Natural remedies for cholera, diarrhoea

Can a combination of corn-pap; bitter leaf, guava, black tamarind, local clay and activated charcoal provide a novel drug for the prevention and treatment of cholera and diarrhoeal diseases? CHUKWUMA MUANYA, Assistant Editor writes

Cholera is here again. In Nigeria, cholera and other diarrhoeal diseases are usually associated with flooding and dirty environment. The menace is causing havoc not just in Nigeria but worldwide from Kenya to Yemen.

According to the World Health Organisation (WHO), cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholera that can kill within hours if left untreated. Researchers have estimated that each year there are 1.3 to 4.0 million cases of cholera, and 21 000 to 143 000 deaths worldwide due to cholera.

Most of those infected will have no or mild symptoms, and can be successfully treated with oral rehydration solution. Among people who develop symptoms, the majority has mild or moderate symptoms, while a minority develops acute watery diarrhoea with severe dehydration. This can lead to death if left untreated. However, severe cases will need rapid treatment with intravenous fluids and antibiotics.

According to the WHO, provision of safe water and sanitation is critical to control the transmission of cholera and other waterborne diseases. Oral cholera vaccines are an additional way to control cholera, but should not replace conventional control measures.WHO noted that safe oral cholera vaccines should be used in conjunction with improvements in water and sanitation to control cholera outbreaks and for prevention in areas known to be high risk for cholera.
But are there evidence-based and effective alternative treatments for cholera and diarrhoeal diseases?

Corn pap, bitter leaf and guava validated as ‘cure’ cholera, diarrhoea
A recent study published in the journal African Health Sciences has validated the efficacy of corn pap (Ogi-tutu in Yoruba and Akamu in Ibo), Vernonia amygdalina (bitter leaf) and Psidium guajava (guava) in treating cholera and diarrhoeal diseases.

The study is titled “Intestinal ameliorative effects of traditional Ogi-tutu, Vernonia amygdalina and Psidium guajava in mice infected with Vibrio cholera.”The Nigerian researchers investigated the ameliorative effects of Ogi-tutu, Vernonia amygdalina and Psidium guajava on intestinal histopathology of experimental mice infected with Vibro cholerae.

The researchers wrote: “Several traditional treatments of diarrhea and specifically, cholera are in practice in South-Western Nigeria. These traditional claims require experimental investigation to ascertain their effectiveness. Preliminary investigation of vibriocidal activities of Ogi-tutu, V. amygdalina and P. guajava showed in vitro vibriocidal activities. These agreed with findings on antibacterial activities documented in the literature.

“However, investigation on histopathological effects gave varied ameliorative effects. Ogi-tutu (500 mg/ml) was less effective in treating V. cholerae infection as evidenced by the moderate diffuse degenerative and inflammatory changes observed at histopathology. Ogi-tutu contains lactic acid bacteria (LAB), which have been shown to possess or have antimicrobial potentials, and it is significant in the management of human clinical infections.

“Vernonia amygdalina showed very high preventive and effective treatment measures in both the immediate and delayed groups of mice demonstrating excellent ameliorative effect and very mild degenerative changes in vivo. Similar antidiarrheal activity was demonstrated in castor oil induced diarrhea24. The varied biological activity of V. amygdalina is said to be likely due to the combination of its active compounds such as saponins and alkaloids, terpenes, steroids, coumarines, flavonoids, phenolic acids, lignans, xanthones and anthraquinones edotides, tannins and sesquiterpene lactone.

“Psidium guajava displayed very high activity as both prevention and treatment of V. cholerae infections when compared with positive and negative control groups. The ameliorative effects of this plant were attested to by the very mild degenerative and inflammatory changes observed in this study. Antidiarrheal activity of the leaves has been proven26 and also, of the fruit in castor oil induced diarrhea27. The decoction of the leaves is capable of neutralizing Vibrio cholerae28. Pharmacological investigation indicated that its bark, fruit and leaves posses antibacterial, hypoglycemic, anti-inflammatory, analgesic, antipyretic, spasmolytic and Central Nervous System (CNS) depressant properties.”

The researchers concluded: “Ogi-tutu displayed less ameliorative effects in the prevention and treatment of V. cholerae infection. However, V. amygdalina showed better ameliorative effects than P. guajava in infected mice. The ameliorative effects in decreasing order were V. amygdalina > P. guajava > Ogi-tutu. Vernonia amygdalina could be used for preventive and treatment of Vibrio cholerae infection. Further investigations on the active principles of V. amygdalina with its mechanism of action are warranted. This might channel a new pathway and better alternative therapeutic agents in the management of diarrhea associated with V. cholerae.”

Black tamarind shows promise in cholera, diarrhoea treatment
Researchers have found that besides the folklore uses of extracts of Black Tamarind in the treatment of infections such as severe cough, bronchitis, wounds, stomachaches, malaria fever, jaundice, antiulcer and haemorrhoids, it is also an effective therapy for antibiotic-resistant cholera and diarrhoea.

Nigerian and South African researchers have found that the leaf extracts of Black Tamarind compares favourably with standard antibiotics in the treatment of water and food borne diseases such as diarrhoea and cholera.

The researchers also noted that further investigations on this plant might lead to the development of antimicrobial drugs of natural origin that may combat the rapid development of multiple resistant to the available antibiotics by pathogens.Commonly called Black tamarind, Dialium guineense belongs to the plant family Leguminosae-caesalpinioideae. The Igbos of South-east Nigeria calls it Icheku; while to the Yorubas of South-west know it as Awin.

The researchers from the Department of Biochemistry and Microbiology, Applied and Environmental Microbiology Research Group (AEMREG), University of Fort Hare, Alice 5700, South Africa, and Department of Microbiology, Obafemi Awolowo University, Ile Ife, Nigeria concluded: “D. guineense leaf extract exhibited significant antimicrobial properties on the environmental strains of Vibrio spp. used in this study and it compared favourably with the two standard antibiotics – ampicillin and streptomycin used as positive controls.

“D. guineense forms part of the ingredients used in preparing decoction for the treatment of some ailments and thus it is suppose to be safe in consumption and drugs formulated from this plant may pose no danger to the users. Antimicrobial drugs of natural origin developed from this plant may go a long way in preventing the establishment of an infection caused by vibrios and other pathogens that are now developing resistance to the existing antimicrobial drugs. Efforts are going on in our laboratory to isolate pure compounds of pharmacological importance from the plant crude extract.”

The study titled: “Anti-vibrio and preliminary phytochemical characteristics of crude methanolic extracts of the leaves of Dialium guineense (Wild)” was published in the Journal of Medicinal Plants Research.

Previous reports in some literatures indicate that Dialium guineense leaves and stem bark are used as folklore remedies for the treatment of infections such as diarrhoea, severe cough, bronchitis, wound, stomachaches, malaria fever, jaundice, antiulcer and haemorrhoids. Lawal et al. (2010) reported in their findings that D. guineense is used as antiulcer and as a vitamin supplement among some tribes in the southern part of Nigeria.

How clay can heal stomach problems, drug-resistant bacteria
It may sound absurd but it is true. Local clay can be used to stop nausea and abortion in pregnant women, diarrhoea, drug-resistant Staphylococcus aureus, skin diseases, and in the making of tablets. However, scientists are providing evidence to support these claims.

The Igbos calls the whitish chalk type nzu and the ash clayey type ulo. It is ore in Urhobo, ndom in Efik and Ibibio. The Yorubas call it efun ile (local chalk). It is usually collected from caves, mountains and rivers.In Nigeria, pregnant women eat it to prevent feeling of vomiting. It is also taken to stop stomach problems, diarrhoea and cholera. It is ground into powder, mixed with water. And rubbed on the skin to stop skin rashes and itching.Indeed, people have used local clay for healing wounds, helping indigestion, and killing intestinal worms.

A herbalist and Laboratory Technician at the Department of Pharmacognosy, College of Medicine University of Lagos (CMUL), Idi-Araba, Mr. Isaac T. Adeleke told The Guardian: “It is used to stop diarrhoea or running stomach. Mixed with some herbs to prevent threatening abortion. It is dissolved in water with addition of pure honey and rubbed on the body to treat measles, chicken pox and small pox. It can be applied around the eye incase of small pox to prevent it entering the eye. It is ground with new plantain flowers (Isana Ogede in Yoruba) with black soap to bath small babies to alleviate the pains of teething. Local clay is mixed with Annona senegalensis (Abo in Yoruba) in water. Add little lime or lemon to increase sperm count. It is ground and mixed with honey to treat burns.”

Scientists are starting to look further into local clay to see what exactly they do and how they work because their encounters with germs that are resistant to drugs are a serious problem.According to studies, when taken internally, clay supports the intestinal system in the elimination of toxins.

Charcoal validated to treat diarrhoea
It is locally used in Nigeria to make the teeth whiter, as antidote to poison, to prevent fermentation in grounded beans, among others. But scientists are now applying activated charcoal not in water purification but as antidote to adverse drug reaction from overdose as well as treatment of many disease conditions such as liver damage, bloating, skin infections, high cholesterol, diarrhoea, flatulence, indigestion, and hangovers.

Several studies have shown that activated charcoal can be used to treat skin ailments, diarrhoea, bad breath, constipation and body odour. It can be used as a poultice to treat insect stings, mushroom poisoning, poison ivy, cholera, dysentery, bites and inflammation.

Until now, activated charcoal was documented for use in treating medical conditions. It has been used by North American Indians to treat bruises, inflammation and skin infections. Activated charcoal has also been reported to help lower cholesterol, triglycerides and lipids found in the blood.

According to Natural News, single teaspoon of activated charcoal has a surface area of approximately 10 000 square feet. It adsorbs (binds to and helps eliminate from the body) poisons, heavy metals, chemicals and intestinal gases that have thousands of times more weight than it has, making it very effective in detoxing and eliminating toxins and poisonous substances from the body. It is also able to adsorb many different pharmaceutical drugs, opium, cocaine, morphine, pesticides, chemicals, mercury and even lead.

Several studies have shown that activated charcoal can be used to treat skin ailments, diarrhoea, bad breath, constipation and body odour. It can be used as a poultice to treat insect stings, mushroom poisoning, poison ivy, cholera, dysentery, bites and inflammation. It can also be used to treat snakebites in an emergency. Babies born with jaundice have been reportedly treated with activated charcoal as well. Activated charcoal is available in many different forms such as powder in a capsule, liquid form, suspension, chewable tablets and powder form. It is often used as an ingredient in body detox products and colon cleansers. Some people report that using activated charcoal when they have flu or other viruses helps them to recover quicker. The reason for this is that it is able to prevent viruses and bacteria from remaining active in the body while absorbing a great deal of their toxins before they have a chance to spread or multiply.

Studies have shown that activated charcoal even has anti-ageing properties. It helps improve liver, adrenal gland and kidney functions with regular use. Those suffering from digestive ailments such as indigestion, bloating or gas can benefit from activated charcoal because the charcoal enters the digestive tract and absorbs excess gas, which may be present there. It also improves the functioning of the liver, heart and brain and helps to decrease cholesterol levels and the risk of coronary artery disease.

Naturopaths recommend that when using activated charcoal, it is best to take it between meals and a few hours after using any vitamin or mineral supplements, as it may interfere with the absorption of these into the body. It must also be stored in a properly sealed container away from heat and moisture. It should preferably be used with water only, or taken alone, as anything else such as fruit juice or ice cream will cause it to lose a great deal of its effectiveness.

Also, studies have shown that in large doses, activated charcoal may cause stools to turn black. This is normal. In large doses, it may also lead to diarrhoea, nausea or vomiting. Those suffering from obstruction of the bowel should not use this product.