gastritis, IBD, and functional dyspepsia. Excessive production of reactive oxygen species can damage the GI mucosa by promoting lipid peroxidation, altering cellular proteins and DNA, impairing mitochondrial function, and triggering apoptosis. These oxidative changes are often accompanied by inflammation, immune activation, and barrier dysfunction. Accordingly, natural products that possess antioxidant activity play a significant role in mitigating GI damage and promoting mucosal healing.

One such compound is galangin, a naturally occurring flavonoid that exhibited strong antioxidant and gastroprotective properties in an ethanol-induced gastric mucosal injury model. Galangin significantly decreased MDA, a marker of lipid peroxidation, and increased the activities of key antioxidant enzymes, including SOD and CAT. Histologically, galangin reversed mucosal damage and increased the expression of cytoprotective proteins, such as HSP70 and Bcl-2, while decreasing the expression of the pro-apoptotic protein Bax. It also downregulated pro-inflammatory signaling through inhibition of NF-κB, COX-2, and TRPV1, suggesting a dual antioxidant and anti-inflammatory action that supported both mucosal integrity and epithelial regeneration.¹⁶⁸

Canolol, a phenolic compound derived from rapeseed oil, has also demonstrated potent antioxidant activity in experimental models of ethanol-induced gastric ulceration. Canolol treatment restored gastric mucosal antioxidant defenses by significantly increasing the levels of glutathione, CAT, and SOD. Moreover, it downregulated oxidative stress-related pro-inflammatory proteins, such as p38 MAPK and NF-κB, and decreased the Bax/Bcl-2 ratio, thus reducing apoptosis and enhancing mucosal cell survival. Canolol’s multi-targeted antioxidant response contributed to the repair of mucosal lesions and the prevention of further oxidative damage.¹⁶⁹

SKN, a flavonoid with anti-inflammatory and antioxidant properties, was shown to significantly improve antioxidant enzyme activity in the colon. In particular, SKN increased nitric oxide production through upregulation of endothelial nitric oxide synthase and proliferator-activated receptor alpha expression, while simultaneously decreasing iNOS, COX-2, and other oxidative markers. The antioxidant protection provided by SKN was associated with reduced mucosal inflammation and improved histological scores in GI inflammatory models.¹⁶⁷

Triptolide, a diterpenoid compound discussed for its anti-inflammatory potential, also exhibited secondary antioxidant effects. In a chronic stress-induced IBS model, triptolide reduced levels of MDA and supported the endogenous antioxidant defense system, which included elevated levels of SOD and CAT. These changes were closely linked to reduced colonic inflammation and restored mucosal structure, indicating that the antioxidant action of triptolide contributed significantly to its protective effects in stress-related GI dysfunction.¹⁶⁵

Finally, chlorogenic acid (CGA), known for its antioxidant capacity, showed an indirect antioxidative role by modulating gut microbiota and improving mucosal integrity. Although its primary mechanism was microbiota modulation, the resulting decrease in gut inflammation and oxidative stress was partly attributed to its reactive oxygen species-scavenging action and maintenance of mitochondrial function in epithelial cells.¹⁷¹

Taken together, these findings illustrate that phytochemicals, such as flavonoids (galangin, SKN), terpenoids (triptolide), phenolic acids (canolol, CGA), and polyphenols, act as potent antioxidants in the GI tract. By reducing oxidative stress, restoring redox balance, preventing apoptosis, and enhancing epithelial repair mechanisms, these compounds offer a robust therapeutic approach in the treatment and prevention of oxidative stress-mediated GI disorders.

Gut microbiota modulation

The GI tract hosts a dense and diverse community of microorganisms that play a critical role in maintaining digestive health, regulating immunity, synthesizing vitamins, metabolizing indigestible substrates, and maintaining the mucosal barrier. Disruptions in the composition and function of gut microbiota, termed dysbiosis, have been implicated in the pathogenesis of various GI disorders, including IBS, IBD, PI-IBS, and colorectal inflammation. An emerging area of research highlights the capacity of plant-based natural products to modulate the gut microbiota, leading to significant therapeutic effects.

A key study demonstrated the microbiota-modulating effects of CGA in a PI-IBS rat model. CGA not only reduced clinical markers of inflammation and hypersensitivity but also shifted microbial composition by significantly increasing the abundance of Bacteroides acidifaciens. This bacterial strain, in turn, produced extracellular vesicles enriched in glycine. These extracellular vesicles exerted anti-inflammatory effects on colonic epithelial cells by suppressing the NF-κB signaling pathway, ultimately reducing TNF-α and IL-6 expression and restoring intestinal barrier integrity.¹⁷¹ This study provided a unique mechanism linking polyphenol intake, microbiota composition, and microbial metabolite-driven immunomodulation.

Similarly, berberine, an isoquinoline alkaloid, has shown profound regulatory effects on gut microbiota in multiple experimental models of GI inflammation. In a PI-IBS model, berberine treatment resulted in the downregulation of Proteobacteria and pathogenic Escherichia/Shigella strains, while promoting beneficial genera such as Lactobacillus, Clostridium IV, and Ruminococcus. This microbiota-reshaping effect was associated with restored intestinal permeability, increased short-chain fatty acid (SCFA) production, and reduced levels of pro-inflammatory cytokines.^172,173 Furthermore, berberine enhanced the expression of tight junction proteins such as occludin and claudin-1, highlighting its combined microbiota- and barrier-restoring function.

Another microbiota-targeted compound is ganoderic acid, derived from Ganoderma lucidum. In a Dextran Sulfate Sodium-induced colitis model, oral administration of ganoderic acid enriched beneficial microbial taxa, including Lactobacillus and Oscillospira, while reducing the abundance of pathogenic bacteria. This modulation was paralleled by improved mucosal morphology, increased expression of tight junction proteins (occludin, claudin-1, ZO-1), and reduced colonic inflammation. Ganoderic acid’s dual impact on microbial ecology and barrier function supports its role as a biotherapeutic agent in microbiota-linked gut disorders.¹⁷⁴

Additionally, costunolide, a sesquiterpene lactone, improved microbial diversity and intestinal permeability in IBS models. It increased the relative abundance of Bacteroides while reducing Escherichia and Shigella spp., alongside upregulating occludin and downregulating claudin-2. Costunolide also improved central nervous system parameters, such as serotonin and norepinephrine levels in the hippocampus, indicating its bidirectional effects on the gut-brain axis.¹⁷⁵

Piperine, the active alkaloid in Piper nigrum, has been shown to not only exert anti-inflammatory and antioxidant effects but also positively influence microbiota composition. In a DSS-induced colitis model, piperine administration increased the levels of Lactobacillus and Bifidobacterium, decreased Enterobacteriaceae, and improved colonic histopathology. Its ability to restore microbial balance was closely associated with its anti-colitic effects.¹⁷⁶

Cardamonin, a chalcone found in Alpinia katsumadai, similarly demonstrated beneficial effects on gut microbiota in IBD models. It improved colonic inflammation, suppressed the NOD-like receptor protein 3 (NLRP3) inflammasome, and increased short-chain fatty acid-producing bacterial genera, which collectively contributed to mucosal healing and immune regulation.¹⁷⁷

In another study, morroniside, an iridoid glycoside from Cornus officinalis, alleviated 5-HT-induced diarrhea and gastric ulcers while modulating hypothalamic-pituitary-adrenal axis activity. Though its primary effect was hormonal, the reduction in colonic inflammation and diarrhea suggests indirect effects on microbiota–gut interactions through neuroimmune modulation.¹⁷⁸

Taken together, these studies underscore the multifaceted ability of plant-derived compounds to positively modulate the gut microbiota. Phytochemicals such as CGA, berberine, ganoderic acid, costunolide, piperine, and cardamonin not only reshape microbial communities but also influence their metabolites, gut barrier function, mucosal immunity, and even central nervous system signaling. These microbiota-mediated effects represent a critical pharmacological axis in the therapeutic potential of natural products for GI diseases.

Other mechanisms of action

Beyond the primary mechanisms of anti-inflammatory activity, antioxidant defense, microbiota modulation, enzyme inhibition, and mucosal protection, natural products also exert therapeutic effects in GI disorders through several additional pathways. These include modulation of the gut-brain axis, immunomodulatory effects, anti-apoptotic signaling, regulation of GI motility, antimicrobial activity, and nociceptive modulation.

A prominent mechanism in functional GI disorders such as IBS is the modulation of the gut-brain axis. Costunolide, a sesquiterpene lactone, demonstrated gut-brain regulatory effects in a chronic stress-induced IBS model by increasing levels of serotonin (5-HT), brain-derived neurotrophic factor, GluN2A, p-ERK1/2, and p-CREB in the hippocampus. These changes were accompanied by improved colonic architecture and reduced visceral hypersensitivity.¹⁷⁵ Similarly, morroniside, an iridoid glycoside from Cornus officinalis, normalized gut-brain communication by reducing the secretion of hypothalamic-pituitary-adrenal axis hormones including corticotropin-releasing factor, adrenocorticotropic hormone, and corticosterone. This modulation helped restore gut motility and reduce stress-induced diarrhea and ulceration.¹⁷⁸ Triptolide also demonstrated multiple beneficial effects in IBS models, including reduction of colonic inflammation and modulation of gut microbiota composition. In a post-inflammatory IBS model, triptolide alleviated visceral hypersensitivity but did not significantly improve anxiety- or depression-like behaviors.¹⁶⁵ However, studies in animal models reported that triptolide improved behavioral test scores,¹⁷⁹ suggesting gut–brain axis modulation through regulation of serotonergic and dopaminergic neurotransmission. Phlorizin, a flavonoid glycoside, alleviated visceral hypersensitivity by inhibiting sodium/glucose cotransporter 1 (SGLT1) expression and blocking corticotropin-releasing factor- and lipopolysaccharide (LPS)-induced epithelial permeability, indirectly supporting gut-brain homeostasis.¹⁸⁰

Natural products also exhibit significant immunomodulatory effects, helping to balance the immune response and prevent mucosal overactivation. Engeletin, a flavonoid from Smilax glabra, suppressed Toll-like receptor 4-NF-κB signaling, reduced the expression of IL-1β, IL-6, and TNF-α, and inhibited macrophage polarization from the pro-inflammatory M1 phenotype. These effects led to a decrease in colonic inflammation in ulcerative colitis models.¹⁷⁰ Berberine promoted immune homeostasis by modulating the Wnt/β-catenin signaling pathway and restoring gut microbiota balance, leading to reductions in epithelial permeability and inflammatory cytokines in PI-IBS.¹⁷³

Juglone, a bioactive naphthoquinone, demonstrated protective effects in DSS-induced colitis by downregulating NF-κB signaling and mitochondrial stress responses. It increased levels of IL-10 and reduced TNF-α, supporting both anti-inflammatory and immune-regulatory functions.¹⁸¹ Similarly, sclareol significantly decreased levels of IL-1β, TNF-α, and IL-6 in Crohn’s disease models while upregulating tight junction proteins and preserving mucosal structure, indicating immunomodulatory and barrier-stabilizing roles.¹⁸²

Another important mechanism is the anti-apoptotic and epithelial proliferative action of several compounds. Galangin upregulated cytoprotective proteins Bcl-2 and HSP70 while downregulating Bax and caspase-3, reducing cell death and promoting mucosal regeneration in gastric injury models.¹⁶⁸ Canolol similarly reduced apoptosis via inhibition of p38 MAPK, lowering Bax levels and enhancing Bcl-2 expression in gastric mucosal cells.¹⁶⁹ SKN reduced colonic caspase-3 expression and enhanced epithelial survival, likely contributing to its mucosal protective effects.¹⁶⁷ Additionally, Russelioside B upregulated epidermal growth factor and restored HSP70 levels in the gastric mucosa, aiding in epithelial repair and regeneration.¹⁸³

Several natural compounds also play key roles in the regulation of GI motility and secretion. Morroniside accelerated gastric emptying and improved intestinal transit by modulating serotonin signaling, while simultaneously reducing stress-induced diarrhea.¹⁷⁸ Costunolide improved motility in IBS models, possibly via modulation of the enteric nervous system and neurotransmitters.¹⁷⁵ Traditional agents like ginger and peppermint, though not elaborated in the primary dataset, have been widely cited (e.g., Brierley & Kelber, 2011) for their ability to regulate motility through TRP channel modulation and calcium channel blockade.³⁷

In terms of antimicrobial activity, berberine demonstrated strong effects against dysbiotic bacteria in IBS models, reducing the abundance of Escherichia/Shigella and Proteobacteria while enriching beneficial taxa such as Lactobacillus and Ruminococcus.¹⁷² In a similar vein, 2,3,5,4′-Tetrahydroxystilbene-2-O-β-D-glucoside reshaped the gut microbiota in ulcerative colitis models by lowering the abundance of Bacteroides and Lachnoclostridium, thereby improving immune parameters and intestinal histology.¹⁸⁴

Finally, many phytochemicals exert anti-nociceptive effects by modulating sensory neuron activity and inflammatory pain pathways. For instance, galangin downregulated TRPV1, CGRP, and substance P—key nociceptive markers involved in visceral hypersensitivity and gastric pain in models of ethanol-induced mucosal injury.¹⁶⁸ As reviewed by Brierley & Kelber, compounds like gingerol, menthol, and eugenol target TRP channels (e.g., TRPA1, TRPM8), which are responsible for pain and motility regulation in the GI tract.³⁷ These mechanisms are particularly relevant in IBS, where sensory neuron hypersensitivity contributes to abdominal pain and bloating.

Taken together, these additional mechanisms reinforce the multifaceted pharmacological nature of natural products. By influencing not just inflammation and oxidation but also immune function, neuronal signaling, epithelial regeneration, and microbial ecosystems, plant-derived compounds serve as holistic and promising therapeutic agents in the treatment of GI disorders. Key natural products, their phytoconstituents, and pharmacological activities relevant to GI disorders are summarized in Table 2^,^37,164–194 while their integrative therapeutic mechanisms are illustrated in Figure 3.

Table 2

Bioactive natural compounds, their mechanisms, and gastrointestinal applications

S. No.	Compound/source	Bioactive class	Mechanism(s) of action	GI application(s)	Dose/HED*	References
1.	Oridonin (Rabdosia rubescens)	Diterpenoid	Inhibits NF-κB/iNOS/COX-2/IL-1β/IL-6; activates PXR-CYP3A4	Post-infectious IBS	(20 mg/kg mouse) HED ≈1.6 mg/kg	¹⁶⁴
2.	Triptolide (Tripterygium wilfordii)	Diterpenoid	↓ IL-1, IL-6, TNF-α, ODC1; reduces MDA; improves behavioral symptoms	Stress-induced IBS	100 µg/kg (Clinical caution consensus; toxicity data)	¹⁶⁵^,¹⁷⁹
3.	Atractylenolide I	Sesquiterpene lactone	Inhibits JNK/iNOS; ↓ IFN-γ, TNF-α; ↑ occludin, claudin-1	PI-IBS	(10 mg/kg mouse) HED ≈ 0.81mg/kg	¹⁶⁶
4.	Sakuranetin (SKN)	Flavonoid	↓ COX-2, iNOS; ↑ eNOS, PAX; ↓ caspase-3, NOx; improves survival markers	Colonic inflammation	20 & 40 mg/kg mouse) HED ≈ 1.6–3.2 mg/kg	¹⁶⁷
5.	Galangin	Flavonoid	↓ MDA, TRPV1, COX-2, Bax; ↑ HSP70, Bcl-2, TJ proteins; ↓ CGRP, SP	Gastric mucosal injury, nociception	(25–50 mg/kg mouse) HED ≈ 2.03–4.05 mg/kg	¹⁶⁸
6.	Canolol	Phenolic compound	↑ GSH, SOD, CAT; ↓ Bax, p38 MAPK, NF-κB; ↑ Bcl-2	Gastric ulcers	–	¹⁶⁹
7.	Engeletin (Smilax glabra)	Flavonoid	Inhibits TLR4/NF-κB; ↓ IL-1β, TNF-α, IL-6; ↑ occludin, claudin-1	Ulcerative colitis	(10 & 20 mg/kg mouse) HED ≈ 0.81–1.6 mg/kg	¹⁷⁰
8.	Chlorogenic acid (CGA)	Phenolic acid	↑ B. acidifaciens; glycine-EVs ↓ NF-κB; improves barrier	PI-IBS	50 mg/kg mouse) HED ≈ 4.05 mg/kg	¹⁷¹
9.	Berberine	Alkaloid	Modifies microbiota; ↓ Shigella, ↑ Lactobacillus; ↑ TJ proteins; immunomodulatory	IBS, IBD	(900–1,500 mg/day)(commonly adopted clinical dose)	¹⁷²^,¹⁷³^,¹⁸⁵
10.	Ganoderic acid (G. lucidum)	Triterpenoid	↑ Lactobacillus, ↑ occludin, claudin-1, ZO-1; restores mucosa	DSS-induced colitis	1.5–3 g/day standardized extract (human)	¹⁷⁴^,¹⁸⁶
11.	Costunolide	Sesquiterpene lactone	↑ occludin, ↓ claudin-2; modulates 5-HT, NE, BDNF, p-CREB (gut-brain axis)	IBS, diarrhea	(5–20 mg/kg mouse) HED ≈ 0.4–1.6 mg/kg	¹⁷⁵
12.	Piperine (Piper nigrum)	Alkaloid	↑ Lactobacillus, ↓ Enterobacteriaceae; improves colitis histology	DSS-induced colitis	5–20 mg/day (as bioenhancer with curcumin)	¹⁷⁶^,¹⁸⁷
13.	Cardamonin (Alpinia katsumadai)	Chalcone	Inhibits NLRP3 inflammasome; ↑ SCFA-producing microbiota	IBD	(15–60 mg/kg mouse)	¹⁷⁷
14.	Morroniside (Cornus officinalis)	Iridoid glycoside	↓ CRF, ACTH, corticosterone; improves HPA axis & motility	Stress-induced ulcers, diarrhea	(20–50 mg/kg mouse) HED ≈ 1.6–4.1 mg/kg	¹⁷⁸
15.	Phlorizin	Flavonoid glycoside	Inhibits SGLT1; ↓ CRF-induced colonic permeability, visceral hypersensitivity	IBS, LPS-induced inflammation	(30–80 mg/kg mouse); HED ≈ 2.4–6.5 mg/kg (oral clinical use limited	¹⁸⁰
16.	Quercetin	Flavonoid	Inhibits H⁺/K⁺ ATPase, COX-2, iNOS; ↑ SOD, GSH, CAT; ↓ histamine	GERD	500–1,000 mg/day (human)	¹⁸⁸^,¹⁸⁹
17.	Euphorbia hirta flavonoids	Flavonoids	Inhibit H⁺/K⁺ ATPase, COX-2, TNF-α; ↑ catalase	GERD	100 mg/kg mouse) HED ≈ 16.2 mg/kg	¹⁹⁰
18	Gallic acid	Phenolic acid	Antioxidant; ↑ mucin	Gastric ulcers	150–300 mg/day (human supplements)	¹⁹¹
19.	Russelioside B	Glycosidic saponin	↑ EGF, HSP70; anti-apoptotic	Gastric injury	(20 mg/kg mouse) HED ≈ 1.6 mg/kg	¹⁸³
20.	Sclareol (SCL)	Diterpene	↓ IL-6, IL-1β, TNF-α; ↑ claudin-1, occludin; preserves barrier	Crohn’s disease	(5 mg/kg mouse) HED ≈ 0.4 mg/kg	¹⁸²
21.	Juglone	Naphthoquinone	↓ NF-κB, ↑ IL-10, ↓ TNF-α; ↓ apoptosis; modulates microbiota	DSS-induced colitis	(150 mg/kg mouse) HED-toxicity cautions	¹⁸¹
22.	TSG (Tetrahydroxystilbene glucoside)	Stilbene	Alters microbiota; ↓ Bacteroides, ↑ TJ proteins; modulates IL-6, TNF-α	Ulcerative colitis	(25 & 100 mg/kg mouse) HED ≈ 2.03–8.1 mg/kg	¹⁸⁴
23.	Gingerol/Menthol/Eugenol	Terpenoid/Phenolics	Modulate TRP channels (TRPA1, TRPM8); reduce pain and motility disturbances	IBS, visceral pain	Ginger: 1–2 g/day; Peppermint oil (EC): 180–225 mg/day; Eugenol: not used orally as stand-alone due to safety	³⁷^,¹⁹²^,¹⁹³

*HED estimates derive from commonly used mouse doses unless otherwise noted: HED (mg/kg) = animal dose × (3/37) for mouse → human. Where only human clinical/traditional doses are established (e.g., berberine, quercetin, ginger, peppermint oil), those are shown directly.¹⁹⁴ Safety note: Actual clinical dosing depends on formulation, standardization, bioavailability, and safety. Compounds such as triptolide and juglone are toxic with narrow therapeutic windows; no over-the-counter human dosing is recommended. Use only within controlled research/clinical settings. ↑, increase; ↓, decrease. ACTH, adrenocorticotropic hormone; Bcl-2, B-cell lymphoma 2; BDNF, brain-derived neurotrophic factor; CAT, catalase; CGRP, calcitonin gene-related peptide; COX-2, cyclooxygenase-2; CRF, corticotropin-releasing factor; CYP3A4, cytochrome P450 3A4; DSS, dextran sulfate sodium; EC, epithelial cells; eNOS, endothelial nitric oxide synthase; EVs, extracellular vesicles; GI, gastrointestinal; GSH, glutathione; HPA, hypothalamic–pituitary–adrenal; HSP70, heat shock protein 70; IBS, irritable bowel syndrome; IFN-γ, interferon-gamma; IL, interleukin; iNOS, inducible nitric oxide synthase; JNK, c-Jun N-terminal kinase; LPS, lipopolysaccharide; MAPK, mitogen-activated protein kinase; MDA, malondialdehyde; NE, norepinephrine; NF-κB, nuclear factor kappa-light-chain-enhancer of activated B cells; ODC1, ornithine decarboxylase 1; PAX, paired box protein; p-CREB, phosphorylated cAMP response element-binding protein; PI-IBS, post-infectious irritable bowel syndrome; PXR, pregnane X receptor; SCFA, Short-Chain Fatty Acids; SGLT1, sodium-glucose transporter 1; SOD, superoxide dismutase; SP, substance P; TJ, tight junction; TLR4, Toll-like receptor 4; TNF-α, tumor necrosis factor-alpha; TRPV1, transient receptor potential vanilloid 1; ZO-1, zonula occludens-1.

Fig. 3 Mechanisms of key bioactive compounds in modulating signaling pathways involved in gastrointestinal disorders.

↑, increase; ↓, decrease. BDNF, brain-derived neurotrophic Factor; CAT, catalase; COX-2, cyclooxygenase-2; CYP3A4, cytochrome P450 3A4; eNOS, endothelial nitric oxide synthase; ERK1/2, extracellular signal-regulated kinases 1 and 2; GABA, gamma-aminobutyric acid; GSH, glutathione; IFN-γ, interferon-gamma; IL, interleukin; iNOS, inducible nitric oxide synthase; JNK, c-Jun N-terminal kinase; MDA, malondialdehyde; NF-κB, nuclear factor kappa-light-chain-enhancer of activated B Cells; ODC1, ornithine decarboxylase 1; PAX, paired box; p-CREB, phosphorylated cAMP Response element-binding protein; p-NPY, Phosphorylated Neuropeptide Y; PXR, pregnane X receptor; SOD, superoxide dismutase; TNF-α, tumor necrosis factor-alpha.

Clinical evidence and human trials

Recent scientific evaluations have increasingly explored the clinical efficacy of natural products and traditional herbs in treating GI disorders such as IBS, functional dyspepsia, constipation, peptic ulcer, and other functional GI conditions. Multiple RCTs, observational studies, and meta-analyses provide a growing evidence base for their use in routine practice. Cassia alata Linn., known for its anthraquinone-rich laxative leaves, was tested in a RCT involving 80 patients with constipation. The study found that 83% of those in the Cassia alata group had bowel movements within 24 h, compared to 86% in the Mist. alba group and only 18% in the placebo group, with results being statistically and clinically significant (p < 0.001). Mild, self-limiting adverse effects were reported in 16–25% of patients.¹⁹⁵ In IBS management, a notable randomized, double-blind, placebo-controlled trial with 116 patients showed that both standardized and individualized Chinese herbal medicine (CHM) significantly improved symptoms and quality of life versus placebo (p < 0.05). Notably, only the individualized CHM group sustained improvements 14 weeks post-treatment.¹⁹⁶

Further, an Ayurvedic formulation combining Aegle marmelos and Bacopa monnieri demonstrated 64.9% effectiveness in a six-week double-blind trial with 169 IBS patients, compared to 78.3% with standard therapy and 32.7% with placebo. The Ayurvedic remedy was particularly effective in diarrhea-predominant IBS, although long-term relapse prevention was not observed.¹⁹⁷ The Tibetan herbal formulation Padma-179 also showed promising results in a placebo-controlled trial involving 72 patients with constipation-predominant IBS. It significantly improved abdominal pain, stool frequency, bloating, and overall well-being compared to placebo.¹⁹⁸ In functional dyspepsia, Curcuma domestica Val. (turmeric) was tested in a multicenter, double-blind trial with 116 patients. The turmeric group showed an 87% treatment response, outperforming the flatulence remedy group (83%) and placebo (53%). Though mild adverse effects were evenly distributed, patient satisfaction hovered around 50% across all groups.¹⁹⁹ For ulcer management, mastic gum (Pistacia lentiscus) demonstrated potent therapeutic effects in a double-blind trial with 38 duodenal ulcer patients. A daily dose of 1 g led to 80% symptom relief and 70% ulcer healing, significantly outperforming placebo outcomes (50% and 22%, respectively; p < 0.01). Mastic gum was well tolerated, reinforcing its potential in peptic ulcer treatment.²⁰⁰

Moreover, one of the most promising agents is curcumin (turmeric). In a pilot RCT by Bundy et al.²⁰¹ involving 207 patients, curcumin supplementation (72–144 mg/day for eight weeks) resulted in a ∼60% reduction in IBS prevalence and improved quality of life, although pain reduction narrowly missed statistical significance (p = 0.071). Similarly, a meta-analysis by Ng et al.²⁰² reviewed five RCTs (three included in the final analysis with 326 patients) and found curcumin safe and potentially beneficial, though not statistically significant, highlighting the need for larger trials. Peppermint oil remains one of the most well-studied natural agents for IBS. Meta-analyses by Ford et al.¹⁹³ and trials like Cappello et al.²⁰³ confirm its effectiveness in reducing abdominal pain, bloating, and global IBS symptoms. The number needed to treat was as low as 2.5, with a favorable safety profile when used in enteric-coated formulations. The poly-herbal formulation STW 5 (Iberogast), composed of nine medicinal plant extracts, has shown efficacy in both IBS and functional dyspepsia. Studies by Madisch et al.²⁰⁴ and Melzer et al.²⁰⁵ reported significant symptom improvement, particularly in pain and bloating. A supporting meta-analysis confirmed STW 5’s efficacy, showing it to be comparable or even superior to conventional prokinetics, with good tolerability.

In an Ayurvedic herbal RCT involving Murraya koenigii, Punica granatum, and Curcuma longa, Lauche et al.²⁰⁶ found no significant difference compared to placebo in managing diarrhea-predominant IBS. However, the preparation was considered safe, with good compliance despite minor adverse events reported in about one-third of participants. CHM was evaluated through a comprehensive meta-analysis and trial sequential analysis involving 10 RCTs and 2,501 participants. CHM significantly improved global IBS symptoms (RR 1.76) and abdominal pain (RR 1.85) but was also linked to a higher rate of adverse events (RR 1.51). The findings were supported by a sufficient sample size and indicate potential efficacy with a need for caution.⁵⁹ Probiotics, particularly Saccharomyces boulardii, also show promise. In a trial by Choi et al.,²⁰⁷ daily supplementation with nine billion CFU over four weeks significantly reduced stool frequency and improved symptoms in 87.5% of IBS patients compared to placebo. Further, an observational study in Belgium assessed the combined use of berberine and curcumin (Enterofytol® PLUS) in 146 IBS patients. After two months, significant reductions were observed in the IBS severity index (−47.5%), abdominal discomfort, bloating, and transit issues (all p < 0.0001). Use of antispasmodics and antidiarrheals declined by over 64%, and 93.1% reported symptom improvement.²⁰⁸ A broader systematic review by Rahimi & Abdollahi analyzed over 20 clinical studies,²⁰⁹ concluding that herbal remedies like peppermint oil, STW 5, and CHM are generally effective and well-tolerated for managing functional gastrointestinal disorders. Clinical evidence supports the efficacy and safety of several traditional herbal therapies in managing GI disorders. These findings highlight their potential role as complementary therapies alongside conventional care. However, despite the wide ethnomedicinal use of plants for GI conditions, only a fraction has been evaluated through in vitro and in vivo studies, and an even smaller number has progressed to clinical validation. This gap is clearly represented in the evidence pyramid (Fig. 4), underscoring the urgent need for systematic scientific evaluation and standardized clinical trials to strengthen their integration into mainstream care.

Fig. 4 Evidence pyramid for herbal medicines in gastrointestinal disorders.

IBD, inflammatory bowel disease; IBS, irritable bowel syndrome; RCT, randomized controlled trial.

Safety, toxicity, and herb-drug interactions

Herbal medicine continues to be widely used across the globe for managing GI disorders such as indigestion, constipation, IBS, IBD, and dyspepsia. While the traditional use of herbal remedies offers a promising therapeutic approach, the issues of safety, toxicity, and herb-drug interactions remain critical in contemporary clinical practice. Many herbal therapies are generally well tolerated, such as peppermint oil, curcumin, Glycyrrhiza glabra, and Triphala, while mild adverse effects like bloating, flatulence, nausea, or heartburn are frequently reported. Notably, non–enteric-coated peppermint oil may induce gastric irritation,²⁰³ and high doses of curcumin (>4 g/day) can lead to GI discomfort.²¹⁰

Serious toxicological concerns arise from herbs like Aloe vera latex and Cassia angustifolia (senna), both known to cause nephrotoxicity, electrolyte imbalance, or melanosis coli when used excessively.²¹¹Glycyrrhiza glabra (licorice) is used for dyspepsia and ulcers but can cause pseudoaldosteronism, especially with corticosteroids or diuretics, increasing risks of hypokalemia and hypertension.^212,213 Likewise, turmeric and ginger, though safe in culinary doses, may exert hepatotoxic or uterotonic effects when consumed in excess, particularly in sensitive individuals or during pregnancy.^214,215

The application of natural products and traditional herbals for GI disorders in special populations, such as pregnant women and children, requires particular caution due to limited clinical data, potential risks, and substantial data gaps in safety profiles. While many herbal preparations are traditionally prescribed across cultures during pregnancy for digestive complaints such as nausea, constipation, or heartburn, systematic safety data remain scarce.

In pregnancy, several herbs are traditionally used for managing nausea, vomiting, or constipation, but safety is variable. Peppermint oil has shown efficacy in reducing pregnancy-associated nausea, generally with a favorable safety profile in moderate doses, though excessive intake may risk uterine bleeding or miscarriage.^216,217 Ginger (Zingiber officinale) has also shown efficacy in reducing pregnancy-related nausea, but concerns remain about dosage and potential bleeding risk.^218,219 Turmeric (Curcuma longa) is considered safe in culinary amounts for digestive support, yet high-dose supplementation may exert uterotonic effects and increase bleeding risk.^220,221 Licorice (Glycyrrhiza glabra) is contraindicated in pregnancy, as glycyrrhizin can elevate cortisol, increasing risks of preterm birth, hypertension, and developmental problems.^219,222 Psyllium (Plantago ovata) is regarded as safe for pregnancy-related constipation due to its bulk-forming, non-absorbed nature, with minimal adverse effects.^223,224 In contrast, Triphala, though widely used in Ayurveda, lacks adequate safety data and is not recommended in pregnancy because its laxative components (e.g., Haritaki) may promote downward flow and raise miscarriage risks.^225,226

In pediatrics, herbal therapies are also frequently employed but require careful evaluation. Peppermint oil demonstrates evidence for reducing spasms and managing functional abdominal pain or IBS in children, with generally good tolerability, though long-term data remain scarce.^227,228 Psyllium husk is safe and effective for pediatric constipation, abdominal pain with IBS and improving GI regularity, and is recommended as a first-line dietary fiber.^229,230 Similarly, fennel (Foeniculum vulgare) is used for infantile colic,²³¹ yet reports of estrogenic effects and rare hepatotoxicity warrant careful monitoring. In pediatrics, herbs like chamomile and peppermint are often given as teas for colic or dyspepsia, though standardized pediatric dosing guidelines are lacking.²³²

Overall, data gaps persist regarding long-term safety, optimal dosing, herb–drug interactions, and age-specific pharmacokinetics in these vulnerable groups. Healthcare providers should prioritize evidence-based guidelines, avoid unsupervised use, and carefully individualize herbal treatments during pregnancy and in pediatric populations to ensure safety.²³²

Herb-drug interactions further complicate clinical use. St. John’s Wort induces CYP3A4 and can reduce plasma concentrations of PPIs like omeprazole, while curcumin and berberine can inhibit CYP3A4 and P-glycoprotein, raising toxicity risks with drugs such as warfarin, statins, or immunosuppressants.^233,234 Berberine, while effective in microbial modulation, can disrupt gut flora and interfere with cytochrome activity, intensifying risks of adverse interactions.²³⁴

Alarmingly, contamination with heavy metals, pesticides, or undisclosed pharmaceuticals like corticosteroids has been reported in various herbal products, amplifying toxicological risks.^235,236 In one study from Saudi Arabia, over 76% of herbal medicine users were unaware of potential herb-drug interactions, highlighting the urgent need for awareness programs and physician inquiry during patient history intake.¹²⁶ Mechanistically, most interactions involve modulation of hepatic enzymes and transporters, which can lead to subtherapeutic effects or heightened toxicity depending on whether the herb acts as an enzyme inducer or inhibitor.²³⁷

To ensure safety, healthcare providers must actively screen for herbal use, particularly in vulnerable populations such as pregnant women, neonates, and patients with hepatic or renal compromise. Regulatory measures, including product standardization, contamination testing, and transparent labelling, are crucial.²³⁸ Recent advancements in toxicity prediction using 3D liver cell models and integrated herbal safety databases are steps toward modernizing herbal pharmacovigilance.^239–241 While herbal medicines offer considerable therapeutic promise for GI disorders, their responsible use demands careful risk-benefit analysis, enhanced regulatory oversight, and increased clinician and patient awareness to optimize therapeutic outcomes and minimize harm.

Regulatory and quality control aspects

As the global interest in herbal therapies for GI disorders continues to grow, ensuring the quality, safety, and efficacy of herbal products has become a major concern. The therapeutic success of natural remedies largely depends on their standardization, adherence to regulatory frameworks, and resolution of formulation-related challenges such as stability, consistency, and labeling.

Standardization of herbal preparations is critical for maintaining therapeutic uniformity and consumer trust. Unlike synthetic drugs, which typically consist of a single active pharmaceutical ingredient, herbal products contain complex mixtures of phytochemicals that can vary based on species, geographic origin, harvest time, storage, and processing methods. Standardization involves identifying and quantifying active constituents (e.g., curcumin in Curcuma longa, sennosides in Cassia angustifolia) using techniques like high-performance liquid chromatography (HPLC), gas chromatography-mass spectrometry (GC-MS), and liquid chromatography/mass spectrometry (LC-MS/MS). It also includes setting quality benchmarks for parameters such as extract ratios, ash values, moisture content, and microbial load. Pharmacopoeial monographs (e.g., the World Health Organization Monographs on Selected Medicinal Plants, Ayurvedic Pharmacopoeia of India) guide standardization, but in practice, only a fraction of marketed herbal products are rigorously standardized. Poor standardization can result in subtherapeutic or even toxic outcomes, especially in sensitive conditions like ulcerative colitis, GERD, or pediatric GI disorders.^242–244

Globally, regulatory bodies have implemented guidelines for herbal product registration and quality assurance, although frameworks differ significantly across regions. In the United States, the Food and Drug Administration classifies most herbal products as dietary supplements under the Dietary Supplement Health and Education Act (1994). This allows them to be marketed without pre-approval, although manufacturers are responsible for ensuring product safety and truthful labeling.²⁴⁵

In India, the Ministry of AYUSH regulates traditional herbal formulations under the Drugs and Cosmetics Act, 1940. It mandates adherence to Good Manufacturing Practices, scientific validation (via Central Council for Research in Ayurvedic Sciences (CCRAS)/AYUSH Research Portal), and compliance with the Ayurvedic Pharmacopoeia of India for raw materials and finished products. In Europe, the European Medicines Agency supports two main regulatory tracks: “well-established use” and “traditional use registration” under Directive 2004/24/EC, which requires data on safety, efficacy, and pharmacovigilance.^244,246 These systems have helped improve the credibility and accessibility of standardized herbal products across the European Union.

Despite regulatory advances, several challenges persist in the formulation and quality control of herbal drugs, particularly when used in GI applications. One issue is the chemical instability of active compounds such as curcumin and aloin, which degrade rapidly in gastric conditions unless protected by encapsulation or phytosomal systems. Another concern is batch-to-batch variability, which arises from unregulated sourcing of plant materials and inconsistent processing. Adulteration with synthetic drugs (e.g., corticosteroids in anti-diarrheal preparations) or contamination with heavy metals and pesticides further undermines safety.²⁴⁷ Additionally, there is a lack of uniform labeling standards, with many products omitting details about exact dosages, plant parts used, extraction solvents, or potential herb-drug interactions.²³⁸

The absence of universally accepted biomarkers for complex mixtures makes it difficult to validate efficacy claims and mechanistic pathways. Regulatory authorities are now encouraging industry stakeholders to adopt modern analytical tools (e.g., DNA barcoding, nuclear magnetic resonance (NMR) spectroscopy, and chemometrics) and post-market surveillance systems to track adverse events and ensure consumer safety. Furthermore, with the rise of global e-commerce in herbal supplements, there is an urgent need for harmonization of regulatory frameworks and cross-border monitoring mechanisms to prevent the proliferation of substandard or counterfeit products.

In conclusion, while herbal medicines hold significant promise for the treatment of GI disorders, their large-scale clinical acceptance depends on robust standardization protocols, adherence to national and international regulatory guidelines, and overcoming persistent challenges related to formulation stability, labeling, and quality assurance. Regulatory reforms, scientific validation, and technological integration must go hand in hand to ensure that natural product-based interventions achieve their full therapeutic potential in modern gastroenterology.

Challenges, emerging trends, and future directions

The use of natural products and traditional herbal remedies in GI disorders is undergoing a profound transformation due to advances in biomedical sciences, biotechnology, and computational tools. While their historical relevance is well-documented, the future of herbal therapeutics in gastroenterology lies in their integration with modern medicine, enhancement through novel delivery systems, and validation using multi-omics and artificial intelligence (AI)-driven approaches. These innovations are not only strengthening their therapeutic value but also paving the way for personalized herbal interventions.

One of the most promising trends is the integration of herbal products into conventional gastroenterological practice, especially for chronic conditions like IBS, IBD, GERD, and peptic ulcers. Modern clinical protocols are increasingly considering evidence-based phytotherapeutics such as Iberogast®, Triphala, and Licorice root extracts as adjunct therapies, particularly where long-term drug use poses risks of adverse effects. A growing number of hospitals and integrative clinics now offer herbal and dietary interventions alongside allopathic regimens, particularly in Asia, Europe, and parts of North America.²⁴⁸ Additionally, the World Health Organization’s Traditional Medicine Strategy (2025–2034) has encouraged countries to incorporate validated herbal remedies into national healthcare systems.²⁴⁹

To overcome limitations such as poor solubility, stability, and bioavailability of plant-based actives, researchers are increasingly turning to nanotechnology and advanced delivery systems. Nano-encapsulation, liposomes, solid lipid nanoparticles, and phytosomes have been developed to enhance the GI absorption and targeted delivery of herbal actives like curcumin, berberine, and andrographolide. For example, curcumin-loaded nanoparticles have shown better mucosal penetration and anti-inflammatory action in colitis models than crude curcumin extract.²⁵⁰ Similarly, phytosomal formulations of Triphala and Boswellia serrata have demonstrated improved bioavailability and therapeutic performance in clinical settings.^251,252 These systems can protect the active compounds from gastric degradation and facilitate sustained release, enhancing efficacy while minimizing required doses.

Another major advancement is the application of omics-based technologies such as metabolomics, gut microbiome profiling, and transcriptomics to understand the mechanisms of herbal action and host interaction. These approaches are shedding light on how herbs modulate gut microbiota composition, metabolite production (like SCFAs), and immune responses. For instance, berberine’s ability to modulate Lactobacillus, Bacteroides, and Clostridium species has been elucidated using metagenomic sequencing.²⁵³ Metabolomic studies have also revealed how polyphenols like CGA influence gut health through microbial metabolites such as glycine-rich extracellular vesicles, which suppress NF-κB signaling and reduce inflammation.¹⁷¹

In parallel, AI and machine learning are being employed to accelerate herbal drug discovery, toxicity prediction, and compound-target mapping.²⁵⁴ AI platforms are now used to screen phytochemical libraries for bioactive candidates, simulate herb–drug interactions, and optimize formulation strategies. Machine learning models trained on network pharmacology data can predict which herbal combinations are most likely to act synergistically on complex diseases like IBD. Recent advances in deep learning algorithms have further enabled virtual screening of thousands of herbal constituents against GI-relevant targets like COX-2, TNF-α, and H⁺/K⁺ ATPase with high accuracy.²⁵⁵ These technologies reduce time, cost, and labor in herbal pharmacology while increasing the precision of candidate selection.

Finally, the emergence of personalized herbal medicine guided by genetic profiling and Ayurgenomics marks a futuristic shift in the field. Ayurgenomics is a cutting-edge approach that integrates Ayurvedic “Prakriti” classification with genomics to personalize treatment.^256,257 Individuals with specific genetic markers or microbiome signatures may respond differently to herbal interventions, which can be predicted using polygenic risk scores and single-nucleotide polymorphism (SNP)-based analyses. For instance, variations in genes related to metabolism (e.g., CYP450 polymorphisms) or inflammation (e.g., TNF-α, IL-6) may affect how a patient responds to herbs like licorice or Triphala. Studies integrating Ayurveda with pharmacogenomics are being piloted in India under the Centre for Ayurgenomics and other national research bodies.²⁵⁷

In conclusion, the future of herbal medicine in gastroenterology is multidisciplinary, data-driven, and highly personalized. The convergence of traditional knowledge with modern tools—nanotechnology, omics, AI, and genomics—offers exciting new pathways for enhancing efficacy, safety, and acceptance of natural products in GI healthcare. With growing scientific validation and patient demand for integrative solutions, herbal therapeutics are well-positioned to play a central role in next-generation GI treatment paradigms.

Conclusions

This review highlights the therapeutic promise of natural products and traditional herbal medicines in managing GI disorders such as IBS, IBD, GERD, peptic ulcers, and functional constipation. Evidence from phytochemicals, including flavonoids, alkaloids, terpenoids, polyphenols, tannins, and glycosides, demonstrates diverse pharmacological actions, particularly anti-inflammatory, antioxidant, antimicrobial, immunomodulatory, and mucosal-protective effects. Several herbs and formulations, including licorice (Glycyrrhiza glabra), peppermint (Mentha piperita) oil, turmeric (Curcuma longa), and Triphala, have shown consistent clinical and experimental efficacy, supporting their relevance in both symptom relief and disease modification.

The global surge in demand for herbal medicine, reflected in significant market growth, underscores the increasing acceptance of natural therapies as complementary or alternative options. Advances in modern analytical and molecular techniques are progressively validating the safety and efficacy of these traditional practices, bridging ancient wisdom with contemporary science. Importantly, traditional medicine systems such as Ayurveda, TCM, and Unani offer holistic approaches that align with current trends toward personalized and integrative healthcare.

Taken together, the evidence suggests that natural products and herbal formulations represent valuable therapeutic resources for GI health. Their multifaceted mechanisms of action, cultural acceptance, and perceived safety position them as strong candidates for integration into modern gastroenterology. This review emphasizes that, while scientific validation is ongoing, herbal therapies already demonstrate substantial potential in addressing unmet clinical needs. By distilling insights from traditional knowledge and modern research, natural products can be positioned not merely as complementary options but as integral components of comprehensive, patient-centered GI care.

Declarations

Acknowledgement

The authors express their sincere gratitude to revered Swami Ramdev Ji for his invaluable support and guidance. They also acknowledge the assistance and cooperation provided by the Patanjali Herbal Research Department, Patanjali Research Foundation, Haridwar, India. Additionally, the authors are thankful to Mr. Uday Juyal for his contribution in providing graphical assistance for this manuscript.

Funding

None.

Conflict of interest

The authors have no conflicts of interest related to this publication.

Authors’ contributions

Study concept and design (AB), acquisition of data (RP, AK), analysis and interpretation of data (DS, NS), drafting of the manuscript (RP, AK), critical revision of the manuscript for important intellectual content (DS, NS), study supervision, administrative, technical, and material support (VA). All authors have made significant contributions to this study and have approved the final manuscript.

References

1	Manske S. Gastrointestinal Health: A Foundation for Whole-body Wellness. Altern Ther Health Med 2024;30(7):6-10 PubMed/NCBI

2	Ezenabor EH, Adeyemi AA, Adeyemi OS. Gut Microbiota and Metabolic Syndrome: Relationships and Opportunities for New Therapeutic Strategies. Scientifica (Cairo) 2024;2024:4222083 View Article PubMed/NCBI

3	Lukáčová I, Ambro Ľ, Dubayová K, Mareková M. The gut microbiota, its relationship to the immune system, and possibilities of its modulation. Epidemiol Mikrobiol Imunol 2023;72(1):40-53 PubMed/NCBI

4	Wiertsema SP, van Bergenhenegouwen J, Garssen J, Knippels LMJ. The Interplay between the Gut Microbiome and the Immune System in the Context of Infectious Diseases throughout Life and the Role of Nutrition in Optimizing Treatment Strategies. Nutrients 2021;13(3):886 View Article PubMed/NCBI

5	Zhang D, Liu J, Lv L, Chen X, Qian Y, Zhao P, et al. Total flavone of Abelmoschus manihot regulates autophagy through the AMPK/mTOR signaling pathway to treat intestinal fibrosis in Crohn’s disease. J Gastroenterol Hepatol 2024;39(8):1586-1596 View Article PubMed/NCBI

6	Ma ZF, Lee YY. The Role of the Gut Microbiota in Health, Diet, and Disease with a Focus on Obesity. Foods 2025;14(3):492 View Article PubMed/NCBI

7	Koloski NA, Talley NJ, Boyce PM. The impact of functional gastrointestinal disorders on quality of life. Am J Gastroenterol 2000;95(1):67-71 View Article PubMed/NCBI

8	Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Tack J, et al. Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology 2021;160(1):99-114.e3 View Article PubMed/NCBI

9	Huang JQ, Sridhar S, Hunt RH. Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease: a meta-analysis. Lancet 2002;359(9300):14-22 View Article PubMed/NCBI

10	Peery AF, Murphy CC, Anderson C, Jensen ET, Deutsch-Link S, Egberg MD, et al. Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2024. Gastroenterology 2025;168(5):1000-1024 View Article PubMed/NCBI

11	Lam JR, Schneider JL, Zhao W, Corley DA. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA 2013;310(22):2435-2442 View Article PubMed/NCBI

12	Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA 2006;296(24):2947-2953 View Article PubMed/NCBI

13	Lessa FC, Mu Y, Bamberg WM, Beldavs ZG, Dumyati GK, Dunn JR, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med 2015;372(9):825-834 View Article PubMed/NCBI

14	Freedberg DE, Kim LS, Yang YX. The Risks and Benefits of Long-term Use of Proton Pump Inhibitors: Expert Review and Best Practice Advice From the American Gastroenterological Association. Gastroenterology 2017;152(4):706-715 View Article PubMed/NCBI

15	Yibirin M, De Oliveira D, Valera R, Plitt AE, Lutgen S. Adverse Effects Associated with Proton Pump Inhibitor Use. Cureus 2021;13(1):e12759 View Article PubMed/NCBI

16	Stallmach A, Hagel S, Bruns T. Adverse effects of biologics used for treating IBD. Best Pract Res Clin Gastroenterol 2010;24(2):167-182 View Article PubMed/NCBI

17	Sohail R, Mathew M, Patel KK, Reddy SA, Haider Z, Naria M, et al. Effects of Non-steroidal Anti-inflammatory Drugs (NSAIDs) and Gastroprotective NSAIDs on the Gastrointestinal Tract: A Narrative Review. Cureus 2023;15(4):e37080 View Article PubMed/NCBI

18	Gerretsen P, Pollock BG. Drugs with anticholinergic properties: a current perspective on use and safety. Expert Opin Drug Saf 2011;10(5):751-765 View Article PubMed/NCBI

19	Lim R, Kalisch Ellett LM, Widagdo IS, Pratt NL, Roughead EE. Analysis of anticholinergic and sedative medicine effects on physical function, cognitive function, appetite and frailty: a cross-sectional study in Australia. BMJ Open 2019;9(9):e029221 View Article PubMed/NCBI

20	Black CJ, Drossman DA, Talley NJ, Ruddy J, Ford AC. Functional gastrointestinal disorders: advances in understanding and management. Lancet 2020;396(10263):1664-1674 View Article PubMed/NCBI

21	Wei L, Singh R, Ro S, Ghoshal UC. Gut microbiota dysbiosis in functional gastrointestinal disorders: Underpinning the symptoms and pathophysiology. JGH Open 2021;5(9):976-987 View Article PubMed/NCBI

22	Aware CB, Patil DN, Suryawanshi SS, Mali PR, Rane MR, Gurav RG, et al. Natural bioactive products as promising therapeutics: a review of natural product-based drug development. S Afr J Bot 2022;147:512-528 View Article

23	Nasim N, Sandeep IS, Mohanty S. Plant-derived natural products for drug discovery: current approaches and prospects. Nucleus (Calcutta) 2022;65(3):399-411 View Article PubMed/NCBI

24	Wahab S, Annadurai S, Abullais SS, Das G, Ahmad W, Ahmad MF, et al. Glycyrrhiza glabra (Licorice): A Comprehensive Review on Its Phytochemistry, Biological Activities, Clinical Evidence and Toxicology. Plants (Basel) 2021;10(12):2751 View Article PubMed/NCBI

25	Pastorino G, Cornara L, Soares S, Rodrigues F, Oliveira MBPP. Liquorice (Glycyrrhiza glabra): A phytochemical and pharmacological review. Phytother Res 2018;32(12):2323-2339 View Article PubMed/NCBI

26	Alammar N, Wang L, Saberi B, Nanavati J, Holtmann G, Shinohara RT, et al. The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC Complement Altern Med 2019;19(1):21 View Article PubMed/NCBI

27	Ingrosso MR, Ianiro G, Nee J, Lembo AJ, Moayyedi P, Black CJ, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-941 View Article PubMed/NCBI

28	Karthikeyan A, Young KN, Moniruzzaman M, Beyene AM, Do K, Kalaiselvi S, et al. Curcumin and Its Modified Formulations on Inflammatory Bowel Disease (IBD): The Story So Far and Future Outlook. Pharmaceutics 2021;13(4):484 View Article PubMed/NCBI

29	Peng Y, Ao M, Dong B, Jiang Y, Yu L, Chen Z, et al. Anti-Inflammatory Effects of Curcumin in the Inflammatory Diseases: Status, Limitations and Countermeasures. Drug Des Devel Ther 2021;15:4503-4525 View Article PubMed/NCBI

30	Tarasiuk A, Mosińska P, Fichna J. Triphala: current applications and new perspectives on the treatment of functional gastrointestinal disorders. Chin Med 2018;13:39 View Article PubMed/NCBI

31	Bairwa VK, Kashyap AK, Meena P, Jain BP. Triphala’s characteristics and potential therapeutic uses in modern health. Int J Physiol Pathophysiol Pharmacol 2025;17(2):19-36 View Article PubMed/NCBI

32	Future Market Insights. Herbal Medicinal Products Market Size and Share Forecast Outlook 2025 to 2035. London: Future Market Insights; 2023. Available from: https://www.futuremarketinsights.com/reports/herbal-medicinal-products-market

33	Patwardhan B, Chorghade M, Vaidya ADB. Ayurveda and natural products drug discovery. Curr Sci 2015;109(9):1551-1557

34	Balakrishnan P, Subhose V, Mahajon B, Sharma S, Jain AK, Khanduri S, et al. Globalization of Ayurveda: A traditional Indian system of medicine–Current challenges and way forward. Int J Ayurveda Res 2023;4(4):248-254 View Article

35	Tan N, Gwee KA, Tack J, Zhang M, Li Y, Chen M, et al. Herbal medicine in the treatment of functional gastrointestinal disorders: A systematic review with meta-analysis. J Gastroenterol Hepatol 2020;35(4):544-556 View Article PubMed/NCBI

36	Holtmann G, Shah A, Morrison M. Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview. Dig Dis 2017;35(Suppl 1):5-13 View Article PubMed/NCBI

37	Brierley SM, Kelber O. Use of natural products in gastrointestinal therapies. Curr Opin Pharmacol 2011;11(6):604-611 View Article PubMed/NCBI

38	Teschke R, Wolff A, Frenzel C, Eickhoff A, Schulze J. Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders. World J Gastroenterol 2015;21(15):4466-4490 View Article PubMed/NCBI

39	Peterson CT, Denniston K, Chopra D. Therapeutic Uses of Triphala in Ayurvedic Medicine. J Altern Complement Med 2017;23(8):607-614 View Article PubMed/NCBI

40	Sharma RK, Das VB. Chapter 15, Verses 13-14: Grahani Dosa Adhyaya. Caraka Samhita of Agnivesa, Vol. IV, Chikitsa Sthana. Varanasi: Chaukhamba Krishnadas Academy; 2009:22-23

41	Sharma A. Adhyaya 25: Amlapitta. Kayachikitsa (Part 2). Varanasi: Chaukhamba Publishers; 2013:324

42	Patil SS, Khilare MC. Ayurvedic management of amlapitta with special reference to hyperacidity: a case study. World J Adv Res Rev 2022;16(2):1022-1027 View Article

43	Parwe S, Nisargandha M. An Ayurvedic Approach to Constipation. Alternative Medicine - New Insights. London: IntechOpen; 2024 View Article

44	Mitra SK, Rangesh PR. Constipation (Vibandha). Scientific Basis for Ayurvedic Therapies. New York: Routledge; 2003:347-362

45	Kunte A, Moreshwar V, Krushnashashtri N. . Ashtang Hrudayam (Vagbhata) with commentaries of Arundatta and Hemadri. 9th ed. Varanasi: Chaukhamba Sanskrit Sanstha; 2005:513

46	Joshi K, Thapliyal A, Singh V. The Tridosha theory according to Ayurveda. Int J Mod Trends Sci Technol 2021;7(8):120-124 View Article

47	Prakash S, Shelke AU. Role of Triphala in dentistry. J Indian Soc Periodontol 2014;18(2):132-135 View Article PubMed/NCBI

48	Mishra SN. Bhaisajya Ratnavali of Govind Nath Sen, Siddhiprabha Hindi commentary, Amlapittarogadhikar. Varanasi: Chaukhambha Surabharati Prakashan; 2005, 903

49	Yadav Y, Sharma KC, Rajesh K, Arun S. An updated review on recent in-vitro, in-vivo and clinical researches of Avipattikar Churna. Sch Int J Tradit Complement Med 2019;2(6):113-123 View Article

50	Joshi SV. Ayurveda and Panchakarma: The Science of Healing and Rejuvenation. Twin Lakes (WI): Lotus Press; 1997

51	Tian XT, Zhan JP, Qiao C, Ge JL, Li DH. Rising of natural therapies: Potential and challenges of traditional Chinese medicine in the management of gastrointestinal diseases. World J Gastroenterol 2025;31(9):103145 View Article PubMed/NCBI

52	Wu HZ, Fang ZQ, Cheng PJ. Introduction to Diagnosis in Traditional Chinese Medicine. Vol 2. Singapore: World Scientific; 2013

53	Hong H. Principles of Chinese Medicine: A Modern Interpretation. Singapore: World Scientific; 2015

54	Remadevi R, Surendran E, Ravindran PN. Properties and medicinal uses of ginger. In: Ravindran PN, Babu KN (eds). Ginger: The Genus Zingiber. 1st ed. Boca Raton (FL): CRC Press; 2016:509-528 View Article

Hong GE, Kim JA, Nagappan A, Yumnam S, Lee HJ, Kim EH, et al. Flavonoids Identified from Korean Scutellaria baicalensis Georgi Inhibit Inflammatory Signaling by Suppressing Activation of NF- κ B and MAPK in RAW 264.7 Cells. Evid Based Complement Alternat Med 2013;2013:912031 View Article PubMed/NCBI

56	Kim EH, Shim B, Kang S, Jeong G, Lee JS, Yu YB, et al. Anti-inflammatory effects of Scutellaria baicalensis extract via suppression of immune modulators and MAP kinase signaling molecules. J Ethnopharmacol 2009;126(2):320-331 View Article PubMed/NCBI

57	Wang ZL, Wang S, Kuang Y, Hu ZM, Qiao X, Ye M. A comprehensive review on phytochemistry, pharmacology, and flavonoid biosynthesis of Scutellaria baicalensis. Pharm Biol 2018;56(1):465-484 View Article PubMed/NCBI

58	Wang G, Li TQ, Wang L, Xia Q, Chang J, Zhang Y, et al. Tong-xie-ning, a Chinese herbal formula, in treatment of diarrhea-predominant irritable bowel syndrome: a prospective, randomized, double-blind, placebo-controlled trial. Chin Med J (Engl) 2006;119(24):2114-2119 PubMed/NCBI

59	Zheng H, Jin S, Shen YL, Peng WY, Ye K, Tang TC, et al. Chinese Herbal Medicine for Irritable Bowel Syndrome: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials. Front Pharmacol 2021;12:694741 View Article PubMed/NCBI

60	Xiao Y, Liu YY, Yu KQ, Ouyang MZ, Luo R, Zhao XS. Chinese herbal medicine liu jun zi tang and xiang sha liu jun zi tang for functional dyspepsia: meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med 2012;2012:936459 View Article PubMed/NCBI

61	Health Lab. Ban Xia Xie Xin Tang: a traditional Chinese herbal remedy for digestive harmony. Healthlab; 2025. Available from: https://www.healthlaborganics.com/post/ban-xia-xie-xin-tang

62	Miraj S, Kiani S. A scientific correlation between dystemprament in Unani medicine and diseases: a systematic review. Electronic Physician 2016;8(11):3240 View Article PubMed/NCBI

63	Ghayas S, Hannan A, Javed R. Analysis of systemic diseases based on frequency of humoral pathologies in four temperaments. Hamdard Med 2020;63(1):16-27

64	Khan A. Iksir-i-A’zam. Vol II. Lucknow: Matba Naval Kishore; 1906, 401, 561-563

65	Masihi AS. Kamil-us-sana (Urdu). Vol II. Lucknow: Matba Munshi Naval Kishore; 1889, 504-505

66	Arzani A. Tibb-e-Akbar (Urdu). Vol I. Lucknow: Munshi Naval Kishore and Sons; 1925, 309-310

67	Jurjani AH. Zakheera Khawarizm Shahi. Vol I. Lucknow: Matba Nami Naval Kishore; 1903, 367-368

68	Sehar N, Nafees KM, Mahboob S, Mohd N, Jamal A. Clinical efficacy of Unani drug in the management of Tabkheer-I-Meda (gastroesophageal reflux disease). Ayushdhara 2021;8(4):3405-3411 View Article

69	Muthiah K, Ganesan K, Ponnaiah M, Parameswaran S. Concepts of body constitution in traditional Siddha texts: A literature review. J Ayurveda Integr Med 2019;10(2):131-134 View Article PubMed/NCBI

70	Rao KK, Veluchamy G. Siddha medicine and its usefulness in day-to-day life. In: Subramanian SV, Madhaven VR (eds). Heritage of Tamil Siddha Medicine. Madras: International Institute of Tamil Studies; 1983:171-184

71	Soundharya R, Aruna V, Amruthavalli GV. Absolute science of siddha sastric drugs-An experimental proof. Int J Complement Alt Med 2019;12(2):75-77 View Article

72	Thiyagarajan R, Kalaimohan P, Iyswarya S, Tamilselvi S, Mathukumar S. Milagu related Siddha formulations indicated for various ailments: A literature review. Int J Ayurveda Pharma Res 2022;10(7):38-48 View Article

73	Thalam. Digestion problem. 2025. Available from: https://www.thalam.in/integrated-medicine/siddha/therapeutic/digestion-problem

74	Ansari S. Overview of traditional systems of medicine in different continents. In: Egbuna C, Mishra AP, Goyal MR (eds). Preparation of Phytopharmaceuticals for the Management of Disorders. Cambridge: Academic Press; 2021:431-473 View Article

75	Theuwissen E, Mensink RP. Water-soluble dietary fibers and cardiovascular disease. Physiol Behav 2008;94(2):285-292 View Article PubMed/NCBI

76	Purohit P, Rathore HS. Isabgol: A herbal remedy. World J Pharm Res 2019;8(7):579-585 View Article

77	Shabbir S. Psyllium: the hidden superfood of all times. J Nutraceut Food Sci 2019;4(1):2

78	Thaker K, Patoliya J, Rabadiya K, Reddy NRR, Joshi R. Senna (Cassia angustifolia Vahl.): A comprehensive review of ethnopharmacology and phytochemistry. Pharmacol Res Nat Prod 2023;1:100003 View Article

79	Ahmad J, Viquar U, Kalam MA, Haque SU, Avid M, Husain GM. Sanā Makkī (Cassia angustifolia Vahl.): Pharmacognostic, pharmacological and therapeutic profile - A review. Int J Res Anal Rev 2023;10(3):556-561 View Article

80	Davis RH, Leitner MG, Russo JM, Byrne ME. Anti-inflammatory activity of Aloe vera against a spectrum of irritants. J Am Podiatr Med Assoc 1989;79(6):263-276 View Article PubMed/NCBI

81	Gupta S, Modanwal A, Modanwal AK. Herbal drugs used in gastrointestinal disorders. Int J Innov Sci Res Technol 2025;10(4):3134-3139 View Article

82	McCallum RW, González-Stuart AE. Medicinal plants used for digestive disorders: what the gastroenterologist needs to know. Pract Gastroenterol 2015;13:12-25

83	Cupp MJ. Toxicology and Clinical Pharmacology of Herbal Products. Totowa (NJ): Humana Press; 2000, 123-129

84	Capasso F, Gaginella TS, Grandolini G, Izzo AA. Phytotherapy: A Quick Reference to Herbal Medicine. Heidelberg (Germany): Springer Verlag; 2003

85	Grigoleit HG, Grigoleit P. Peppermint oil in irritable bowel syndrome. Phytomedicine 2005;12(8):601-606 View Article PubMed/NCBI

86	Dalvi SS, Nadkarni PM, Pardesi R, Gupta KC. Effect of peppermint oil on gastric emptying in man: a preliminary study using a radiolabelled solid test meal. Indian J Physiol Pharmacol 1991;35(3):212-214 PubMed/NCBI

87	Huang MT, Lysz T, Ferraro T, Abidi TF, Laskin JD, Conney AH. Inhibitory effects of curcumin on in vitro lipoxygenase and cyclooxygenase activities in mouse epidermis. Cancer Res 1991;51(3):813-819 PubMed/NCBI

88	Shoba FG, Thomas M. Study of antidiarrhoeal activity of four medicinal plants in castor-oil induced diarrhoea. J Ethnopharmacol 2001;76(1):73-76 View Article PubMed/NCBI

89	Grieve M. A Modern Herbal. New York (NY): Dover Publications; 1931

90	Molina GV. Medicinal Plants of the Basque Country (in Spanish). San Sebastian (Spain): Editorial Txertoa; 1999

91	Milić N, Milosević N, Suvajdzić L, Zarkov M, Abenavoli L. New therapeutic potentials of milk thistle (Silybum marianum). Nat Prod Commun 2013;8(12):1801-1810 PubMed/NCBI

92	Prasad AD, Shyma TB, Raghavendra MP. Plants used by the tribes for the treatment of digestive system disorders in Wayanad district, Kerala. J Appl Pharm Sci 2013;3(8):171-175 View Article

Iloki-Assanga SB, Lewis-Luján LM, Lara-Espinoza CL, Gil-Salido AA, Fernandez-Angulo D, Rubio-Pino JL, et al. Solvent effects on phytochemical constituent profiles and antioxidant activities, using four different extraction formulations for analysis of Bucida buceras L. and Phoradendron californicum. BMC Res Notes 2015;8:396 View Article PubMed/NCBI

94	Chaurasiya ND, Zhao J, Pandey P, Doerksen RJ, Muhammad I, Tekwani BL. Selective Inhibition of Human Monoamine Oxidase B by Acacetin 7-Methyl Ether Isolated from Turnera diffusa (Damiana). Molecules 2019;24(4):810 View Article PubMed/NCBI

95	Alvarez-Pérez OB, Ventura-Sobrevilla JM, Ascacio-Valdés JA, Rojas R, Verma DK, Aguilar CN. Valorization of Flourensia cernua DC as source of antioxidants and antifungal bioactives. Ind Crops Prod 2020;152:112422 View Article

96	Ebrahimzadeh Attari V, Somi MH, Asghari Jafarabadi M, Ostadrahimi A, Moaddab SY, Lotfi N. The Gastro-protective Effect of Ginger (Zingiber officinale Roscoe) in Helicobacter pylori Positive Functional Dyspepsia. Adv Pharm Bull 2019;9(2):321-324 View Article PubMed/NCBI

97	Krupavaram B, Babu AK, Pillay SM, Siang TC, Menon BV, Paneerselvam GS, et al. A review of herbal treatment for functional gastrointestinal disorders and infection. Prog Microbes Mol Biol 2023;6(1):a0000346 View Article

98	Parham S, Kharazi AZ, Bakhsheshi-Rad HR, Nur H, Ismail AF, Sharif S, et al. Antioxidant, Antimicrobial and Antiviral Properties of Herbal Materials. Antioxidants (Basel) 2020;9(12):E1309 View Article PubMed/NCBI

99	Deutsch JK, Levitt J, Hass DJ. Complementary and Alternative Medicine for Functional Gastrointestinal Disorders. Am J Gastroenterol 2020;115(3):350-364 View Article PubMed/NCBI

100	Adzet T, Camarasa J, Laguna JC. Hepatoprotective activity of polyphenolic compounds from Cynara scolymus against CCl4 toxicity in isolated rat hepatocytes. J Nat Prod 1987;50(4):612-617 View Article PubMed/NCBI

101	Clifford M, Walker R. Chlorogenic acids: confounders of coffee-serum cholesterol relationships. Food Chem 1987;24:77-80 View Article

102	Jiménez-Escrig A, Dragsted LO, Daneshvar B, Pulido R, Saura-Calixto F. In vitro antioxidant activities of edible artichoke (Cynara scolymus L.) and effect on biomarkers of antioxidants in rats. J Agric Food Chem 2003;51(18):5540-5545 View Article PubMed/NCBI

103	Lattanzio V, Kroon PA, Linsalata V, Cardinali A. Globe artichoke: a functional food and source of nutraceutical ingredients. J Funct Foods 2009;1(2):131-144 View Article

104	Peterson CT, Sharma V, Uchitel S, Denniston K, Chopra D, Mills PJ, et al. Prebiotic Potential of Herbal Medicines Used in Digestive Health and Disease. J Altern Complement Med 2018;24(7):656-665 View Article PubMed/NCBI

105	Cherrada N, Chemsa AE, Gheraissa N, Laib I, Gueboudji Z, El-Shazly M, et al. Gastroprotective Efficacy of North African Medicinal Plants: A Review on Their Therapeutic Potential for Peptic Ulcers. Food Sci Nutr 2024;12(11):8793-8824 View Article PubMed/NCBI

106	Altaf S, Abbas RZ, Akhtar T, Faisal Siddique F, Mahmood MS, Khan MK, et al. Antioxidant-rich medicinal plants as a potential candidate to treat gastric ulcer. Bol Latinoam Caribe Plant Med Aromat 2023;22(5):560-580 View Article

107	Tariq A, Mussarat S, Adnan M, Abd Allah EF, Hashem A, Alqarawi AA, et al. Ethnomedicinal Evaluation of Medicinal Plants Used against Gastrointestinal Complaints. Biomed Res Int 2015;2015:892947 View Article PubMed/NCBI

108	Olajuyigbe OO, Afolayan AJ. Ethnobotanical survey of medicinal plants used in the treatment of gastrointestinal disorders in the Eastern Cape Province, South Africa. J Med Plants Res 2012;6(18):3415-3424 View Article

109	Khedr A. Antiulcer protective activity of gum Arabic (Acacia senegal) in adult rats. Bull Natl Nutr Inst Arab Repub Egypt 2017;49(1):1-28 View Article

110	Czigle S, Bittner Fialová S, Tóth J, Mučaji P, Nagy M, On Behalf Of The Oemonom. Treatment of Gastrointestinal Disorders-Plants and Potential Mechanisms of Action of Their Constituents. Molecules 2022;27(9):2881 View Article PubMed/NCBI

111	Niyazmand S, Erfaniyan A, Hajzadeh Mosarreza M, Khoshnood A. The effects of aqueous-ethanol extract of Achillea wilhelmsii on gastric acid secretion at basal, vagotomized and vagal-stimulated conditions. Feyz Periodic 2008;12:12-16

112	Rokaya MB, Uprety Y, Poudel RC, Timsina B, Münzbergová Z, Asselin H, et al. Traditional uses of medicinal plants in gastrointestinal disorders in Nepal. J Ethnopharmacol 2014;158(Pt A):221-229 View Article PubMed/NCBI

113	Jahan R, Rana AH, Ara N, Jannat K, Bondhon TA, Rahmatullah M, et al. Tribal differences in Bangladesh in the selection of medicinal plants for treatment of gastrointestinal disorders: a short review. EC Gastroenterol Dig Syst 2020;7(3):1-10

114	Yao Y, Habib M, Bajwa HF, Qureshi A, Fareed R, Altaf R, et al. Herbal therapies in gastrointestinal and hepatic disorders: An evidence-based clinical review. Front Pharmacol 2022;13:962095 View Article PubMed/NCBI

115	Tangjitman K, Wongsawad C, Kamwong K, Sukkho T, Trisonthi C. Ethnomedicinal plants used for digestive system disorders by the Karen of northern Thailand. J Ethnobiol Ethnomed 2015;11:27 View Article PubMed/NCBI

116	Bahmani M, Zargaran A, Rafieian-Kopaei M. Identification of medicinal plants of Urmia for treatment of gastrointestinal disorders. Rev Bras Farmacogn 2014;24(4):468-480 View Article

117	Hani M, Merghem M, Lebazda R. Medicinal plants used against gastrointestinal disorders in Setifian High Plateau, Algeria. Appl Ecol Environ Res 2023;21(2):1459-1470 View Article

118	Atta AH, Mouneir SM. Antidiarrhoeal activity of some Egyptian medicinal plant extracts. J Ethnopharmacol 2004;92(2-3):303-309 View Article PubMed/NCBI

119	Shaker E, Mahmoud H, Mnaa S. Anti-inflammatory and anti-ulcer activity of the extract from Alhagi maurorum (camelthorn). Food Chem Toxicol 2010;48(10):2785-2790 View Article PubMed/NCBI

120	Kacholi DS, Amir HM, Isidory AJ. Traditional medicinal plants used for gastrointestinal disorders by the Nyamwezi traditional health practitioners of Tabora region, Tanzania. Ethnobot Res Appl 2024;29:1-16 View Article

121	Sutovská M, Nosálová G, Sutovský J, Franová S, Prisenznáková L, Capek P. Possible mechanisms of dose-dependent cough suppressive effect of Althaea officinalis rhamnogalacturonan in guinea pigs test system. Int J Biol Macromol 2009;45(1):27-32 View Article PubMed/NCBI

122	Zargari A. Medicinal Plants. 6th ed. Tehran: Tehran University Press; 1997

123	Mardani-Nejhad S, Vazirpour M. Ethno-botany of medicinal plants by Mobarakeh’s people (Isfahan) (in Persian). J Herb Drugs 2012;3(2):111-129

124	Dogan Y, Ugulu I. Medicinal plants used for gastrointestinal disorders in some districts of Izmir Province, Turkey. Ethno Med 2013;7(3):149-161 View Article

125	Sadeghi H, Barjian A. Medicinal Plant Species of Cheshme-Anjir Area in Shiraz. J Pant Environ Physiol 2012;7:42-59

126

Elmaghraby DA, Alsalman GA, Alawadh LH, Al-Abdulqader SA, Alaithan MM, Alnuwaysir BI. Integrated traditional herbal medicine in the treatment of gastrointestinal disorder: the pattern of use and the knowledge of safety among the Eastern Region Saudi population. BMC Complement Med Ther 2023;23(1):373 View Article PubMed/NCBI

127	Ivancheva S, Nikolova M, Tsvetkova R. Pharmacological activities and biologically active compounds of Bulgarian medicinal plants. Phytochemistry: Advances in Research. Kerala: Research Signpost; 2006:87-103

128	Benmansour N, Cherif H, El Hanballi F, Akssira M. Study of the biological activities of the seeds of the plant Ceratonia siliqua L. recovered in the Bejaia region. Med Technol J 2020;4(1):520-521 View Article

129	Baytop T. Turkiye’de Bitkilerle Tedavi. Istanbul: Nobel Tıp Kitabevleri; 1999

130	Dolatkhahi M, Yousefi M, Bagher Nejad J, Dolatkhahi A. Introductory study of the medicinal plant species of Kazeroon, Fars Province. J Herb Drugs 2010;3:47-56

131	Jeslin MA, Dhanusha S, Aneesha V, Hardha B, Senthil KM. Review on natural and synthetic drugs used in gastrointestinal disorders. Int J Pharm Res Appl 2023;8(5):1346-1357 View Article

132

Azzini E, Bugianesi R, Romano F, Di Venere D, Miccadei S, Durazzo A, et al. Absorption and metabolism of bioactive molecules after oral consumption of cooked edible heads of Cynara scolymus L. (cultivar Violetto di Provenza) in human subjects: a pilot study. Br J Nutr 2007;97(5):963-969 View Article PubMed/NCBI

133	Khare CP. Indian Medicinal Plants: An Illustrated Dictionary. New York: Springer Science & Business Media; 2008

134	Koohpayeh A, Ghasemi Pirbalouti M, Yazdanpanah Ravari MM, Pourmohseni E, Nasab E, Arjomand D. Study of the ethno-veterinary use of medicinal plants in Kerman Province, Iran. J Herb Drugs 2011;2:211-216

135	Jamal A, Javed K, Aslam M, Jafri MA. Gastroprotective effect of cardamom, Elettaria cardamomum Maton. fruits in rats. J Ethnopharmacol 2006;103(2):149-153 View Article PubMed/NCBI

136	Ahmed W, Khan AQ, Malik A. Two triterpenes from the leaves of Ficus carica. Planta Med 1988;54(5):481 View Article PubMed/NCBI

137	Zolfaghari A, Adeli E, Mozaffarian VA, Babaei S, Habibi Bibalan GH. Identification of medicinal herbs in Arasbaran and indigenous knowledge of local people. Iran J Med Aromat Plants 2012;28:534-550

138	Duke JA. Handbook of Medicinal Herbs. 2nd ed. London: CRC Press; 2001

139	Hosseinzadeh H, Karimi GR, Ameri M. Effects of Anethum graveolens L. seed extracts on experimental gastric irritation models in mice. BMC Pharmacol 2002;2:21 View Article PubMed/NCBI

140	Ayoola M, Akinlolu A, Adeboga S, Otulana J. Gastroprotective activities of the n-hexane fraction of Heliotropium indicum on gastric ulceration. Niger J Basic Appl Sci 2016;24(1):7-13 View Article

141	Alsabri SG, Rmeli NB, Zetrini AA, et al. Phytochemical, anti-oxidant, anti-microbial, anti-inflammatory, and anti-ulcer properties of Helianthemum lippii. J Pharmacogn Phytochem 2013;2(2):86-96

142	Ben Ali MJ, Guesmi F, Harrath AH, Alwasel S, Hedfi A, Ncib S, et al. Investigation of Antiulcer and Antioxidant Activity of Juniperus phoenicea L. (1753) Essential Oil in an Experimental Rat Model. Biol Pharm Bull 2015;38(11):1738-1746 View Article PubMed/NCBI

143	Ben Mansour R, Wasli H, Serairi-Beji R, Bourgou S, Dakhlaoui S, Selmi S, et al. In vivo gastroprotective effect and biological potentialities of six Tunisian medicinal plants using multivariate data treatment. Plant Biosyst 2022;156(1):152-163 View Article

144	Loolaie M, Moasef N, Rasouli H, Adibi H. Peppermint and its functionality: a review. Arch Clin Microbiol 2017;8(4):54 View Article

145	Shah PP, D’Mello PM. A review of medicinal uses and pharmacological effects of Mentha piperita. Nat Prod Radiance 2004;3(4):214-221

146	Newall CA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press; 1996, 96

147	Mahmoud AA. New monoterpenes from Mentha microphylla. Planta Med 2005;71(8):782-784 View Article PubMed/NCBI

148	Mahdavi FS, Mardi P, Mahdavi SS, Kamalinejad M, Hashemi SA, Khodaii Z, et al. Therapeutic and Preventive Effects of Olea europaea Extract on Indomethacin-Induced Small Intestinal Injury Model in Rats. Evid Based Complement Alternat Med 2020;2020:6669813 View Article PubMed/NCBI

149	Bakhtaoui FZ, Lakmichi H, Chait A, Gadhi CA. In vivo gastroprotective effects of five Moroccan medicinal plants against gastric ulcer. Am J Phytomed Clin Ther 2014;2:1262-1276

150	Akram W, Ahmed S, Rihan M, Arora S, Khalid M, Ahmad S, et al. An updated comprehensive review of the therapeutic properties of chamomile (Matricaria chamomilla L.). Int J Food Prop 2024;27(1):133-164 View Article

151	Tuzlacı E, Erol MK. Turkish folk medicinal plants. Part II: Eğirdir (Isparta). Fitoterapia 1999;70(6):593-610 View Article

152	Kale BS, Bambare AS, Bhale MS. Pharmacological, phytochemistry and ethnomedicinal profiles of Osyris quadripartita Salzm. ex Decne: a critical review. South Asian J Exp Biol 2023;13(3):189-196 View Article

153	Abascal K, Yarnell E. The many faces of Silybum marianum (milk thistle): Part 1-treating cancer and hyperlipidemia and restoring kidney function. Altern Complement Ther 2003;9(4):170-175 View Article

154	Kroll DJ, Shaw HS, Oberlies NH. Milk thistle nomenclature: why it matters in cancer research and pharmacokinetic studies. Integr Cancer Ther 2007;6(2):110-119 View Article PubMed/NCBI

155	Jainu M, Devi CS. Antioxidant effect of methanolic extract ofSolanum nigrum berries on aspirin induced gastric mucosal injury. Indian J Clin Biochem 2004;19(1):57-61 View Article PubMed/NCBI

156

Schütz K, Muks E, Carle R, Schieber A. Separation and quantification of inulin in selected artichoke (Cynara scolymus L.) cultivars and dandelion (Taraxacum officinale WEB. ex WIGG.) roots by high-performance anion exchange chromatography with pulsed amperometric detection. Biomed Chromatogr 2006;20(12):1295-1303 View Article PubMed/NCBI

157	Amin GH. Traditional and Medicinal Herbs of Iran. Vol 1. Tehran: Medicinal Plants Research Institute of Iran; 1991, 39-40

158	Koh EM, Kim HJ, Kim S, Choi WH, Choi YH, Ryu SY, et al. Modulation of macrophage functions by compounds isolated from Zingiber officinale. Planta Med 2009;75(2):148-151 View Article PubMed/NCBI

159	Platel K, Srinivasan K. Influence of dietary spices and their active principles on pancreatic digestive enzymes in albino rats. Nahrung 2000;44(1):42-46 View Article PubMed/NCBI

160	Stott JR, Barnes GR, Wright RJ, Ruddock CJ. The effect on motion sickness and oculomotor function of GR 38032F, a 5-HT3-receptor antagonist with anti-emetic properties. Br J Clin Pharmacol 1989;27(2):147-157 View Article PubMed/NCBI

161	Azadmehr A, Latifi R, Mosalla S, Hajiaghaee R, Shahnazi M. Immunomodulatory effects of Ziziphora tenuior L. extract on the dendritic cells. Daru 2014;22(1):63 View Article PubMed/NCBI

162	Kim YS, Kim JW, Ha NY, Kim J, Ryu HS. Herbal Therapies in Functional Gastrointestinal Disorders: A Narrative Review and Clinical Implication. Front Psychiatry 2020;11:601 View Article PubMed/NCBI

163	Wang Q, Huang H, Yang Y, Yang X, Li X, Zhong W, et al. Reinventing gut health: leveraging dietary bioactive compounds for the prevention and treatment of diseases. Front Nutr 2024;11:1491821 View Article PubMed/NCBI

164	Shao YY, Guo Y, Feng XJ, Liu JJ, Chang ZP, Deng GF, et al. Oridonin Attenuates TNBS-induced Post-inflammatory Irritable Bowel Syndrome via PXR/NF-κB Signaling. Inflammation 2021;44(2):645-658 View Article PubMed/NCBI

165	Zhu N, Zhu L, Zhang X, Huang C, Xiang W, Huang B. Triptolide attenuates irritable bowel syndrome via inhibiting ODC1. BMC Gastroenterol 2023;23(1):202 View Article PubMed/NCBI

166

Jianan Y, Kunming C, Chao LI, Xiang Z, Zeyu D, Bing LI, et al. Atractylenolide I ameliorates post-infectious irritable bowel syndrome by inhibiting the polymerase I and transcript release factor and c-Jun N-terminal kinase/inducible nitric oxide synthase pathway. J Tradit Chin Med 2025;45(1):57-65 View Article PubMed/NCBI

167	Ali DE, El-Shiekh RA, El Sawy MA, Khalifa AA, Elblehi SS, Elsokkary NH, et al. In vivo anti-gastric ulcer activity of 7-O-methyl aromadendrin and sakuranetin via mitigating inflammatory and oxidative stress trails. J Ethnopharmacol 2024;335:118617 View Article PubMed/NCBI

168	Lin K, Wang Z, Wang E, Zhang X, Liu X, Feng F, et al. Targeting TRPV1 signaling: Galangin improves ethanol-induced gastric mucosal injury. J Ethnopharmacol 2024;335:118605 View Article PubMed/NCBI

169	Ma C, Zhang L, Huang Q, Deng Q, Huang F, Xu J. Canolol Alleviates Ethanol-Induced Gastric Ulcer by Inhibiting p38 MAPK/NF-κB/NLRP3 Pathway. J Agric Food Chem 2025;73(15):9103-9111 View Article PubMed/NCBI

170	Wei Z, Ni X, Cui H, Shu C, Peng Y, Liu J, et al. Engeletin attenuates the inflammatory response via inhibiting TLR4-NFκB signaling pathway in Crohn’s disease-like colitis. J Ethnopharmacol 2025;336:118733 View Article PubMed/NCBI

171	Zheng C, Zhong Y, Zhang W, Wang Z, Xiao H, Zhang W, et al. Chlorogenic Acid Ameliorates Post-Infectious Irritable Bowel Syndrome by Regulating Extracellular Vesicles of Gut Microbes. Adv Sci (Weinh) 2023;10(28):e2302798 View Article PubMed/NCBI

172	Chen H, Zhang F, Li R, Liu Y, Wang X, Zhang X, et al. Berberine regulates fecal metabolites to ameliorate 5-fluorouracil induced intestinal mucositis through modulating gut microbiota. Biomed Pharmacother 2020;124:109829 View Article PubMed/NCBI

173	Dong Y, Fan H, Zhang Z, Jiang F, Li M, Zhou H, et al. Berberine ameliorates DSS-induced intestinal mucosal barrier dysfunction through microbiota-dependence and Wnt/β-catenin pathway. Int J Biol Sci 2022;18(4):1381-1397 View Article PubMed/NCBI

174	Ye Y, Abulizi A, Zhang Y, Lu F, An Y, Ren C, et al. Ganoderic Acid Ameliorates Ulcerative Colitis by Improving Intestinal Barrier Function via Gut Microbiota Modulation. Int J Mol Sci 2025;26(6):2466 View Article PubMed/NCBI

175

Li X, Liu Q, Yu J, Zhang R, Sun T, Jiang W, et al. Costunolide ameliorates intestinal dysfunction and depressive behaviour in mice with stress-induced irritable bowel syndrome via colonic mast cell activation and central 5-hydroxytryptamine metabolism. Food Funct 2021;12(9):4142-4151 View Article PubMed/NCBI

176

Guo G, Shi F, Zhu J, Shao Y, Gong W, Zhou G, et al. Piperine, a functional food alkaloid, exhibits inhibitory potential against TNBS-induced colitis via the inhibition of IκB-α/NF-κB and induces tight junction protein (claudin-1, occludin, and ZO-1) signaling pathway in experimental mice. Hum Exp Toxicol 2020;39(4):477-491 View Article PubMed/NCBI

177	Wang K, Lv Q, Miao YM, Qiao SM, Dai Y, Wei ZF. Cardamonin, a natural flavone, alleviates inflammatory bowel disease by the inhibition of NLRP3 inflammasome activation via an AhR/Nrf2/NQO1 pathway. Biochem Pharmacol 2018;155:494-509 View Article PubMed/NCBI

178	Kimura Y, Taniguchi M. Effects of morroniside isolated from Cornus officinalis fruits on functional gastrointestinal disorders and gastric ulcer in mice. Fitoterapia 2024;179:106249 View Article PubMed/NCBI

179	Hu X, Dong Y, Jin X, Zhang C, Zhang T, Zhao J, et al. The novel and potent anti-depressive action of triptolide and its influences on hippocampal neuroinflammation in a rat model of depression comorbidity of chronic pain. Brain Behav Immun 2017;64:180-194 View Article PubMed/NCBI

180	Nozu T, Miyagishi S, Ishioh M, Takakusaki K, Okumura T. Phlorizin attenuates visceral hypersensitivity and colonic hyperpermeability in a rat model of irritable bowel syndrome. Biomed Pharmacother 2021;139:111649 View Article PubMed/NCBI

181	Chen S, Wu X, Yu Z. Juglone Suppresses Inflammation and Oxidative Stress in Colitis Mice. Front Immunol 2021;12:674341 View Article PubMed/NCBI

182	Wang L, Song X, Zhou Y, Xia Y, Yang Z, Chen X, et al. Sclareol protected against intestinal barrier dysfunction ameliorating Crohn’s disease-like colitis via Nrf2/NF-B/MLCK signalling. Int Immunopharmacol 2024;133:112140 View Article PubMed/NCBI

183	El-Shiekh RA, Salama A, Al-Mokaddem AK, Bader A, Abdel-Sattar EA. Russelioside B; A pregnane glycoside for treatment of gastric ulcer via modulation of heat shock protein-70 and vascular endothelial growth factor. Steroids 2021;165:108759 View Article PubMed/NCBI

184	He X, Liu J, Long G, Xia XH, Liu M. 2,3,5,4′-Tetrahydroxystilbene-2-O-β-D-glucoside, a major bioactive component from Polygoni multiflori Radix (Heshouwu) suppresses DSS induced acute colitis in BALb/c mice by modulating gut microbiota. Biomed Pharmacother 2021;137:111420 View Article PubMed/NCBI

185	Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism 2008;57(5):712-717 View Article PubMed/NCBI

186	Wachtel-Galor S, Benzie IFF. Ganoderma lucidum (Lingzhi or Reishi): A medicinal mushroom. In: Benzie IFF, Wachtel-Galor S (eds). Herbal Medicine: Biomolecular and Clinical Aspects. 2nd ed. Boca Raton (FL): CRC Press/Taylor & Francis; 2011:175-199

187	Shoba G, Joy D, Joseph T, Majeed M, Rajendran R, Srinivas PS. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta Med 1998;64(4):353-356 View Article PubMed/NCBI

188	Rao CV, Vijayakumar M. Effect of quercetin, flavonoids and alpha-tocopherol, an antioxidant vitamin, on experimental reflux oesophagitis in rats. Eur J Pharmacol 2008;589(1-3):233-238 View Article PubMed/NCBI

189	Heinz SA, Henson DA, Austin MD, Jin F, Nieman DC. Quercetin supplementation and upper respiratory tract infection: A randomized community clinical trial. Pharmacol Res 2010;62(3):237-242 View Article PubMed/NCBI

190	Gupta SS, Azmi L, Mohapatra PK, Rao CV. Flavonoids from whole Plant of Euphorbia hirta and their Evaluation against Experimentally induced Gastroesophageal Reflux Disease in Rats. Pharmacogn Mag 2017;13(Suppl 1):S127-S134 View Article PubMed/NCBI

191	Hadidi M, Liñán-Atero R, Tarahi M, Christodoulou MC, Aghababaei F. The Potential Health Benefits of Gallic Acid: Therapeutic and Food Applications. Antioxidants (Basel) 2024;13(8):1001 View Article PubMed/NCBI

192	Lete I, Allué J. The Effectiveness of Ginger in the Prevention of Nausea and Vomiting during Pregnancy and Chemotherapy. Integr Med Insights 2016;11:11-17 View Article PubMed/NCBI

193	Ford AC, Talley NJ, Spiegel BM, Foxx-Orenstein AE, Schiller L, Quigley EM, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ 2008;337:a2313 View Article PubMed/NCBI

194	Reagan-Shaw S, Nihal M, Ahmad N. Dose translation from animal to human studies revisited. FASEB J 2008;22(3):659-661 View Article PubMed/NCBI

195	Thamlikitkul V, Bunyapraphatsara N, Dechatiwongse T, Theerapong S, Chantrakul C, Thanaveerasuwan T, et al. Randomized controlled trial of Cassia alata Linn. for constipation. J Med Assoc Thai 1990;73(4):217-222 PubMed/NCBI

196	Bensoussan A, Talley NJ, Hing M, Menzies R, Guo A, Ngu M. Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial. JAMA 1998;280(18):1585-1589 View Article PubMed/NCBI

197	Yadav SK, Jain AK, Tripathi SN, Gupta JP. Irritable bowel syndrome: therapeutic evaluation of indigenous drugs. Indian J Med Res 1989;90:496-503 PubMed/NCBI

198	Ligumsky M, Sallon S, Shapiro H, Ben-Ari E, Davidson R, Ginsberg G. Treatment of irritable bowel syndrome with Tibetan herbal multicompound, Padma-179: a controlled, double-blind study. Gastroenterology 1999;116(4 Suppl):A1029

199	Thamlikitkul V, Bunyapraphatsara N, Dechatiwongse T, Theerapong S, Chantrakul C, Thanaveerasuwan T, et al. Randomized double blind study of Curcuma domestica Val. for dyspepsia. J Med Assoc Thai 1989;72(11):613-620 PubMed/NCBI

200	Al-Habbal MJ, Al-Habbal Z, Huwez FU. A double-blind controlled clinical trial of mastic and placebo in the treatment of duodenal ulcer. Clin Exp Pharmacol Physiol 1984;11(5):541-544 View Article PubMed/NCBI

201	Bundy R, Walker AF, Middleton RW, Booth J. Turmeric extract may improve irritable bowel syndrome symptomology in otherwise healthy adults: a pilot study. J Altern Complement Med 2004;10(6):1015-1018 View Article PubMed/NCBI

202	Ng QX, Soh AYS, Loke W, Venkatanarayanan N, Lim DY, Yeo WS. A Meta-Analysis of the Clinical Use of Curcumin for Irritable Bowel Syndrome (IBS). J Clin Med 2018;7(10):298 View Article PubMed/NCBI

203	Cappello G, Spezzaferro M, Grossi L, Manzoli L, Marzio L. Peppermint oil (Mintoil) in the treatment of irritable bowel syndrome: a prospective double blind placebo-controlled randomized trial. Dig Liver Dis 2007;39(6):530-536 View Article PubMed/NCBI

204

Madisch A, Heydenreich CJ, Wieland V, Hufnagel R, Hotz J. Treatment of functional dyspepsia with a fixed peppermint oil and caraway oil combination preparation as compared to cisapride. A multicenter, reference-controlled double-blind equivalence study. Arzneimittelforschung 1999;49(11):925-932 View Article PubMed/NCBI

205	Melzer J, Rösch W, Reichling J, Brignoli R, Saller R. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004;20(11-12):1279-1287 View Article PubMed/NCBI

206	Lauche R, Kumar S, Hallmann J, Lüdtke R, Rampp T, Dobos G, et al. Efficacy and safety of Ayurvedic herbs in diarrhoea-predominant irritable bowel syndrome: A randomised controlled crossover trial. Complement Ther Med 2016;26:171-177 View Article PubMed/NCBI

207	Choi CH, Jo SY, Park HJ, Chang SK, Byeon JS, Myung SJ. A randomized, double-blind, placebo-controlled multicenter trial of saccharomyces boulardii in irritable bowel syndrome: effect on quality of life. J Clin Gastroenterol 2011;45(8):679-683 View Article PubMed/NCBI

208

Wade U, Pascual-Figal DA, Rabbani F, Ernst M, Albert A, Janssens I, et al. The Possible Synergistic Pharmacological Effect of an Oral Berberine (BBR) and Curcumin (CUR) Complementary Therapy Alleviates Symptoms of Irritable Bowel Syndrome (IBS): Results from a Real-Life, Routine Clinical Practice Settings-Based Study. Nutrients 2024;16(8):1204 View Article PubMed/NCBI

209	Rahimi R, Abdollahi M. Herbal medicines for the management of irritable bowel syndrome: a comprehensive review. World J Gastroenterol 2012;18(7):589-600 View Article PubMed/NCBI

210	Lao CD, Ruffin MT4th, Normolle D, Heath DD, Murray SI, Bailey JM, et al. Dose escalation of a curcuminoid formulation. BMC Complement Altern Med 2006;6:10 View Article PubMed/NCBI

211	Boudreau MD, Beland FA, Nichols JA, Pogribna M. Toxicology and carcinogenesis studies of a nondecolorized [corrected] whole leaf extract of Aloe barbadensis Miller (Aloe vera) in F344/N rats and B6C3F1 mice (drinking water study). Natl Toxicol Program Tech Rep Ser 2013:1-266 PubMed/NCBI

212	Conn JW, Rovner DR, Cohen EL. Licorice-induced pseudoaldosteronism. Hypertension, hypokalemia, aldosteronopenia, and suppressed plasma renin activity. JAMA 1968;205(7):492-496 View Article PubMed/NCBI

213	Asl MN, Hosseinzadeh H. Review of pharmacological effects of Glycyrrhiza sp. and its bioactive compounds. Phytother Res 2008;22(6):709-724 View Article PubMed/NCBI

214	Tiani KA, Arenaz CM, Spill MK, Foster MJ, Davis JS, Bailey RL, et al. The Use of Ginger Bioactive Compounds in Pregnancy: An Evidence Scan and Umbrella Review of Existing Meta-Analyses. Adv Nutr 2024;15(11):100308 View Article PubMed/NCBI

215	Haloub K, McNamara E, Yahya RH. An Unusual Case of Dietary-Induced Liver Injury during Pregnancy: A Case Report of Probable Liver Injury due to High-Dose Turmeric Intake and Literature Review. Case Reports Hepatol 2024;2024:6677960 View Article PubMed/NCBI

216	Safajou F, Soltani N, Taghizadeh M, Amouzeshi Z, Sandrous M. The Effect of Combined Inhalation Aromatherapy with Lemon and Peppermint on Nausea and Vomiting of Pregnancy: A Double-Blind, Randomized Clinical Trial. Iran J Nurs Midwifery Res 2020;25(5):401-406 View Article PubMed/NCBI

217	Joulaeerad N, Ozgoli G, Hajimehdipoor H, Ghasemi E, Salehimoghaddam F. Effect of Aromatherapy with Peppermint Oil on the Severity of Nausea and Vomiting in Pregnancy: A Single-blind, Randomized, Placebo-controlled trial. J Reprod Infertil 2018;19(1):32-38 PubMed/NCBI

218	Viljoen E, Visser J, Koen N, Musekiwa A. A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutr J 2014;13:20 View Article PubMed/NCBI

219	Volqvartz T, Vestergaard AL, Aagaard SK, Andreasen MF, Lesnikova I, Uldbjerg N, et al. Use of alternative medicine, ginger and licorice among Danish pregnant women - a prospective cohort study. BMC Complement Altern Med 2019;19(1):5 View Article PubMed/NCBI

220	Fuloria S, Mehta J, Chandel A, Sekar M, Rani NNIM, Begum MY, et al. A Comprehensive Review on the Therapeutic Potential of Curcuma longa Linn. in Relation to its Major Active Constituent Curcumin. Front Pharmacol 2022;13:820806 View Article PubMed/NCBI

221	Filardi T, Varì R, Ferretti E, Zicari A, Morano S, Santangelo C. Curcumin: Could This Compound Be Useful in Pregnancy and Pregnancy-Related Complications?. Nutrients 2020;12(10):3179 View Article PubMed/NCBI

222	Räikkönen K, Martikainen S, Pesonen AK, Lahti J, Heinonen K, Pyhälä R, et al. Maternal Licorice Consumption During Pregnancy and Pubertal, Cognitive, and Psychiatric Outcomes in Children. Am J Epidemiol 2017;185(5):317-328 View Article PubMed/NCBI

223	Trottier M, Erebara A, Bozzo P. Treating constipation during pregnancy. Can Fam Physician 2012;58(8):836-8 PubMed/NCBI

224	Pond E. Treating Constipation in Pregnancy With Laxatives: Safety Risks and Considerations. Gastroenterology Advisor; 2022. Available from: https://www.gastroenterologyadvisor.com/news/chronic-constipation-pregnancy-otc-prescription-laxatives-safety-profiles/

225	Kubala J. What are the benefits of triphala? Healthline. 2025. Available from: https://www.healthline.com/nutrition/triphala

226	Clark A. Triphala: Are There Any Health Benefits? Verywell Health. 2025. Available from: https://www.verywellhealth.com/triphala-what-should-i-know-about-it-89590

227	Cherry RN, Blanchard SS, Chogle A, Santucci NR, Mehta K, Russell AC. Herbal Approaches to Pediatric Functional Abdominal Pain. Children (Basel) 2022;9(8):1266 View Article PubMed/NCBI

228	Pop D, Pop RS, Farcău D. The Use of Fibers, Herbal Medicines and Spices in Children with Irritable Bowel Syndrome: A Narrative Review. Nutrients 2023;15(20):4351 View Article PubMed/NCBI

229	American Academy of Pediatrics. Psyllium\|Drug lookup\|Pediatric care online. Available from: https://publications.aap.org/pediatriccare/drug-monograph/18/5649/Psyllium

230	Shulman RJ, Hollister EB, Cain K, Czyzewski DI, Self MM, Weidler EM, et al. Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial. Clin Gastroenterol Hepatol 2017;15(5):712-719.e4 View Article PubMed/NCBI

231	Alexandrovich I, Rakovitskaya O, Kolmo E, Sidorova T, Shushunov S. The effect of fennel (Foeniculum Vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study. Altern Ther Health Med 2003;9(4):58-61 PubMed/NCBI

232	Tomassoni AJ, Simone K. Herbal medicines for children: an illusion of safety?. Curr Opin Pediatr 2001;13(2):162-169 View Article PubMed/NCBI

233	Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs 2009;69(13):1777-1798 View Article PubMed/NCBI

234	Tang X, Xin HW, Li WL, Ouyang M. Study of the effects of Berberine on CYP3A4 and P-gp in HepG2 cells and its mechanism in vitro. Chinese Journal of Clinical Pharmacology and Therapeutics 2015;20(1):7-13

235	Saper RB, Kales SN, Paquin J, Burns MJ, Eisenberg DM, Davis RB, et al. Heavy metal content of ayurvedic herbal medicine products. JAMA 2004;292(23):2868-2873 View Article PubMed/NCBI

236	Luo L, Wang B, Jiang J, Fitzgerald M, Huang Q, Yu Z, et al. Heavy Metal Contaminations in Herbal Medicines: Determination, Comprehensive Risk Assessments, and Solutions. Front Pharmacol 2020;11:595335 View Article PubMed/NCBI

237	Yang Y, Xiao G, Cheng P, Zeng J, Liu Y. Protective Application of Chinese Herbal Compounds and Formulae in Intestinal Inflammation in Humans and Animals. Molecules 2023;28(19):6811 View Article PubMed/NCBI

238	Balkrishna A, Sharma N, Srivastava D, Kukreti A, Srivastava S, Arya V. Exploring the safety, efficacy, and bioactivity of herbal medicines: Bridging traditional wisdom and modern science in healthcare. Future Integr Med 2024;3(1):35-49 View Article

239	Serras AS, Rodrigues JS, Cipriano M, Rodrigues AV, Oliveira NG, Miranda JP. A Critical Perspective on 3D Liver Models for Drug Metabolism and Toxicology Studies. Front Cell Dev Biol 2021;9:626805 View Article PubMed/NCBI

240	Zhang Y, Man Ip C, Lai YS, Zuo Z. Overview of Current Herb-Drug Interaction Databases. Drug Metab Dispos 2022;50(1):86-94 View Article PubMed/NCBI

241	Mostafa F, Chen M. Computational models for predicting liver toxicity in the deep learning era. Front Toxicol 2023;5:1340860 View Article PubMed/NCBI

242	Kunle OF, Egharevba HO, Ahmadu PO. Standardization of herbal medicines - A review. Int J Biodivers Conserv 2012;4(3):101-112 View Article

243	Gupta M, Chaudhary P, Tawar MG, Shrivastava B. Need and scope of standardization of herbal medicines - A review. Int J Green Pharm 2022;15(4):346 View Article

244	European Medicines Agency. Guideline on quality of herbal medicinal products/traditional herbal medicinal products. London: EMA; 2021

245	U.S. Food and Drug Administration. Dietary Supplement Health and Education Act of 1994. Silver Spring (MD): FDA; 1994

246	Ministry of AYUSH, Government of India. General Guidelines for Safety/Toxicity evaluation of Ayurvedic formulation. New Delhi: Ministry of AYUSH; 2018

247	Parasuraman S, Thing GS, Dhanaraj SA. Polyherbal formulation: Concept of ayurveda. Pharmacogn Rev 2014;8(16):73-80 View Article PubMed/NCBI

248	Dossett ML, Cohen EM, Cohen J. Integrative Medicine for Gastrointestinal Disease. Prim Care 2017;44(2):265-280 View Article PubMed/NCBI

249	World Health Organization. Draft global traditional medicine strategy (2025-2034). Geneva: WHO; 2024

250	Wang C, Han Z, Wu Y, Lu X, Tang X, Xiao J, et al. Enhancing stability and anti-inflammatory properties of curcumin in ulcerative colitis therapy using liposomes mediated colon-specific drug delivery system. Food Chem Toxicol 2021;151:112123 View Article PubMed/NCBI

251	Mukherjee PK, Venkatesh P, Ponnusankar S. Ethnopharmacology and integrative medicine - Let the history tell the future. J Ayurveda Integr Med 2010;1(2):100-109 View Article PubMed/NCBI

252	Chaudhary K, Rajora A. Phytosomes: a critical tool for delivery of herbal drugs for cancer. Phytochem Rev 2025;24:165-195 View Article

253	Yang T, Qin N, Liu F, Zhao Y, Liu W, Fan D. Berberine regulates intestinal microbiome and metabolism homeostasis to treat ulcerative colitis. Life Sci 2024;338:122385 View Article PubMed/NCBI

254	Gangwal A, Lavecchia A. Artificial Intelligence in Natural Product Drug Discovery: Current Applications and Future Perspectives. J Med Chem 2025;68(4):3948-3969 View Article PubMed/NCBI

255	de Sousa Luis JA, Barros RPC, de Sousa NF, Muratov E, Scotti L, Scotti MT. Virtual Screening of Natural Products Database. Mini Rev Med Chem 2021;21(18):2657-2730 View Article PubMed/NCBI

256	Saini H, Tripathi R. The current era of AyurGenomics and AyurProteomics. Ayush J Integr Oncol 2024;1(1-2):10-12 View Article

257	Madgulwar YD, Shewalkar KJ. The intersection of Ayurveda and genomics: exploring Ayurgenomics for personalized health solutions. J Ayurveda Integr Med Sci 2024;9(10):168-177 View Article

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Balkrishna A, Srivastava D, Parveen R, Kukreti A, Sharma N. Herbal Approaches to Gastrointestinal Disorders: Integrating Tradition and Science. J Transl Gastroenterol. Published online: Nov 6, 2025. doi: 10.14218/JTG.2025.00030.

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Received	Revised	Accepted	Published
July 31, 2025	September 12, 2025	September 22, 2025	November 6, 2025

DOI http://dx.doi.org/10.14218/JTG.2025.00030

Journal of Translational Gastroenterology
eISSN 2994-8754

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Herbal Approaches to Gastrointestinal Disorders: Integrating Tradition and Science

Abstract

Graphical Abstract

Keywords

Introduction

Limitations of conventional therapies

Renewed interest in natural and traditional approaches

Method of literature search

Traditional systems of medicine in gastroenterology

Ayurveda

TCM

Unani and siddha systems

Other folk and ethnomedicinal practices

Classification of natural products used in GI disorders

Laxatives and carminatives

Antiemetic and antispasmodic herbs

Antiulcer and gastroprotective agents

Antimicrobial natural products for GI infections

Hepatoprotective and bile-modulating herbs

Prebiotics and gut microbiota modulators

Phytochemical and pharmacological basis of action

Modulation of inflammatory signaling pathways

Antioxidant effects

Gut microbiota modulation

Other mechanisms of action

Clinical evidence and human trials

Safety, toxicity, and herb-drug interactions

Regulatory and quality control aspects

Challenges, emerging trends, and future directions

Conclusions

Declarations

Acknowledgement

Funding

Conflict of interest

Authors’ contributions

References

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Table of Contents

Herbal Approaches to Gastrointestinal Disorders: Integrating Tradition and Science