Gentian

2010

Historical Note

The genus Gentiana is derived from Gentius, king of ancient llyra who is attributed with the discovery of its therapeutic effects. In ancient Greece and Rome it was used to relieve common gastrointestinal symptoms, much as it is used today. It was first noted in the Chinese medical literature in 50 BC.

Other Names

Gentiana, yellow gentian, wild gentian

Botanical Name / Family

Gentiana lutea (family Gentianaceae)

Plant Parts Used

Root and rhizome

Chemical Components

Secoiridoid bitter glycosides, oligosaccharides, phenolic acids, phytosterols, polysaccharides (inulin and pectin), tannin, lupeol, beta-amyrin triterpenes, xanthones and essential oil.

Main Actions

The active principals in gentian root are the bitter constituents, gentiopicroside and amarogentin.

DIGESTIVE STIMULANT

The bitter principals induce reflex excitation of taste receptors and increased saliva, gastric juice and bile secretion thereby stimulating appetite and digestion according to in vivo experiments. The small human study confirmed oral administration of gentian root extract increases gastric juice secretion and emptying of the gall bladder (ESCOP 2003).

Other Actions

A gentian root preparation inhibited Helicobacter pylori in.

Antioxidant activity has been observed in vitro for the ethyl acetate and chloroform fractions of gentian. Animal studies with amarogentin have identified antileishmanial properties. Traditionally, gentian is considered to have stomachic, anthelmintic, antiseptic, anti-inflammatory and tonic activity.

Clinical Use

Gentian root preparations have not been significantly investigated under clinical trial conditions, so evidence is mainly derived from traditional, in vitro and animal studies.

DYSPEPSIA AND FLATULENCE

The considerable bitter taste of gentian provides a theoretical basis for its use in dyspepsia and flatulence for which increased saliva and gastric acid secretion would be beneficial. Commission E and ESCOP approve its use for this indication (ESCOP 2003).

LOSS OF APPETITE

The considerable bitter taste of gentian provides a theoretical basis for its use in anorexia when increased saliva and gastric acid secretion would be beneficial. Commission E and ESCOP approve its use for this indication (ESCOP 2003).

Other Uses

Traditionally, gentian has also been used for gout, amenorrhea, diarrhea and worms in the stomach and bowel. Gentian is also used in alcoholic drinks such as brandy, medicinal wines and vermouth.

Clinical note — Herbs in alcoholic drinks

The maceration of herbs and spices in wine was common practice in antiquity, and the invention of aromatised wine, the ancestor of vermouth, has been attributed to Hippocrates. Herbs are still commonly used in alcoholic drink production today, either as flavourings, or as both fermentation substrates and flavouring agents. The volatile components of a herb will provide its distinctive odour, whereas non-volatile constituents can affect some gustatory reactions and produce a physiological effect. Herbs such as gentian are used for flavour, but also because they contain a significant amount of fermentable sugars that can be converted by strains of yeast into ethanol in an alcoholic fermentation process. Examples of other herbs that are used in brandies, flavoured spirits, liqueurs, medicinal wines and vermouth are anise, caraway, cardamom, coriander, dandelion, sage and yarrow.

Dosage Range

GENERAL GUIDE

• Cut root or dried extract: 2-4 g/day.

• Fluid extract (1:1): 1-2 mL taken 1 hour before meals up to three times daily.

• Tincture (1:5): 3-12 mL/day.

• Infusion: 1-2 g in 150 mL boiled water taken 1 hour before meals and up to three times daily

Adverse Reactions

Headaches have been reported (ESCOP 2003) and nausea and vomiting with high doses.

Significant Interactions

Interactions are unknown.

Contraindications and Precautions

Contraindicated in gastric or duodenal ulcers and hyperacidity according to Commission E.

Pregnancy Use

There is insufficient reliable information available to make a recommendation.

Practice Points / Patient Counselling

• Gentian root and its preparations are extremely bitter.

• Gentian preparations stimulate salivation, gastric juice and bile secretion.

• They are used to improve digestion, relieve flatulence and stimulate appetite.

• Little clinical investigation has been undertaken with the herb so evidence of efficacy relies on traditional and animal studies.

• It should not be used in cases of gastric or duodenal ulcer or hyperacidity.

Answers to Patients’ Frequently Asked Questions

What will this herb do for me?

Gentian preparations stimulate taste buds when taken orally, and increase gastric juice secretion, thereby improving digestion.

When will it start to work?

Effects are expected within several minutes of ingestion.

Are there any safety issues?

It should not be used by people with gastric or duodenal ulcers or with gastric hyperacidity.