**Author details**

Muhammad Akram1 , Muhammad Daniyal<sup>2</sup> \*, Aatiqa Ali3 , Iftikhar Ahmed Khan4 , Rida Zainab1 , Khan Usmanghani<sup>5</sup> and Wei Wang2

1 Department of Eastern Medicine, Directorate of Medical Sciences, Government College University Faisalabad, Pakistan

2 TCM and Ethnomedicine Innovation and Development International Laboratory, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China

3 Department of Eastern Medicine, Jinnah University for Women, Karachi, Pakistan

4 Department of Eastern Medicine, Faculty of Medical and Health Sciences, University of Poonch, Rawalakot, Azad Jammu and Kashmir, Pakistan

5 Herbion Pakistan (Pvt.) Ltd., Karachi, Pakistan

\*Address all correspondence to: daniyaldani151@yahoo.com

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**63**

2015;**102**:107-112

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

[11] Gupta PC, Sharma N, Rao CV. Pharmacognostic studies of the leaves and stem of *Careya arborea* Roxb. Asian Pacific Journal of Tropical Biomedicine.

[12] Zaidi MB, Estrada-García T. Shigella: A highly virulent and elusive pathogen. Current Tropical Medicine

of *Salmonella enterica* serotype Typhimurium-induced diarrhea. Infection and Immunity. 2003;**71**(1):1-12

[13] Zhang S et al. Molecular pathogenesis

[14] Vaishnavi C, Kaur S. *Clostridium perfringens* enterotoxin in antibioticassociated diarrhea. Indian Journal of Pathology and Microbiology.

[15] Thakkar S, Agrawal R. A case of *Staphylococcus aureus* enterocolitis: A rare entity. Gastroenterology &

[16] Haque R et al. Epidemiologic and clinical characteristics of acute diarrhea with emphasis on *Entamoeba histolytica* infections in preschool children in an urban slum of Dhaka, Bangladesh. The American Journal of Tropical Medicine and Hygiene. 2003;**69**(4):398-405

[17] Adam RD. Biology of *Giardia lamblia*. Clinical Microbiology Reviews.

[18] Lassailly G et al. Bariatric surgery reduces features of nonalcoholic

[19] Armstrong LE et al. Mild dehydration affects mood in healthy young women, 2. The Journal of Nutrition. 2011;**142**(2):382-388

[20] Levine AC et al. Ultrasound assessment of severe dehydration in

steatohepatitis in morbidly obese patients. Gastroenterology. 2015;**149**(2):379-388

2001;**14**(3):447-475

Hepatology. 2010;**6**(2):115

Reports. 2014;**1**(2):81-87

2012;**2**(5):404-408

2008;**51**(2):198

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

[1] Aranda-Michel J, Giannella RA. Acute diarrhea: A practical review. The American Journal of Medicine.

[3] Nataro JP, Kaper JB. Diarrheagenic *Escherichia coli*. Clinical Microbiology

[4] Gonçalves J et al. In vitro anti-rotavirus activity of some medicinal plants used in Brazil against diarrhea. Journal of Ethnopharmacology. 2005;**99**(3):403-407

[5] Ojewole JA, Awe EO, Chiwororo WD. Antidiarrhoeal activity of *Psidium guajava* Linn.(Myrtaceae) leaf aqueous extract in rodents. Journal of Smooth Muscle Research. 2008;**44**(6):195-207

[6] Jafari A, Aslani M, Bouzari S. *Escherichia coli*: A brief review of diarrheagenic pathotypes and their role in diarrheal diseases in Iran. Iranian Journal of Microbiology. 2012;**4**(3):102

[7] Haberberger R Jr et al. Etiology of acute diarrhea among United States Embassy personnel and dependents in Cairo, Egypt. The American Journal of Tropical Medicine and Hygiene.

[8] Hodges K, Gill R. Infectious diarrhea: Cellular and molecular mechanisms.

Gut Microbes. 2010;**1**(1):4-21

[9] Kovbasnjuk O et al. Human enteroids: Preclinical models of noninflammatory diarrhea. Stem Cell Research & Therapy. 2013;**4**(1):S3

[10] Moon C et al. Drug-induced secretory diarrhea: A role for CFTR. Pharmacological Research.

1994;**51**(6):870-874

1999;**106**(6):670-676

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Journal. 2009;**2**(1):9389

[2] Daryani NE et al. Colonic diverticular abscess presenting as chronic diarrhea: A case report. Cases

Reviews. 1998;**11**(1):142-201

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

## **References**

*Perspective of Recent Advances in Acute Diarrhea*

Data sharing not applicable to this article as no datasets were generated or

**Availability of data and material**

analyzed during the current study.

**Author details**

Rida Zainab1

Muhammad Akram1

**62**

provided the original work is properly cited.

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

, Muhammad Daniyal<sup>2</sup>

, Khan Usmanghani<sup>5</sup>

5 Herbion Pakistan (Pvt.) Ltd., Karachi, Pakistan

\*Address all correspondence to: daniyaldani151@yahoo.com

College University Faisalabad, Pakistan

\*, Aatiqa Ali3

and Wei Wang2

1 Department of Eastern Medicine, Directorate of Medical Sciences, Government

2 TCM and Ethnomedicine Innovation and Development International Laboratory, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China

3 Department of Eastern Medicine, Jinnah University for Women, Karachi, Pakistan

4 Department of Eastern Medicine, Faculty of Medical and Health Sciences, University of Poonch, Rawalakot, Azad Jammu and Kashmir, Pakistan

, Iftikhar Ahmed Khan4

,

[1] Aranda-Michel J, Giannella RA. Acute diarrhea: A practical review. The American Journal of Medicine. 1999;**106**(6):670-676

[2] Daryani NE et al. Colonic diverticular abscess presenting as chronic diarrhea: A case report. Cases Journal. 2009;**2**(1):9389

[3] Nataro JP, Kaper JB. Diarrheagenic *Escherichia coli*. Clinical Microbiology Reviews. 1998;**11**(1):142-201

[4] Gonçalves J et al. In vitro anti-rotavirus activity of some medicinal plants used in Brazil against diarrhea. Journal of Ethnopharmacology. 2005;**99**(3):403-407

[5] Ojewole JA, Awe EO, Chiwororo WD. Antidiarrhoeal activity of *Psidium guajava* Linn.(Myrtaceae) leaf aqueous extract in rodents. Journal of Smooth Muscle Research. 2008;**44**(6):195-207

[6] Jafari A, Aslani M, Bouzari S. *Escherichia coli*: A brief review of diarrheagenic pathotypes and their role in diarrheal diseases in Iran. Iranian Journal of Microbiology. 2012;**4**(3):102

[7] Haberberger R Jr et al. Etiology of acute diarrhea among United States Embassy personnel and dependents in Cairo, Egypt. The American Journal of Tropical Medicine and Hygiene. 1994;**51**(6):870-874

[8] Hodges K, Gill R. Infectious diarrhea: Cellular and molecular mechanisms. Gut Microbes. 2010;**1**(1):4-21

[9] Kovbasnjuk O et al. Human enteroids: Preclinical models of noninflammatory diarrhea. Stem Cell Research & Therapy. 2013;**4**(1):S3

[10] Moon C et al. Drug-induced secretory diarrhea: A role for CFTR. Pharmacological Research. 2015;**102**:107-112

[11] Gupta PC, Sharma N, Rao CV. Pharmacognostic studies of the leaves and stem of *Careya arborea* Roxb. Asian Pacific Journal of Tropical Biomedicine. 2012;**2**(5):404-408

[12] Zaidi MB, Estrada-García T. Shigella: A highly virulent and elusive pathogen. Current Tropical Medicine Reports. 2014;**1**(2):81-87

[13] Zhang S et al. Molecular pathogenesis of *Salmonella enterica* serotype Typhimurium-induced diarrhea. Infection and Immunity. 2003;**71**(1):1-12

[14] Vaishnavi C, Kaur S. *Clostridium perfringens* enterotoxin in antibioticassociated diarrhea. Indian Journal of Pathology and Microbiology. 2008;**51**(2):198

[15] Thakkar S, Agrawal R. A case of *Staphylococcus aureus* enterocolitis: A rare entity. Gastroenterology & Hepatology. 2010;**6**(2):115

[16] Haque R et al. Epidemiologic and clinical characteristics of acute diarrhea with emphasis on *Entamoeba histolytica* infections in preschool children in an urban slum of Dhaka, Bangladesh. The American Journal of Tropical Medicine and Hygiene. 2003;**69**(4):398-405

[17] Adam RD. Biology of *Giardia lamblia*. Clinical Microbiology Reviews. 2001;**14**(3):447-475

[18] Lassailly G et al. Bariatric surgery reduces features of nonalcoholic steatohepatitis in morbidly obese patients. Gastroenterology. 2015;**149**(2):379-388

[19] Armstrong LE et al. Mild dehydration affects mood in healthy young women, 2. The Journal of Nutrition. 2011;**142**(2):382-388

[20] Levine AC et al. Ultrasound assessment of severe dehydration in children with diarrhea and vomiting. Academic Emergency Medicine. 2010;**17**(10):1035-1041

[21] Gasparinho C et al. Etiology of diarrhea in children younger than 5 years attending the Bengo General Hospital in Angola. The Pediatric Infectious Disease Journal. 2016;**35**(2):e28-e34

[22] Ahmed T et al. Management of severe malnutrition and diarrhea. The Indian Journal of Pediatrics. 2001;**68**(1):45-51

[23] Kato J et al. Is sigmoidoscopy sufficient for evaluating inflammatory status of ulcerative colitis patients? Journal of Gastroenterology and Hepatology. 2011;**26**(4):683-687

[24] Mulla WA et al. Evaluation of antidiarrheal and in vitro antiprotozoal activities of extracts of leaves of *Alocasia indica*. Pharmaceutical Biology. 2011;**49**(4):354-361

[25] Davies M, Mayne A. Oral rehydration therapy. Archives of Disease in Childhood. 2001;**84**(3):199

[26] Baker DE. Loperamide: A pharmacological review. Reviews in Gastroenterological Disorders. 2007;**7**:S11-S18

[27] Kimura M, Nakamura T, Nawa Y. Experience with intravenous metronidazole to treat moderate-tosevere amebiasis in Japan. The American Journal of Tropical Medicine and Hygiene. 2007;**77**(2):381-385

[28] Pichler H, Diridl G, Wolf D. Ciprofloxacin in the treatment of acute bacterial diarrhea: A double blind study. Wiesbaden: Vieweg+ Teubner Verlag; Ciprofloxacin. V 1986. pp. 112-114

[29] Bartels MC, Mergenhagen KA. Octreotide for symptomatic treatment of diarrhea due to *Cytomegalovirus* 

*colitis*. Annals of Pharmacotherapy. 2011;**45**(1):126-126

[30] Harford WV et al. Acute effect of diphenoxylate with atropine (Lomotil) in patients with chronic diarrhea and fecal incontinence. Gastroenterology. 1980;**78**(3):440-443

[31] Schultz AA et al. Effects of pectin on diarrhea in critically ill tubefed patients receiving antibiotics. American Journal of Critical Care. 2000;**9**(6):403

[32] Rahman M et al. Antidiarrhoeal activity of the bark extract of *Careya arborea* Roxb. Fitoterapia. 2003;**74**(1-2):116-118

[33] Gulfraz M et al. Comparison of the antidiabetic activity of *Berberis lyceum* root extract and berberine in alloxaninduced diabetic rats. Phytotherapy Research. 2008;**22**(9):1208-1212

[34] Asif A et al. Wound healing activity of root extracts of *Berberis lyceum* Royle in rats. Phytotherapy Research. 2007;**21**(6):589-591

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[37] Patwardhan B et al. Clinical evaluation of *Terminalia belerica* in diarrhoea. Ancient Science of Life. 1990;**10**(2):94

[38] Misar A, Bhagat R, Mujumdar A. Antidiarrhoeal activity of *Acacia nilotica* Willd. bark methanol extract. Hindustan Antibiotics Bulletin. 2007;**49**(1-4):14-20

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An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives. 1999;**13**(4):292-295

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[49] Mandal SC, Kumar CA. Studies on anti-diarrhoeal activity of *Ficus hispida.* Leaf extract in rats. Fitoterapia.

[50] Gilani AH et al. Mechanisms underlying the antispasmodic and bronchodilatory properties of *Terminalia bellerica* fruit. Journal of Ethnopharmacology.

[51] Nampoothiri SV et al. In vitro antioxidant and inhibitory potential of *Terminalia bellerica* and *Emblica officinalis* fruits against LDL oxidation and key enzymes linked to type 2 diabetes. Food and Chemical Toxicology. 2011;**49**(1):125-131

[52] Babu DR et al. Antidiarrheal activity of *Cynodon dactylon*. pers. Pharmacognosy Magazine.

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Sciences. 2005;**8**(1):39-46

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*mauritiana* root extract in rodents. African Journal of Biotechnology. 2006;(**5**):10

[54] Venkatesan N et al. Anti-diarrhoeal potential of *Asparagus racemosus* wild root extracts in laboratory animals. Journal of Pharmacy & Pharmaceutical

2002;**73**(7-8):663-667

2008;**116**(3):528-538

2009;**5**(19):23

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

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[41] Ahmad S, Mika D. Chemoprotective and immunomodulatory effect of *Acacia nilotica* during cyclophosphamide induced toxicity. Journal of

Experimental Therapeutics & Oncology.

[42] Bello I et al. Mechanisms underlying the antihypertensive effect of *Alstonia scholaris*. Journal of Ethnopharmacology. 2015;**175**:422-431

2006;**108**(2):311-315

2010;**1**(1):41

[43] Ghule B et al. Immunostimulant effects of *Capparis zeylanica* Linn. leaves. Journal of Ethnopharmacology.

[44] Sharma P et al. Antidiarrhoeal activity of leaf extract of *Celosia Argentea* in experimentally induced diarrhoea in rats. Journal of Advanced Pharmaceutical Technology & Research.

[45] Priya KS, Babu M, Wells A. 136 *Celosia argentea* Linn. Leaf Extract Improves Wound Healing in Rat Burn Wound Model. Wound Repair and Regeneration. 2004;**12**(2):A35-A35

[46] Sini KR, Sinha BN, Rajasekaran A. Antidiarrheal activity of *Capparis zeylanica* leaf extracts. Journal of Advanced Pharmaceutical Technology

[47] Akah P, Aguwa C, Agu R. Studies on the antidiarrhoeal properties of *Pentaclethra macrophylla* leaf extracts. Phytotherapy Research:

& Research. 2011;**2**(1):39

[39] Shah AJ et al. Calcium channel blocking activity of *Mentha longifolia L.* explains its medicinal use in diarrhoea and gut spasm. Phytotherapy Research.

2010;**24**(9):1392-1397

2016;**86**:443-453

2012;**10**(2)

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

[39] Shah AJ et al. Calcium channel blocking activity of *Mentha longifolia L.* explains its medicinal use in diarrhoea and gut spasm. Phytotherapy Research. 2010;**24**(9):1392-1397

*Perspective of Recent Advances in Acute Diarrhea*

*colitis*. Annals of Pharmacotherapy.

[30] Harford WV et al. Acute effect of diphenoxylate with atropine (Lomotil) in patients with chronic diarrhea and fecal incontinence. Gastroenterology.

[31] Schultz AA et al. Effects of pectin on diarrhea in critically ill tubefed patients receiving antibiotics. American Journal of Critical Care.

[32] Rahman M et al. Antidiarrhoeal activity of the bark extract of *Careya arborea* Roxb. Fitoterapia.

[33] Gulfraz M et al. Comparison of the antidiabetic activity of *Berberis lyceum* root extract and berberine in alloxaninduced diabetic rats. Phytotherapy Research. 2008;**22**(9):1208-1212

[34] Asif A et al. Wound healing activity of root extracts of *Berberis lyceum* Royle in rats. Phytotherapy Research.

Ethnomedicinal uses of plant resources

2011;**45**(1):126-126

1980;**78**(3):440-443

2000;**9**(6):403

2003;**74**(1-2):116-118

2007;**21**(6):589-591

2012;**6**(29):4540-4549

1999;**68**(1-3):205-208

1990;**10**(2):94

2007;**49**(1-4):14-20

[35] Shedayi AA, Gulshan B.

[36] Das AK et al. Studies on antidiarrhoeal activity of *Punica granatum* seed extract in rats. Journal of Ethnopharmacology.

[37] Patwardhan B et al. Clinical evaluation of *Terminalia belerica* in diarrhoea. Ancient Science of Life.

[38] Misar A, Bhagat R, Mujumdar A. Antidiarrhoeal activity of *Acacia nilotica* Willd. bark methanol extract. Hindustan Antibiotics Bulletin.

in Gilgit-Baltistan of Pakistan. Journal of Medicinal Plant Research.

children with diarrhea and vomiting. Academic Emergency Medicine.

[21] Gasparinho C et al. Etiology of diarrhea in children younger than 5 years attending the Bengo General Hospital in Angola. The Pediatric Infectious Disease

[22] Ahmed T et al. Management of severe malnutrition and diarrhea. The Indian Journal of Pediatrics.

[23] Kato J et al. Is sigmoidoscopy sufficient for evaluating inflammatory status of ulcerative colitis patients? Journal of Gastroenterology and Hepatology. 2011;**26**(4):683-687

[24] Mulla WA et al. Evaluation of antidiarrheal and in vitro antiprotozoal activities of extracts of leaves of

[25] Davies M, Mayne A. Oral

in Childhood. 2001;**84**(3):199

[26] Baker DE. Loperamide: A pharmacological review. Reviews in Gastroenterological Disorders.

Experience with intravenous metronidazole to treat moderate-tosevere amebiasis in Japan. The American

Journal of Tropical Medicine and Hygiene. 2007;**77**(2):381-385

[28] Pichler H, Diridl G, Wolf D. Ciprofloxacin in the treatment of acute bacterial diarrhea: A double blind study. Wiesbaden: Vieweg+ Teubner Verlag; Ciprofloxacin. V 1986.

[29] Bartels MC, Mergenhagen KA. Octreotide for symptomatic treatment of diarrhea due to *Cytomegalovirus* 

*Alocasia indica*. Pharmaceutical Biology.

rehydration therapy. Archives of Disease

[27] Kimura M, Nakamura T, Nawa Y.

2010;**17**(10):1035-1041

Journal. 2016;**35**(2):e28-e34

2001;**68**(1):45-51

2011;**49**(4):354-361

2007;**7**:S11-S18

**64**

pp. 112-114

[40] Barapatre A et al. In vitro evaluation of antioxidant and cytotoxic activities of lignin fractions extracted from *Acacia nilotica*. International Journal of Biological Macromolecules. 2016;**86**:443-453

[41] Ahmad S, Mika D. Chemoprotective and immunomodulatory effect of *Acacia nilotica* during cyclophosphamide induced toxicity. Journal of Experimental Therapeutics & Oncology. 2012;**10**(2)

[42] Bello I et al. Mechanisms underlying the antihypertensive effect of *Alstonia scholaris*. Journal of Ethnopharmacology. 2015;**175**:422-431

[43] Ghule B et al. Immunostimulant effects of *Capparis zeylanica* Linn. leaves. Journal of Ethnopharmacology. 2006;**108**(2):311-315

[44] Sharma P et al. Antidiarrhoeal activity of leaf extract of *Celosia Argentea* in experimentally induced diarrhoea in rats. Journal of Advanced Pharmaceutical Technology & Research. 2010;**1**(1):41

[45] Priya KS, Babu M, Wells A. 136 *Celosia argentea* Linn. Leaf Extract Improves Wound Healing in Rat Burn Wound Model. Wound Repair and Regeneration. 2004;**12**(2):A35-A35

[46] Sini KR, Sinha BN, Rajasekaran A. Antidiarrheal activity of *Capparis zeylanica* leaf extracts. Journal of Advanced Pharmaceutical Technology & Research. 2011;**2**(1):39

[47] Akah P, Aguwa C, Agu R. Studies on the antidiarrhoeal properties of *Pentaclethra macrophylla* leaf extracts. Phytotherapy Research:

An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives. 1999;**13**(4):292-295

[48] Ali M, Chaudhary N. *Ficus hispida* Linn.: A review of its pharmacognostic and ethnomedicinal properties. Pharmacognosy Reviews. 2011;**5**(9):96

[49] Mandal SC, Kumar CA. Studies on anti-diarrhoeal activity of *Ficus hispida.* Leaf extract in rats. Fitoterapia. 2002;**73**(7-8):663-667

[50] Gilani AH et al. Mechanisms underlying the antispasmodic and bronchodilatory properties of *Terminalia bellerica* fruit. Journal of Ethnopharmacology. 2008;**116**(3):528-538

[51] Nampoothiri SV et al. In vitro antioxidant and inhibitory potential of *Terminalia bellerica* and *Emblica officinalis* fruits against LDL oxidation and key enzymes linked to type 2 diabetes. Food and Chemical Toxicology. 2011;**49**(1):125-131

[52] Babu DR et al. Antidiarrheal activity of *Cynodon dactylon*. pers. Pharmacognosy Magazine. 2009;**5**(19):23

[53] Dahiru D, Sini J, John-Africa L. Antidiarrhoeal activity of *Ziziphus mauritiana* root extract in rodents. African Journal of Biotechnology. 2006;(**5**):10

[54] Venkatesan N et al. Anti-diarrhoeal potential of *Asparagus racemosus* wild root extracts in laboratory animals. Journal of Pharmacy & Pharmaceutical Sciences. 2005;**8**(1):39-46

[55] Uddin S et al. Antidiarrhoeal activity of the methanol extract of the barks of *Xylocarpus moluccensis* in castor oil-and magnesium sulphateinduced diarrhoea models in mice. Journal of Ethnopharmacology. 2005;**101**(1-3):139-143

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Section 5

Prevention of Acute Diarrhea

**67**

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Section 5
