# Comparative Study on the Prokinetic Effects of Ginger, Caraway, and Peppermint in Relieving Gastrointestinal Disturbances in Pulmonary TB Patients: A Clinical Trial

## TL;DR

This study found that ginger and peppermint can help reduce gastrointestinal issues in TB patients undergoing treatment.

## Contribution

The study introduces ginger and peppermint as effective nutraceuticals for alleviating gastrointestinal disturbances in pulmonary TB patients.

## Key findings

- Ginger and peppermint showed significant reduction in gastrointestinal disturbances during the washout phase.
- All three nutraceuticals alleviated GI symptoms in TB patients on ATT.
- Ginger had the highest total phenolic and flavonoid content, contributing to its prokinetic effects.

## Abstract

Anti‐tuberculosis treatment (ATT) leads to adverse gastrointestinal disturbances (vomiting, nausea, postprandial distress) due to its prolonged duration in TB patients. This study assessed the prokinetic effects of ginger, caraway, and peppermint nutraceuticals in alleviating these symptoms in pulmonary TB patients on ATT. The selected nutraceuticals were procured, cleaned, dried, and crushed to perform proximate analysis, TPC, TFC, DPPH, ABTS, and FRAP. Further, a randomized clinical trial (Registered No. NCT06157034) involved 200 participants divided into four groups (placebo = 48, ginger = 47, caraway = 48, peppermint = 46), with 11 dropouts. Participants received varied dosages of selected nutraceuticals (Ginger: 1 g, Caraway: 2 g, and Peppermint: 3 mL daily), and data were collected at baseline, intervention (after 3 months), and washout (after 1 month) phases. Ginger and peppermint showed the highest moisture content (81.67%, 81.74%), while caraway had the highest protein (29.72%) and crude fiber (45.11%). Peppermint had the highest crude fat (54.47%) and crude fiber (4.81%). Moreover, ginger had the highest TPC (1035.51 mgGAE/g) and TFC (465.34 mgQE/g), with notable DPPH, FRAP, and ABTS values. Participants had a mean age (39.03 years), family income (17,385 ± 528.72Rs), and BMI (19.43 ± 5.67). Sputum testing and other biochemical analyses were also done. Energy and macronutrient consumption did not differ significantly across all phases (p > 0.05). The hierarchical heatmap graph depicted the intensity/severity of relieving gastrointestinal disturbances with the consumption of nutraceuticals. Thus, the results concluded that both ginger and peppermint groups, particularly during the washout phase, showed a promising reduction in GI disturbances, suggesting their potential as adjunctive therapy for TB patients on ATT.

Selected nutraceuticals, rich in bioactive compounds, contributed to their potential prokinetic effect. Heatmap was employed to compare the intensities of GI disturbances among participants on the intervention of selected nutraceuticals in different phases. All three nutraceuticals significantly alleviated the GI disturbances in TB patients.