A critical review on the plants used for the treatment of ulcer in Kerala

Peptic ulcer disease and its complications remain the cause of significant morbidity worldwide, representing a major burden for health care resources. Although potent anti-ulcer drugs are available, most of them produce several side effects, thus emphasizing the need to search for new alternatives. As high as 80% of the world population depends on plant- derived medicines for the first line of primary health care, reinforcing the theory that plant extracts can be good sources of new drugs. This review focuses to consolidate the evidence-based information on antiulcer plants used in Kerala accumulated in databases (Google Scholar, PubMed, Scopus, Science Direct and Web of Science) upto January 2019. Plants like Acacia nilotica L., Achyranthes aspera Linn., Aegle marmelos L., Allium sativum L., Aloe barbadensis Miller, Annona muricata Linn., Bacopa monnieri Linn., Carica papaya Linn., Centella asiatica Linn., Curcuma longa Linn., Elettaria cardamomum Linn., Hibiscus rosa-sinensis Linn., Mangifera indica Linn., Mimosa pudica L., Moringa oleifera Linn., Ocimum sanctum Linn., Piper nigrum Linn., Phyllanthus emblica Linn., Terminalia chebula Retz., and Zingiber officinale Roscoe. are available in Kerala, reported with antiulcer activity. The secondary metabolites present in the plants like alkaloids, flavonoids, terpenoids, tannins, glycosides, terpines, and resins also have an important role in reliving ulcers due to its antisecretory, antioxidant, and cytoprotective properties. This review summarizes the botany, ethnopharmacology, phytochemistry and mechanism of action of antiulcer plants.