*1.5.5 Mentha longifolia*

*Perspective of Recent Advances in Acute Diarrhea*

It is available in tablets containing diphenoxylate and atropine. Atropine is added to discourage the addiction liability with diphenoxylate. This combination of

Kaolin, pectin, chalk, ispaghula, methylcellulose, and sterculia can be used in the treatment of diarrhea, but their effect is weak. Ispaghula, methylcellulose, and sterculia are used in cases of diverticular disease, ileostomy, and colostomy [31].

**1.5 Medicinal plants with antidiarrheal and related beneficial properties**

It belongs to family Lecythidaceae. Leaves and stem are used treat diarrhea. Chemical constituents contain flavonoids, tannins, saponins, and triterpenoids. It is used in bronchitis, cancer, wounds, dysentery, jaundice, diarrhea, boil, ulcer, filaria, swelling, fever, ear pain, skin diseases, stomach diseases, smallpox, body pain, rheumatic pain, eye complaints, asthma, and dental disorders. It is anthelmintic, demulcent, tonic, anticancer, antipyretic, antidiarrheal, antioxidant, antileishmanial, hepatoprotective, and analgesic [11]. The methanol extract of this plant was used for study. Mice were selected for study. Castor oil-induced diarrhea was prevented by the use of *Careya arborea* Roxb. bark. This study indicated that plant has antidiarrheal activity [32].

It belongs to family Berberidaceae. Roots, fruits, leaves, and stem are used to treat diarrhea. Chemical constituents contain palmitine, berberine, iron, zinc, calcium, and vitamin C. It is used in gonorrhea, chronic diarrhea, piles, broken bones, wounds, acute conjunctivitis, jaundice, and diabetes [33]. Pharmacological activities include antioxidant, antidiarrheal, and wound healer [34]. Arshad et al.

It belongs to family Lythraceae. Parts used are twig exudates, fruit, flowers, and

It belongs to family Boraginaceae. Parts used are roots. Chemical constituents contain lanast-5-en-3β-D-glucopyranosyl-21 (24)-olide, stigmast-5-en-3β-ol-23-one,

stem. Chemical constituents contain copper, potassium, phosphorus, sulfur, carotene, vitamin c, fiber, pectin, pelletierine, isopelletierine, iron, calcium, magnesium, calcium, and carbohydrates. It is used in diabetes mellitus, cancer, and cardiovascular disorders. It is antiviral, antibacterial, antidiabetic, chemopreventive, antioxidant, and cardioprotective [36] reported the antidiarrheal activity of *Punica granatum* seed extract in rats. Methanol extract of this plant was used for antidiarrheal activity. Rat models were selected for study. Castor oil-induced diarrhea was prevented by the use of *Punica granatum* seed extract. Charcoal meal test was also performed in rats. Gastrointestinal motility was decreased in rat by the use

of extract. This study indicated that plant has antidiarrheal activity.

reported the ethnomedicinal use of this plant in diarrhea [35].

diphenoxylate with atropine is known as co-phenotrope [30].

*1.4.4 Diphenoxylate*

*1.4.5 Adsorbents*

*1.5.1 Careya arborea Roxb*

*1.5.2 Berberis lyceum Royle*

*1.5.3 Punica granatum*

*1.5.4 Trichodesma indicum*

**58**

It belongs to family Lamiaceae. Parts used are dried leaves and young twigs. It is used in diarrhea and dysentery. It is carminative, stimulant, antipyretic, antinociceptive, cytotoxic, insecticidal, calcium channel blocker, and antimicrobial [38]. *M. longifolia* was investigated for its efficacy to treat diarrhea. For this purpose, diarrhea was induced by castor oil. About 100–1000 mg/kg of *M. longifolia* extract exhibited antidiarrheal effect similar to loperamide. High potassium-induced jejunum contraction was inhibited in isolated rabbit jejunum preparations. This indicated its antispasmodic activity through blockage of calcium channels. Calcium concentration curve was shifted rightward with the use of *Mentha longifolia.* This response was similar to verapamil. Inhibition of high K-induced contraction and shifting of calcium concentration curve rightward was also observed by the use of loperamide. Most active fraction was petroleum spirit. This study showed *M. longifolia* antispasmodic and antidiarrheal potential via calcium channel blockade [39].

## *1.5.5.1 Acacia nilotica Willd*

It belongs to family Mimosaceae. Parts used are leaves and pods. It is used in diarrhea, dysentery, gonorrhea, diabetes mellitus, sore throat, and cancer [40]. It is anti-plasmodial, chemopreventive, larvicidal, antidiarrheal, hypotensive, and immunomodulant [41]. Antidiarrheal activity of *Acacia nilotica* was investigated. Aqueous, methanol, and petroleum ether extracts were used. Methanol extract exhibited significant antidiarrheal activity. Diarrhea was induced by magnesium sulfate and castor oil. Peristalsis was induced by barium chloride in Swiss albino mice. Antimicrobial activity of *A. nilotica* was investigated against diarrhea-causing organisms. Extract exhibited antidiarrheal potential against magnesium and castor oil-induced diarrhea. Barium chloride peristaltic movements in mice were also reduced by the use of extract. Extract also showed antimicrobial potential against diarrhea-causing organisms. This study validates its use in diarrhea in traditional system of medicine [38].

### *1.5.5.2 Alstonia scholaris*

It belongs to family Apocynaceae. Parts used are barks. Chemical constituents contain porphyrin, alstonine, echitamine, picrinine, detamine, and strictamine. This plant has been used in diarrhea, dysentery, and hypertension [42]. It is bronchodilator, antimalarial, spasmolytic, antidiarrheal, anticancer, and neuroleptic. Castor oil-induced diarrhea was prevented by the crude extract of *Alstonia scholaris.* Effective dose of extract was 100–1000 mg/kg. The activity of extract was comparable to standard drug loperamide. This study indicated that plant can be used in diarrhea [39].

### *1.5.5.3 Capparis zeylanica L*

It belongs to family Capparaceae. Parts used are flowers and leaves. It is used in diarrhea, cardiovascular disorders, and pyrexia. It is antidiarrheal, antipyretic, antimicrobial, anti-ulcer, and immunostimulant [43]. Methanolic extract of this plant

was used for antidiarrheal activity. The activity of plant extract was investigated in castor-induced diarrhea. Mice were selected for study. There was significant reduction in diarrhea in mice. Three level doses (100, 150, and 200 mg/kg) of extract were used for activity. Extract prevented castor oil-induced diarrhea. This activity of plant was comparable to loperamide-treated animals. Intestinal transit was decreased up to 75.97%. This study indicated that plant is effective in diarrhea [44].

#### *1.5.5.4 Celosia argentea Linn*

It belongs to family Amaranthaceae. Parts used are seeds. It is used in hypertension, inflammation, jaundice, ulcer, skin eruption, and diarrhea. It is antioxidant, antidiarrheal, immunomodulant, antimetastatic, antidiabetic, and wound healer [45]. Alcoholic extract of plant was used for study. Different experimental models were used. Diarrhea was induced by castor oil and PGE (2). Loperamide at dose of 2 mg/kg and atropine at dose of 0.1 mg/kg were used as standard drugs. Two level doses (100 and 200 mg/kg) of extract were used for antidiarrheal activity. Antidiarrheal activity of extract was dose-dependent. This study indicated that plant has antidiarrheal activity [46].

#### *1.5.5.5 Pentaclethra macrophylla*

It belongs to family Leguminosae. Parts used are leaves and roots. Chemical constituents contain fatty acids, iodine, oil, and carbohydrates. It is used in pruritis, worms, dysentery, cancer, and inflammation. It is antidiarrheal and antidiabetic. Akah et al. reported the antidiarrheal properties of *Pentaclethra macrophylla* leaf extracts. Aqueous and ethanolic extracts of this plant were used for study. Experimental animal models were selected for study. There was significant reduction in fecal output. Extract-treated rats were protected from castor oil-induced diarrhea. Propulsive movements of gastrointestinal contents were significantly decreased in mice. Contractions induced by histamine, nicotine, and acetylcholine were significantly reduced by the use of this extract on isolated tissue preparations. Growth of common pathogenic microorganisms was inhibited. This study showed that plant has antidiarrheal activity [47].

#### *1.5.5.6 Ficus hispida*

It belongs to family Moraceae. Parts used are leaves. Chemical constituents contain wax, tannin, caoutchouc acid, glucoside, beta-sitosterol, hispidin, bergapten, and psoralen latex. It is used in ulcer, psoriasis, anemia, piles, jaundice, hemorrhage, vitiligo, diarrhea, diabetes, epilepsy, and hepatitis**.** It is antidiuretic, antibacterial, anti-inflammatory, hypolipidemic, memory enhancer, hepatoprotective, and anticancer [48]. Methanol extract of this plant was used for study. Diarrhea was induced by castor oil. Enteropooling was induced by PGE (2). This study was conducted in rats. Extract prevented diarrhea and enteropooling induced by castor oil and PGE (2). Charcoal meal test was also performed. Gastrointestinal motility was also reduced by the use of this extract. This study indicated that plant has antidiarrheal activity [49].

#### *1.5.5.7 Terminalia bellirica*

It belongs to family Combretaceae. Parts used are fruit. Chemical constituents contain tannins, beta-sitosterol, chebulagic acid, ethyl gallate, ellagic acid, and gallic acid. It is used in jaundice, tuberculosis, and inflammation. It is antidiarrheal,

**61**

*Current Knowledge and Therapeutic Strategies of Herbal Medicine for Acute Diarrhea*

antioxidant, antispasmodic, hypoglycemic, and bronchodilator [50, 51].

This study indicated that plants are useful for diarrhea and dysentery.

the active constituents responsible for efficacy to treat diarrhea.

Authors declare that there is no conflict of interest.

**Ethics approval and consent to participate**

There is no identifying information.

This review has revealed that medicinal plants continue to play a vital role in the primary health care of the people. More than half of the people in the world use medicinal plants regularly to treat many ailments, including diarrhea. Hence, further work should be done on the characterization and pharmacological validation of the use of medicinal plants for the treatment of diarrhea. Medicinal plants have potential to treat diarrhea and are prescribed by Unani physician all over the world. Improving hygienic condition prevents diarrhea. Documentation of medicinal plants used to treat diarrhea will help the physician in their practice. There is only description of medicinal plants, but further study should be carried out to find

We acknowledge the Dean Faculty of Medical and Health Sciences for giving

Antidiarrheal activity of plant was investigated. The activity of this plant was also investigated against *E. histolytica*. The activity of plant was investigated against bacteria that cause dysentery and diarrhea. Initially in vitro studies were performed. Furthermore, plant activity was evaluated in clinical trial. Patients having acute and chronic diarrhea and dysentery were selected for study. This study was performed by five medical practitioners. These practitioners were practicing at different clinics. This study was conducted in urban areas of Pune. Clinical trial protocol was given to practitioners. Maximum duration of treatment was 14 days. Bioactive fractions of this plant were used for clinical trial. Tablet was made from bioactive fractions. Tablet was given three times a day at dose of 150 mg. Improvement was observed on second day of treatment. This drug was found effective in diarrhea. Seven patients having amebic dysentery were also recovered attend of treatment.

*DOI: http://dx.doi.org/10.5772/intechopen.82649*

**2. Conclusion**

**Acknowledgements**

**Competing interests**

Not Applicable.

**Consent for publication**

**Funding**

permission to conduct research.

There is no funding source.

*Current Knowledge and Therapeutic Strategies of Herbal Medicine for Acute Diarrhea DOI: http://dx.doi.org/10.5772/intechopen.82649*

antioxidant, antispasmodic, hypoglycemic, and bronchodilator [50, 51]. Antidiarrheal activity of plant was investigated. The activity of this plant was also investigated against *E. histolytica*. The activity of plant was investigated against bacteria that cause dysentery and diarrhea. Initially in vitro studies were performed. Furthermore, plant activity was evaluated in clinical trial. Patients having acute and chronic diarrhea and dysentery were selected for study. This study was performed by five medical practitioners. These practitioners were practicing at different clinics. This study was conducted in urban areas of Pune. Clinical trial protocol was given to practitioners. Maximum duration of treatment was 14 days. Bioactive fractions of this plant were used for clinical trial. Tablet was made from bioactive fractions. Tablet was given three times a day at dose of 150 mg. Improvement was observed on second day of treatment. This drug was found effective in diarrhea. Seven patients having amebic dysentery were also recovered attend of treatment. This study indicated that plants are useful for diarrhea and dysentery.

## **2. Conclusion**

*Perspective of Recent Advances in Acute Diarrhea*

*1.5.5.4 Celosia argentea Linn*

plant has antidiarrheal activity [46].

that plant has antidiarrheal activity [47].

*1.5.5.6 Ficus hispida*

has antidiarrheal activity [49].

*1.5.5.7 Terminalia bellirica*

*1.5.5.5 Pentaclethra macrophylla*

was used for antidiarrheal activity. The activity of plant extract was investigated in castor-induced diarrhea. Mice were selected for study. There was significant reduction in diarrhea in mice. Three level doses (100, 150, and 200 mg/kg) of extract were used for activity. Extract prevented castor oil-induced diarrhea. This activity of plant was comparable to loperamide-treated animals. Intestinal transit was decreased up

It belongs to family Amaranthaceae. Parts used are seeds. It is used in hypertension, inflammation, jaundice, ulcer, skin eruption, and diarrhea. It is antioxidant, antidiarrheal, immunomodulant, antimetastatic, antidiabetic, and wound healer [45]. Alcoholic extract of plant was used for study. Different experimental models were used. Diarrhea was induced by castor oil and PGE (2). Loperamide at dose of 2 mg/kg and atropine at dose of 0.1 mg/kg were used as standard drugs. Two level doses (100 and 200 mg/kg) of extract were used for antidiarrheal activity. Antidiarrheal activity of extract was dose-dependent. This study indicated that

It belongs to family Leguminosae. Parts used are leaves and roots. Chemical constituents contain fatty acids, iodine, oil, and carbohydrates. It is used in pruritis, worms, dysentery, cancer, and inflammation. It is antidiarrheal and antidiabetic. Akah et al. reported the antidiarrheal properties of *Pentaclethra macrophylla* leaf extracts. Aqueous and ethanolic extracts of this plant were used for study. Experimental animal models were selected for study. There was significant reduction in fecal output. Extract-treated rats were protected from castor oil-induced diarrhea. Propulsive movements of gastrointestinal contents were significantly decreased in mice. Contractions induced by histamine, nicotine, and acetylcholine were significantly reduced by the use of this extract on isolated tissue preparations. Growth of common pathogenic microorganisms was inhibited. This study showed

It belongs to family Moraceae. Parts used are leaves. Chemical constituents contain wax, tannin, caoutchouc acid, glucoside, beta-sitosterol, hispidin, bergapten, and psoralen latex. It is used in ulcer, psoriasis, anemia, piles, jaundice, hemorrhage, vitiligo, diarrhea, diabetes, epilepsy, and hepatitis**.** It is antidiuretic, antibacterial, anti-inflammatory, hypolipidemic, memory enhancer, hepatoprotective, and anticancer [48]. Methanol extract of this plant was used for study. Diarrhea was induced by castor oil. Enteropooling was induced by PGE (2). This study was conducted in rats. Extract prevented diarrhea and enteropooling induced by castor oil and PGE (2). Charcoal meal test was also performed. Gastrointestinal motility was also reduced by the use of this extract. This study indicated that plant

It belongs to family Combretaceae. Parts used are fruit. Chemical constituents contain tannins, beta-sitosterol, chebulagic acid, ethyl gallate, ellagic acid, and gallic acid. It is used in jaundice, tuberculosis, and inflammation. It is antidiarrheal,

to 75.97%. This study indicated that plant is effective in diarrhea [44].

**60**

This review has revealed that medicinal plants continue to play a vital role in the primary health care of the people. More than half of the people in the world use medicinal plants regularly to treat many ailments, including diarrhea. Hence, further work should be done on the characterization and pharmacological validation of the use of medicinal plants for the treatment of diarrhea. Medicinal plants have potential to treat diarrhea and are prescribed by Unani physician all over the world. Improving hygienic condition prevents diarrhea. Documentation of medicinal plants used to treat diarrhea will help the physician in their practice. There is only description of medicinal plants, but further study should be carried out to find the active constituents responsible for efficacy to treat diarrhea.

#### **Acknowledgements**

We acknowledge the Dean Faculty of Medical and Health Sciences for giving permission to conduct research.

#### **Competing interests**

Authors declare that there is no conflict of interest.

#### **Funding**

There is no funding source.

#### **Ethics approval and consent to participate**

Not Applicable.

#### **Consent for publication**

There is no identifying information.
