The gastrointestinal tract is regarded as vulnerable due to frequent exposure to a variety of foods. Diarrhea, ulcers, constipation, and parasitic infections are considered to be the most prevalent disorders worldwide. The present study was conducted in the District Sahiwal to appraise the local flora for the treatment of a diverse range of gastrointestinal disorders (GIDs) for the first time. The interviews of 125 respondents were conducted during August 2021-January 2022 via a semi-structured questionnaire. Floristic analysis yielded a total of 73 plant species in 65 genera and 35 families. Fabaceae (n = 9), Cucurbitaceae (n = 5), Apiaceae (n = 5), Malvaceae (n = 5), and Moraceae (n = 5) were observed as the most prominent ethnomedicinal families. The gastrointestinal disorders were categorized into diarrhea, dysentery, stomach burn, abdominal pain, constipation, ulcer, intestinal problems, indigestion and stomachache. The maximum times reported gastrointestinal category was indigestion and stomachache (Informant Consensus Factor = 0.69.). Most of the plants were herbs (50%) and wildly (52%) available in this region. Local people prefer to use their leaves (43%) in the form of decoction or powder (37%). Quantitative data analysis reported Cymbopogon citrates and Musa paradisiaca most utilized medicinal taxa (Used value = 2.25). Furthermore, the study documented two new medicinal species i.e. Alstonia scholaris and Gardenia jasminoides, that were never been identified GID ethnopharmacology. These medicinal plants play a vital role in the development of our pharmaceutical industry for the better livelihoods of future generations. Documenting medicinal flora that was used in the treatment of gastrointestinal disorders in district Sahiwal would be helpful in the development of low-cost, effective, safe, and appropriate medications against gastrointestinal disorders.
Gastrointestinal disorders (GIDs) are the most prevailing disorders in the world. World health organization (WHO), estimates GIDs caused nearly 1 million adult deaths worldwide during 2019 where diarrhea alone was responsible for 370,000 deaths in children under the age of 5 years. According to last reports a major percentage (40%) of entire world is suffering in some kind of GIDs. It is more prevalent in women rather men and also spread over to infants (27%), toddlers (40.5%), children (9.9%), and adolescents (27.5%). The prevalence rate in United States of America reaches to 11 percent for chronic GIDs, whereas in geriatric population it extents to 35 percent and in children up to 23.1 percent. In United Kingdom 81% of population have at least one of GIDs. Flatulence is most commonly reported issue along with abdominal pain and gut disorders in 25% of the infant and child population. Its prevalence is much higher in the countries of Middle East i.e. 30.4 prevalence among children and adolescents (between 4-18 years age group). Data from India show 10 percent prevalence of GIDs in the people aged between 10-17 years. In Pakistan, according to the last reports of Pakistan institute of medical sciences (PIMS), the number of patients with GIDs climbed by 30% over the between June 2016 and June 2017.
Ethnomedicine is considered to be a cultural and spiritual mode of medication. This area of traditional medicine examines how different civilizations see health, illness, and fitness as well as how to seek treatment and alternative healing modalities. Since ages ago, plants have been used medicinally because of their abundant and variety of biologically active compounds. Based on the statistics, utilization of ethnomedicine is prominent in multiple developed nations. For instance, in China between 30-50 percent of all therapeutic usage is made up of herbal remedies and in India, out of the 15,000 herbaceous plants, 6000 have been employed as herbal medications. According to a report seventy percent of HIV/AIDS patients in South Africa, London, and San Francisco use ethnomedicinal therapies for survival. Moreover, especially in underdeveloped countries like Ghana, Mali, Nigeria, and Zambia ethnomedicine serves as the preliminary source of treatment. As per World Health Organization, 80% of the world’s population receives their main medical treatment from traditional medicine, including ethnomedicines. Likewise for other ailments, ethnomedicines are also proven helpful to cure GIDs. Aleo vera, Withania somnifera, Morus nigra, Achyranthes aspera, Azadirachta indica, Mentha spicata, Syzygium cumini, Psidium guajava, Trachyspermum ammi and Foeniculum vulgare were repeatedly reported plants that were utilized in the treatment of gastrointestinal disorders. Low cost, easy availability, and instant relief are some of the certain reasons for the higher number of people’s dependence on local plant-based treatment for GIDs. Additionally, in Asian cultures, many of the GIDs are considered as taboos e.g. piles, irritable bowel syndrome and gas etc. People never feel comfortable of sharing such GIDS with an unknown or non-native (most of the cases) physician. Consequently, the trust of indigenous people on traditional remedies for GIDs is exceptionally high. Conversely, in various remote areas of third world countries including Pakistan, plant-based therapies are the only choice for rural communities.
There were many surveys and researches conducted in all-over the world that identified and described different therapeutic plants that used to cure GIDs. In 2017, a research survey was conducted on ethnomedicinal treatment of GIDs in Romania. This study reported 78 plants potentially useful plants for the treatment of GIDs. Similarly in Nigeria, a study on medicinal plants used for the treatment of gastrointestinal disorders reported 33 medicinally important plants species for GIDs. In Pakistan as well limited ethnomedicinal surveys focusing on GIDs were conducted in past few years. A GIDs specific ethnomedicinal evaluation was undertaken at the five major remote areas (Dera Ismail Khan, Bannu, Lakki Marwat, and Karak and Kohat) of Khyber Pakhtunkhwa province of Pakistan and reported total 52 medicinal plants species that were used for the treatment of gastrointestinal disorders. In another digestive disorders oriented ethnomedicinal survey at the Laspur valley, Chitral, documented 44 medicinal plants. Recently, efficacies of 69 medicinal plants against GIDs were reported from North Waziristan, Pakistan. However, these GIDs specific ethnomedicinal studies are encompassing to northern flora mostly. Therefore, a comprehensive ethnomedicinal study specific for GIDs is required from other regions of Pakistan as well. Moreover, without a proper documentation this traditional knowledge wealth is at the verge of being threatened due to modernization and urbanization. Hence, the basic purpose of this study was to document and preserved the GIDs specific ethnomedicinal knowledge of Sahiwal, Pakistan. The specific research questions were; (1) which medicinal flora used against GIDs by the people of the study area? (2) Which part of plant has medicinal potential, along with its basic drug formulation recipe and mode of administration? (3) What is the cultural relevance and agreement in the use of medicinal plants against certain GIDs? (4) Which plants are most trusted by the local people for GIDs cure? (5) What the statistical association between reported species and their identified attributes e.g. life form, growth habit etc.? (6) What are the similarities and differences between the GIDs associated traditional knowledge of aligned areas? Ethnobotanical indices were applied to answer the last three research questions. This data could be than subjected to further pharmacological and phytochemical investigation.
