Treatment of Patients with Refractory Functional Dyspepsia Using Nardostachys jatamansi (D.Don) DC. Hydroalcoholic Extract: A Case Series
Abstract
Functional dyspepsia (FD) is a highly prevalent condition with high impact on healthcare costs. Considering the complimentary therapies options like phytotherapy, this study aimed to investigate the efficacy and safety of Nardostachys jatamansi (D.Don) DC. extract in sixteen FD patients. The subjects received capsules of 500 mg N. Jatamansi, 3 times daily before meals for 30 days. The severity of early satiation and postprandial fullness were assessed by self-report of improvement at least 50% of symptoms and other FD symptoms assessed by Gastrointestinal Symptom Rating Scale (GSRS) before intervention and at end of treatment. The mean GSRS score level decreased significantly after intervention among study population. Five patients had chief complaint of early satiety and post prandial fullness who all of them reported 50% improvement. According to the results N. jatamansi seems to be effective in patients with refractory FD. Randomized clinical studies seem to be required.
Kumar A, Pate J, Sawant P. Epidemiology of functional dyspepsia. J Assoc Physicians India 2012 ;60(suppl):9-12.
Mahadeva S, Goh KL. Epidemiology of functional dyspepsia: a global perspective. World J Gastroenterol 2006;12:2661.
Lacy BE, Weiser KT, Kennedy AT, Crowell MD, Talley NJ. Functional dyspepsia: the economic impact to patients. Aliment Pharmacol Ther 2013;38:170-177.
El‐Serag HB, Talley NJ. The prevalence and clinical course of functional dyspepsia. Aliment Pharmacol Ther 2004;19:643-654.
Toghiani A, Maleki I, Afshar H, Kazemian A, Translation and validation of the Farsi version of Rome III diagnostic questionnaire for the adult functional gastrointestinal disorders, J Res Med Sci 2016;21:104.
Amini E, Keshteli AH, Jazi MS, Jahangiri P, Adibi P. Dyspepsia in Iran: SEPAHAN systematic review No 3. Int J Prev Med. 2012;3(Suppl1):S18.
Mostafa R. Rome III: The functional gastrointestinal disorders, third edition, 2006. World J Gastroenterol 2008;14:2124-2125.
Futagami S, Yamawaki H, Agawa S, Higuchi K, Ikeda G, Noda H. New classification Rome IV functional dyspepsia and subtypes. Transl Gastroenterol Hepatol 2018;3:70.
Aziz I, Palsson OS, Tornblom H, Sperber AD, Whitehead WE, Simren M. Epidemiology, clinical characteristics, and associations for symptom-based Rome IV functional dyspepsia in adults in the USA, Canada, and the UK: a cross-sectional population-based study. Lancet Gastroenterol Hepatol 2018;3:252-262.
Quartero AO, de Wit NJ, Lodder AC, Numans ME, Smout AJ, Hoes AW. Disturbed solid-phase gastric emptying in functional dyspepsia: a meta-analysis. Dig Dis Sci 1998;43:2028-2033.
Sarnelli G, Caenepeel P, Geypens B, Janssens J, Tack J. Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia. Am J Gastroenterol 2003;98:783-788.
Lacy BE, Talley NJ, Locke GR, Bouras EP, DiBaise JK, El-Serag HB. Review article: current treatment options and management of functional dyspepsia. Aliment Pharmacol Ther 2012;36:3-15.
Talley NJ, Goodsall T, Potter M. Functional dyspepsia. Aust Prescr 2017;40:209-213.
May B, Kohler S, Schneider B. Efficacy and tolerability of a fixed combination of peppermint oil and caraway oil in patients suffering from functional dyspepsia. Aliment Pharmacol Ther 2000;14:1671-1677.
Jin M, Son M. DA-9701 (Motilitone): A Multi-Targeting Botanical Drug for the Treatment of Functional Dyspepsia. Int J Mol Sci 2018;19:4035.
Rösch W, Liebregts T, Gundermann KJ, Vinson B, Holtmann G. Phytotherapy for functional dyspepsia: a review of the clinical evidence for the herbal preparation STW5. Phytomedicine 2006; 24:114-121.
Chu MH, Wu IX, Ho RS, Wong CH, Zhang AL, Zhang Y, Wu JC, Chung VC. Chinese herbal medicine for functional dyspepsia: systematic review of systematic reviews. Ther Adv Gastroenterol 2018;13:1-24.
Mohtashami R, Huseini HF, Heydari M, Amini M, Sadeqhi Z, Ghaznavi H, Mehrzadi S. Efficacy and safety of honey based formulation of Nigella sativa seed oil in functional dyspepsia: A double blind randomized controlled clinical trial. J Ethnopharmacol 2015;4:147-152.
Pasalar M, Choopani R, Mosaddegh M, Kamalinejad M, ohagheghzadeh A, Fattahi MR, Ghanizadeh A, Lankarani KB. Efficacy and Safety of jollab to treat functional dyspepsia: a randomized placebo–controlled clinical trial. Explore 2015;11:199-207.
Ghoshegir SA, Mazaheri M, Ghannadi A, Feizi A, Babaeian M, Tanhaee M, Karimi M, Adibi P. Pimpinella anisum in the treatment of functional dyspepsia: A double-blind, randomized clinical trial. J Res Med Sci 2015;20:13.
Azimi M, javad Zahedi M, Mehrabani M, Tajadini H, Zolala F, reza Baneshi M, Choopani R, Sharififar F, Asadipour A, mahdi Hayatbakhsh M, Ahmadi B. Effect of Apium graveolens and Trachyspermum copticom on clinical symptoms of patients with functional dyspepsia. Avicenna J Phytomed 2017;7:554-564.
Sahu R, Dhongade HJ, Pandey A, Sahu P, Sahu V, Patel D. Medicinal properties of Nardostachys jatamansi (a review). Orient J Chem 2016;32:859-866.
Nakoti SS, Juyal D, Josh AK. A review on pharmacognostic and phytochemical study of a plant Nardostachys Jatamansi. J Pharma Innov 2017;6:936-941.
Pandey MM, Katara A, Pandey G, Rastogi S, Rawat AK. An important Indian traditional drug of ayurveda jatamansi and its substitute bhootkeshi: chemical profiling and antioxidant activity. Evid Based Complementary Altern Med 2013;2013:142517.
Jalali S, Zarrinhaghighi A, Sadraei S, Ghasemi Y, Sakhteman A, Faridi P. A system pharmacology study for deciphering anti depression activity of Nardostachys jatamansi. Curr Drug Metab 2018 ;19:469-476.
Memariani Z, Hajimahmoodi M, Minaee B, Khodagholi F, Yans A, Rahimi R, Amin G, Moghaddam G, Toliyat T, Sharifzadeh M. Protective effect of a polyherbal traditional formula consisting of Rosa damascena Mill., Glycyrrhiza glabra L. and Nardostachys jatamansi DC., against ethanol-induced gastric ulcer. Iran J Pharm Res 2017;16:694-707.
British pharmacopoeia. The Stationery Office, London 2019. Microbiological examination of herbal medicinal products for oral use and extracts used in their preparation; Appendix XVI F. A 544-546.
Mazaheri M, SadatKhoshouei M. Comparison between Psychometric Characteristics of Persian Version of the Gastrointestinal Symptoms Rating Scale in Functional Gastrointestinal Disorders and Normal Groups. Govaresh 2012;17:18-24.
Chiarioni G, Pesce M, Fantin A, Sarnelli G. Complementary and alternative treatment in functional dyspepsia. United European Gastroenterol J 2018;6:5-12.
Thompson Coon J, Ernst E. Herbal medicinal products for non‐ulcer dyspepsia. Aliment Pharmacol Ther 2002;16:1689-1699.
Babaeian M, Naseri M, Kamalinejad M, Ghaffari F, Emadi F, Feizi A, Yekta NH, Adibi P. Herbal remedies for functional dyspepsia and traditional Iranian medicine perspective. Iran Red Crescent Med J 2015;17:9-11.
Aghili-Khorasani MH. Makhzan-Al-Advia. Institute of Medical History, Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran 2009; p 523.
Singh A, Kumar A, Duggal S. Nardostachys jatamansi DC. potential herb with CNS effects. Asian J Pharm Clin Res 2009;1:276-290.
Purnima BM, Kothiyal P. A review article on phytochemistry and pharmacological profiles of Nardostachys jatamansi DC-medicinal herb. J Pharmacogn Phytochem 2015;3:102-106.
Rösch W, Liebregts T, Gundermann KJ, Vinson B, Holtmann G. Phytotherapy for functional dyspepsia: a review of the clinical evidence for the herbal preparation STW5. Phytomedicine 2006;24:114-121.
Melzer J, Rösch W, Reichling J, Brignoli R, Saller R. Meta‐analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW5 (Iberogast). Aliment Pharmacol Ther 2004;20:1279-1287.
Holtmann G, Adam B, Vinson B. Evidence-based medicine and phytotherapy for functional dyspepsia and irritable bowel syndrome: A systematic analysis of evidence for the herbal preparation Iberogast®. Wien Med Wochenschr 2004;154:528-534.
Rösch W, Liebregts T, Gundermann KJ, Vinson B, Holtmann G. Phytotherapy for functional dyspepsia: a review of the clinical evidence for the herbal preparation STW 5. Phytomedicine 2006; 24:114-121.
Nicotra G. Phytotherapy of functional dyspepsia. Herbs for gastric discomfort. Agro Food Ind Hi Tec 2012;23:24-27.
Holtmann G, Adam B, Haag S, Collet W, Grünewald E, Windeck T. Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six‐week placebo‐controlled, double‐blind, multicentre trial. Aliment Pharmacol Ther 2003;18:1099-1105.
Raveendra KR, Srinivasa V, Sushma KR, Allan JJ, Goudar KS, Shivaprasad HN, Venkateshwarlu K, Geetharani P, Sushma G, Agarwal A. An extract of Glycyrrhiza glabra (GutGard) alleviates symptoms of functional dyspepsia: a randomized, double-blind, placebo-controlled study. Evid Based Complement Alternat Med 2012;2012:216970.
Deepa B, Suchetaha K, Rao S. Antidepressant activity of Nardostachys jatamansi in electron beam irradiated mice. Int J Res Ayurveda Pharm 2013;4:101-103.
Prabhu V, Karanth KS, Rao A. Effects of Nardostachys jatamansi on biogenic amines and inhibitory amino acids in the rat brain. Planta medica 1994;60:114-117.
Mukherjee PK, Kumar V, Houghton PJ. Screening of Indian medicinal plants for acetylcholinesterase inhibitory activity. Phytother Res 2007;21:1142-1145.
Tominaga K, Fujikawa Y, Tsumoto C, Kadouchi K, Tanaka F, Kamata N, Yamagami H, Tanigawa T, Watanabe T, Fujiwara Y, Arakawa T. Disorder of autonomic nervous system and its vulnerability to external stimulation in functional dyspepsia. J Clin Biochem Nutr 2016;58:161-165.
Yoshii K, Iikura M, Hirayama M, Toda R, Kawabata Y. Physiologically-based pharmacokinetic and pharmacodynamic modeling for the inhibition of acetylcholinesterase by acotiamide, a novel gastroprokinetic agent for the treatment of functional dyspepsia, in rat stomach. J Pharm Res 2016 ;33:292-300.
Talley NJ. Functional dyspepsia: new insights into pathogenesis and therapy. Korean J Intern Med 2016;31:444-456.
Holtmann G, Shah A, Morrison M. Pathophysiology of functional gastrointestinal disorders: a holistic overview. J Dig Dis 2017;35:5-13.
De Palma G, Collins SM, Bercik P. The microbiota-gut-brain axis in functional gastrointestinal disorders. Gut Microbes 2014;5:419-429.
Mukhtar K, Nawaz H, Abid S. Functional gastrointestinal disorders and gut-brain axis: What does the future hold. World J Gastroenterol 2019;25:552-566.
Bose B, Tripathy D, Chatterjee A, Tandon P, Kumaria S. Secondary metabolite profiling, cytotoxicity, anti-inflammatory potential and in vitro inhibitory activities of Nardostachys jatamansi on key enzymes linked to hyperglycemia, hypertension and cognitive disorders. Phytomedicine 2019;55:58-69.
You HN, Park MH, Hwang SY, Han JS. Nardostachys jatamansi DC Extract Alleviates Insulin Resistance and Regulates Glucose Metabolism in C57BL/KsJ-db/db Mice Through the AMP-Activated Protein Kinase Signaling Pathway. J Med Food 2018;21:324-331.
| Files | ||
| Issue | Vol 4, No 4, 2019 | |
| Section | Case Series | |
| DOI | https://doi.org/10.18502/tim.v4i4.2141 | |
| Keywords | ||
| Dyspepsia; Herbal medicine; N. jatamansi; Traditional medicine | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
