Phytochemistry, efficacy, and safety of medicinal plants used traditionally for the management of peptic ulcer diseases in Ethiopia: a systematic review

Despite significant advances in synthetic medicine, medicinal plants are still widely utilized to treat peptic ulcer disease. This study synthesized evidence on commonly used medicinal plants to manage peptic ulcer disease in Ethiopia. The evidence was synthesized using electronic databases such as PubMed/Medline, Web of Science, Science Direct, Hinari, and Google Scholar. This review considers all controlled in vivo and ex vivo anti-ulcer studies evaluating Ethiopian medicinal plants with regards to phytochemistry, efficacy, and safety. The search technique covered all published papers using descriptors like Ethiopia, medicinal plants, and anti-ulcer until January 30, 2022. The percentage of ulcer reduction was used to measure the success of the treatment. Anti-ulcer properties were investigated in 13 papers. Twelve in vivo and one ex vivo study were retrieved. Osyris quadripartita, Plantago lanceolata, Ensete ventricosum, Taverniera abyssinicia, Crotonmacrostachyus Persea Americana and Moringa stenopetala showed effect close to a standard control in difference ulcer induced model. Osyris quadripartite in the dose of 200 mg/kg, Ficus thonningii in dose of 200 and 400 mg/kg, Plantago lanceolata in dose of 400 mg/kg, Trigonella feonum-gracum in dose of 500 and 1000 mg/kg, Linum ussitatissimum in dose of 1000 and 1500 mg/kg, Urtica simensis 400 mg/kg have higher activity compared with standard control in difference different models. Phytochemistry studies revealed presence of numerous components, including flavonoids, phenols, tannins, and saponins, which may be responsible for the anti-ulcer activity. This study revealed that there are some promising medicinal plant extracts that have been used in Ethiopia for centuries that could be used as anti-ulcer agents. The most effective anti-ulcer agents in animal models are Indigofera spicata Forssk, Thymus schimperi, and Urtica simensis. Identification of most active pharmacological agents and clinical evaluation of Ethiopian medicinal plants used to treat peptic ulcers are worthy of further investigation.