Ginger on Stomach Problems in Osteoarthritic Patients

by | Jan 22, 2016 | 2012, Arthritis, Ginger, Joint Health

Written by Chrystal Moulton, Staff Writer. A ginger and glucosamine preparation reduced the pain of osteoarthritis by 9% compared to an increase of 14.6% in those treated with a traditional drug.

In individuals that require non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of chronic disease, stomach problems are a common and well-known side effect. Stomach problems include gastritis, ulcer, bleeding from the small intestines, and perforation.(1,2) People with osteoarthritis especially are likely to have such stomach issues due to NSAIDs since it is most often prescribed by doctors to combat pain and inflammation of affected joints.(1) Because of these negative effects, doctors are looking for natural medications that are as effective as common NSAIDs for osteoarthritis.(3)

In a randomized study (4), doctors from the Central Gastroenterology Scientific Research Institute in Moscow wanted to compare the effectiveness of a ginger-glucosamine combination to diclofenac (traditional NSAID) in treating patients with osteoarthritis. Their primary goal was to evaluate the gastrointestinal effects of both treatments. Their secondary goal was to compare each treatments pain relieving effects.

Forty-three patients with confirmed osteoarthritis of the hip or knee were included in the study. There were 35 women and 8 men, with an average age of 55 years old and average disease duration of about 7 years. Patients who had severe stomach problems and abdominal pain were excluded. Upon consent to participate, patients were told to discontinue any use of NSAIDs for one month before starting the trial.

Patients were randomized into two groups. The ginger group (n=21) was given a ginger-glucosamine combination called Zinaxin Glucosamine. The combination consisted of 500mg glucosamine sulfate, 100mg ginger extract (20:1 extract; equiv. 2,000 mg of dry rhizome), and 70mg of a lipid carrier. Patients were instructed to take 2 capsules daily for six months. The diclofenac group (n=22) was given Diclofenac Retard (100mg slow-release sodium diclofenac) and glucosamine sulfate (1,000mg). They were instructed to take diclofenac and glucosamine (1,000mg) once daily for six months. Full clinical and laboratorial tests were done on each patient. The doctors’ retrieved patients’ medical history and both a pain and dyspepsia assessment were taken at baseline. GI Assessment was done 28 days into the study. Pain was then, evaluated every 7 days until the GI assessment period (28 days) was complete and once more at the end of the trial (6 months). Endoscopy, biopsy of the stomach, Urine and blood chemistry analysis was done at baseline and at the end of the trial to check for any adverse effects from either treatment. The researchers were particularly interested in the change of prostaglandins (PGE1, PGE2, PGF2α, and PG12) and gastrin-17 levels in stomach membranes. Both prostaglandins and gastrin-17 stimulate production of mucus and are essential to stomach health.

In the ginger group, a slight but significant decrease in upper stomach pain was observed on the 28th day (SODA pain intensity index: baseline 15.6 ±0.9 down to 14.2 ±0.6 day 28, p=0.05). On 28th day, two patients reported heartburn and regurgitation, which stopped 2-3 days after the end of the trial. Overall, patient satisfaction was improved from baseline to the 28th day (13.2 ±0.4 to 15.8 ±0.5, p=0.05). Prostaglandin (all subtypes) and gastrin-17 levels significantly increased after 28 days (p<0.05). Pain while standing and during movement assessment reported a significant decrease, which was maintained until the end of the trial (p<0.05). None of the patients had signs of upper GI tract erosion or sores due to the ginger combination.

In the diclofenac group, upper GI tract pain increased and by the 28th day of treatment pain intensity index increased significantly from 14.3 0.9 to 16.4 1.0, p=0.03. During days 7-10, severe pain and stomach ailment (dyspepsia) required endoscopic analysis in 4 patients. Of the 4 patients, 2 showed signs of aggravated chronic gastritis and 2 patients, who had prior erosions in the stomach lining, showed signs of erosive gastritis. Another patient developed an ulcer and was denied further diclofenac treatment. In all, 5 patients reported adverse effects of diclofenac. Diclofenac treatment significantly increased 3 specific types of prostaglandin (PGE1, PGE2, PGF2α) (p<0.05). Results also showed a slight but non-significant decrease in gastrin-17 levels. Like the ginger group, the diclofenac group reported significant decrease in pain while standing and moving, which was maintained until the end of the trial.

In all, ginger was as effective as diclofenac, a drug generally prescribed for osteoarthritis. However, unlike diclofenac, ginger showed very mild, transient side effects and no serious complications. More notably, ginger supplementation promoted an increase in prostaglandins and gastrin-17, which are essential to stomach health. Larger double-blind studies would be needed to confirm the results, as it is the first study of its kind according to the author.

Source: Drozdov, Vladimir N., et al. “Influence of a specific ginger combination on gastropathy conditions in patients with osteoarthritis of the knee or hip.” The Journal of Alternative and Complementary Medicine 18.6 (2012): 583-588.

© 2012 Mary Ann Liebert, Inc. publishers.   All rights reserved, USA and worldwide.

Posted March 5, 2014.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

  1. The impact of non-steroidal anti-inflammatory drugs on the small intestinal epithelium. Handa O1, Naito Y1, Fukui A1, Omatsu T1, Yoshikawa T2. J Clin Biochem Nutr. 2014 Jan;54(1):2-6. Epub 2013 Dec 18.
  2. Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans. Bjarnason I, Hayllar J, MacPherson AJ, Russell AS. Gastroenterology. 1993 Jun; 104(6):1832-47
  3. Knee osteoarthritis diagnosis, treatment and associated factors of progression: part II. Heidari B. Caspian J Intern Med. 2011 Summer;2(3):249-255.
  4. Influence of a specific ginger combination on gastropathy conditions in patients with osteoarthritis of the knee or hip. Drozdov VN, Kim VA, Tkachenko EV, Varvanina GG. J Altern Complement Med. 2012 Jun;18(6):583-8.