Istanbul J Pharm 49 (1): 33-44 DOI: 10.26650/IstanbulJPharm.2019.404211 Review Plants used in traditional treatment against diarrhea in Turkey Seçil Karahüseyin1, 2 , Aynur Sarı1* Department of Pharmacognosy, İstanbul University, Faculty of Pharmacy, İstanbul, Turkey Department of Pharmacognosy, Çukurova University, Faculty of Pharmacy, Adana, Turkey 1 2 ORCID IDs of the authors: A.S. 0000-0001-8116-7053; S.K.0000-0002-3515-2974. Cite this article as: Karahüseyin S, Sarı A (2019). Plants used in traditional treatment against diarrhea in Turkey. Istanbul J Pharm 49(1): 33-44. ABSTRACT Turkey is one of the richest countries in the world in terms of flora with its extraordinary plant diversity. Its flora consists of about 10,000 vascular plants and approximately one third of them (34.4 %) are endemic to the country. In recent years, the use of ethnobotanical information obtained from medicinal plant research has gained attention all around the world. For this reason, numerous ethnobotanical studies have recently been published and much has been written about medicinal plants in our country. This study deals with 133 taxa used in traditional treatments against diarrhea in Turkey and it aims to give information about scientific and local names of these taxa, families, used parts and usage in diarrhea. Keywords: Diarrhea, medicinal plants, traditional treatment, Turkey INTRODUCTION Diarrhea is defined as loose stools, increased stool frequency, or urgency by patients. Although most patients use this term to describe changes in consistency (loose or watery stool), diarrhea can be considered as urgency or high stool frequency. In fact, with normal consistency, frequent defecation is often referred to as pseudodiarrhea; for this reason, an abnormal stool form and frequency should not be used to describe diarrhea. Most diarrheal episodes in developed countries are acute and self-limited and are usually caused by infections. In immunocompetent patients, acute contagious diarrhea typically resolves within 4 weeks (most often within 1 week). Therefore, chronic diarrhea is defined as that lasting longer than 4 weeks. It is estimated that 1%-5% of adults suffer from chronic diarrhea. In immunocompetent patients in developed countries, chronic diarrhea is not usually contagious (Lawrence et al. 2017). Acute bloody diarrhea in children and adults is a difficult diagnostic problem. Acute bloody stools have different spectra between adults and children, but there are overlapping causes (infectious colitis and less frequently intussusception). Identification of patients with infectious causes is mandatory, so that they are suitably treated with antimicrobials and so that infection control measures can be fulfilled (Lori et al. 2009). Detection of the cause of this disorder may be a problem, because there are many enteric pathogens that cause acute bloody diarrhea and several noninfectious gastrointestinal disorders; these are interpreted as loose, bloody stools, mostly diarrhea (Lori et al. 2009). There is a battle between the host microbiology of normal flora and the exterminating microbes. Symptomatic infections for the host when invaded can alter the bowel barrier and absorptive functions, or can quickly cause a number of problems that can Address for Correspondence : Aynur Sarı, e-mail: aynur@istanbul.edu.tr This work is licensed under a Creative Commons Attribution 4.0 International License. Received: 11.03.2018 Accepted: 12.02.2019 33 Istanbul J Pharm 49 (1): 33-44 lead to lethal dehydration, diarrhea, toxic megacolon or shock. Asymptomatic infections may go unnoticed, but they have durable results for children’s growth and development. Most are acquired through contaminated food or water; however, only few pathogens (such as Shigella, Cryptosporidium, Giardia, rotaviruses, or noroviruses) can cause infection (Pawlowski et al. 2009). Rotavirus is the leading cause of diarrhea hospitalization among children in the world. In 2003, a world-wide estimate of rotavirus-related deaths was published, based on a review of published literature on deaths from diarrhea and rotavirus hospitalizations in children from 1986 to 1999. Studies published between 1986 and 1999 showed that rotavirus causes ≈22% (range 17%-28%) of diarrheal hospitalizations in childhood. From 2000 to 2004, this rate increased to 39% (range 29%-45%). Application of this ratio to the recent World Health Organization estimates of diarrhea-related childhood deaths gave a predicted 611,000 (range 454,000-705,000) rotavirusrelated deaths (Parashar et al. 2006). In mass tourism, traveler’s diarrhea is one of the most common health problems in long-distance journeys. Globally, there are 40 million cases per year. For this reason, travelers to risky areas should be informed in advance of what measures they should take in case of acute diarrhea and which medicines to include in the first aid kit (Jelinek et al. 2017). The first choice of treatment of acute uncomplicated traveler’s diarrhea - more than 90% of all cases - is the secretion inhibitor racecadotril. Usual practice, which recommends the antimotility drug loperamide as the first option, should be rethought in favor of the last active ingredient racecadotril. Antibiotics should be used only in complicated cases. Generally, anticipation of a large number of passengers demanding antibiotic treatment should be impaired. Other therapeutic measures currently available for the treatment of acute diarrhea while traveling play a minor role (Jelinek et al. 2017). Several studies have shown that antibiotics can reduce the rates of diarrhea in travelers to resource-limited countries. However, preventive antibiotic therapy is not recommended because of its side effects and so, if necessary, rapid-acting, single-dose antimicrobial therapy is used. In some studies, probiotics have shown benefit (Pawlowski et al. 2009). There are a lot of kinds of diarrhea shown in this study and the drugs used for the treatment of diarrhea have many side effects. Medicinal plants have traditionally been used for the treatment of diarrhea for many decades. In this study, we have compiled 133 taxa used in traditional treatments of diarrhea in Turkey. The aim is to give information about scientific and local names of these taxa, families, used parts and usage in diarrhea (Table 1). Table 1. List of the plants used in traditional treatment against diarrhea in Turkey Botanical name Family Local name Plant parts used Preparation, administration and use Reference Achillea aleppica DC. subsp. aleppica Asteraceae Civanperçemi Aerial parts Dec., Int. (Doğan 2014) a Achillea wilhelmsii C. Koch. Asteraceae Ayvadere, Kedicırnağı, Kedi Tırnağı, Tilki otu Aerial parts +Milk, Dec. or Inf., Int Crushed, Ext. Dec., Int. Inf., Int. (Oral 2007) (Şenkardeş 2014) (Tuzlacı 2016) Ailanthus altissima (P. Mill.) Swingle Simaroubaceae Ossuruk ağacı Branches Dec., Int. (Güneş et al. 2017) Alchemilla sp. Rosaceae Aslanpençesi, Dutya Aerial parts, Flower Inf., Int. (Karagöz and Serteser 2017) Alhagi maurorum Medik. Fabaceae Xirnuf Fruit Raw, Int. (Dalar et al. 2018) Alhagi pseudoalhagi (Bieb.) Desv. Fabaceae Hurnif, Çeti, Çoban çalısı Fruit Dried Fruits Eaten Crushed, Int. (Korkut 2006; Gençay 2007) Allium sativum L. Liliaceae Sarımsak Bulb +Yoghurt, Fac. (Uysal 2008) Alyssum pateri Nyάr. subsp. pateri Brassicaceae Keselmahmut Aerial parts Dec., Int. (Kaval et al. 2014; Tuzlacı 2016) Anacamptis pyramidalis (L.) Rich. Orchidaceae Sahlep, Salep çiçeği Root Dec., Int. (Doğan 2014; Tuzlacı 2016) Anthemis cretica L. subsp. pontica (Willd.) Grierson Asteraceae Papatya Capitulum Inf., Int. (Tütenocaklı 2014) Artemisia absinthium L. Asteraceae Acı yavşan Leaf Take as a pill, Int. (Yıldırım 2015) (Tuzlacı 2016) 34 Karahüseyin and Sarı. Plants used in traditional treatment against diarrhea in Turkey Table 1. List of the plants used in traditional treatment against diarrhea in Turkey (continued) Botanical name Family Local name Plant parts used Preparation, administration and use Reference Arum conophalloides Kotschy ex Schott Araceae Yılan bıçağı Seed Raw, Swallowed (Güneş et al. 2017) Arum dioscoridis SM. Araceae İlan purçulağı, Kabargan, Ölüm körü, Yılan purçulağı Cooked, Int. (Yıldırım 2015) Berberis crataegina DC. Berberidaceae Karamuk, Karamık, Kızılcık Flowering and Fruity Branches Fruit Dec., Int. Raw, Int. (Özkan 2002; Tuzlacı 2016) (Yeşil and Akalın 2009; Vural 2008) Berberis vulgaris L. Berberidaceae Karamuk, Kadıntuzluğu Fruit Raw, Int. (Korkmaz and Karakuş 2013) Camellia sinensis(L.) Kuntze Theaceae Siyah çay Leaf Inf., Int. Raw or Inf., Int. (Saraç et al. 2013; Tuzlacı 2016) (Uysal 2008) Capparis spinosa L. var. aegyptia (Lam.)Boiss. Capparaceae Gebere, Kebere Gemma Swallowed (Kazan 2007) Cardiospermum helicacabum L. Sapindaceae Balon sarmaşığı, Young Shoots Japon feneri Dec., Int. (Güzel et al 2015) Celtis tournefortii Lam. Ulmaceae Derdoğan Fruit Raw, Int. (Doğan 2014; Tuzlacı 2016) Centaurea pterocaula Trautv. Asteraceae Şermnik Leaf Dec., Int. (Kaval et al. 2014) Centaurea solstitialis L. subsp. solstitialis Asteraceae İshal dikeni Aerial parts Inf., Int. (Şenkardeş 2014; Tuzlacı 2016) Cerasus avium (L.) Moench Rosaceae Kiraz Stem and Branch Bark Dec., Int. (Kural 2012; Tuzlacı 2016) Ceratonia siliqua L. Fabaceae Buynuz, Harıp, Harnup, Keçiboynuzu, Keçibuynuzu Fruit Raw, Int. Jam, Int. Mac., Int. (Bulut 2006; Tuzlacı 2016; Gürdal and Kültür 2013; Yıldırım 2015) Ceterach officinarum DC. Aspleniaceae Altın otu, Mayasıl otu Aerial parts Cooked, Int. Dec., Int. (Güzel et al. 2015) (Bulut 2006; Tuzlacı 2016) Chenopodium foliosum Aschers Chenopodiaceae Kedi üzümü, Kuş üzümü Aerial parts Inf., Int. (Doğan 2014; Şenkardeş 2014; Tuzlaci and Şenkardeş 2011; Tuzlacı 2016) Cicer arietinum L. Fabaceae Nohut Seed Cooked, Int. (Uysal 2008; Tuzlacı 2016) Cistus creticus L. Cistaceae Pamuk otu Leaf Dec., Int. (Onar 2006; Tuzlacı 2016) Citrus limonL. Rutaceae Limon, Limon ağacı Fruit Juice, Int. (Sargın et al. 2013) Convolvulus arvensis L. Convolvulaceae Basırık (Bağırsak) otu, Mahmude otu Branches and Leaves Dec., Int. (Güneş et al. 2017) Cornus mas L. Fruit Raw, Int. Syrup, Int. Dec., Int. Inf., Int. (Koçyiğit and Özhatay 2006; Ayan 2015; Tuzlacı 2016) (Polat 2010; Korkmaz and Karakurt 2014) (Karcı 2013) (Güler et al. 2015) Cornaceae Kızılcık, Kiren, Zaye 35 Istanbul J Pharm 49 (1): 33-44 Table 1. List of the plants used in traditional treatment against diarrhea in Turkey (continued) Botanical name 36 Family Local name Plant parts used Preparation, administration and use Reference Crataegus monogyna Rosaceae Jacq. subsp. monogyna Alıç, Fruit Ekşi muşmula, Leaf, Keçi alıcı, Flower Kız elması, Kocakarı hurması Eaten Inf., Int. (Sargın et al. 2013) (Furkan 2016) Cupressus sempervirens L. Cupressaceae Mezarlık selvisi, Cone Selvi Dec., Int. (Uysal 2008; Tuzlacı 2016) Cydonia oblonga Miller Rosaceae Ayva Leaf Seed Inf., Int. Dec., Int. (Sargın et al. 2013) (Güneş et al. 2017; Flower Dec., Int. Inf., Int. Uysal 2008; Metin 2009; Kayabaşı 2011; Deniz 2008; Kıncal 2018; Tuzlacı 2016) (Uysal 2008; Yüzbaşıoğlu 2010; Tuzlacı 2016) (Yıldırım 2015) Cyperus rotundus L. Cyperaceae Topalak otu Root Crushed, Ext. (Uysal 2008) Diospyros lotus L. Ebenaceae Laz hurması, Kara hurma Leaf Inf., Int. (Saraç et al.2013; Tuzlacı 2016) Elaeagnus angustifolia L. Elaeagnaceae İğde Seed Fruit Leaf Dec., Int. Eaten Inf., Int. (Altundağ 2009) (Güzel et al 2015; Korkmaz and Karakurt 2014) (Polat 2010) Erica manipuliflora Salisb. Ericaceae Funda, Püren, Süpürge otu Young Shoots Dec., Int. (Bulut 2006) Eriobotrya japonica (Thunb.) Lindly Rosaceae Malta eriği, Muşmula Leaf Inf., Int. Dec., Int. (Uysal 2008) (Tuzlacı 2016) Euphorbia denticulata Lam. Euphorbiaceae Hekletis, Sütleğen otu Latex Int. (Kaval et al. 2014; Tuzlacı 2016) Fagus orientalis Lipsky Fagaceae Doğu kayını Stem Bark Dec., Int. (Kural 2012) Ficus carica L. subsp. Moraceae carica İncir Leaf Raw, Int. Dec., Int. (Alkaç 2013) (Tuzlacı 2016) Glaucium leiocarpum Boiss. Gelincik Flower Inf., Int. Dec., Int. (Doğan 2014) (Tuzlacı 2016) Gundelia tournefortii L. Asteraceae Kenger Root Latex, Eaten (Hayta et al. 2014; Çakılcıoğlu and Türkoğlu 2010) Helichrysum Asteraceae arenarium (L.) Moench. Altın otu Leaf Capitulum, Inf., Int. 2015) (Akan and Sade Helichrysum plicatum Asteraceae DC. subsp. plicatum Arı Çiçeği, Ölmez Çiçek, Yayla Çiçeği Aerial parts Flowering Branches Inf., Int. Inf.,Int. (Arısan 2010) (Altundağ 2009) Papaveraceae b Helleborus orientalis L. Ranunculaceae Bohça, Bohça otu, Çöp otu, Çöpleme Leaf, Rhizome Eaten (Kızılarslan and Özhatay 2012) Hordeum vulgare L. Poaceae Arpa Spike Whole plant Inf., Int. Inf., Int. (Sargın et al. 2013) (Korkmaz and Karakurt 2014) Hypericum cerastoides (Spach) N. Robson Hypericaceae Kantaron, Küçük Kantaron Aerial parts Dec., Int. (Kızılarslan and Özhatay 2012; Tuzlacı 2016) Hypericum scabrum L. Hypericaceae Mide otu, Yara otu Aerial parts Inf., Int. (Doğan 2014; Tuzlacı 2016) Karahüseyin and Sarı. Plants used in traditional treatment against diarrhea in Turkey Table 1. List of the plants used in traditional treatment against diarrhea in Turkey (continued) Preparation, administration and use Reference Khişkeş, Mıcve, Leaf Yerce, Zimbit Eaten (Güzel et al. 2015) Juglandaceae Ceviz Seed Leaf Fruit Bark Inf., Int. Dec., Int. Dec., Int. (Aktan 2011) (Şenkardeş 2014; Tuzlacı 2016) (Sargın et al. 2013) Juniperus drupacea L. Cupressaceae Andız Tar +Water, Int. (Orhan 2011) Juniperus oxycedrus L. Cupressaceae Ardıç Leaf, Branches Jurinella moschus (Habl.) Bobrov subsp. pinnatisecta (Boiss.) Danin and P.H.Davis Asteraceae Gazangulpu, Kazankulpu Whole plant Dec., Int. (Altundağ 2009) Lysimachia vulgaris (L.) Pohl Primulaceae Giya baluk Leaf Dec., Int. (Dalar et al. 2018) Malva neglecta Wallr. Malvaceae Ebegümeci, Ebemkömeci Aerial parts Dec., Int. (Altundağ 2009) Matricaria chamomilla Asteraceae L. var. recutita (L.) Grierson Papatya Aerial parts (Without Flower) Inf., Int. (Sargın et al. 2013) Melissa officinalis L. Oğul otu Leaf and Young Shoots Inf., Int. (Bulut 2006; Tuzlacı 2016) Mentha longifolia (L.) Lamiaceae Hudson subsp. longifolia Bung, Pung, Yarpız, Yarpuz Leaf Inf., Int (Altundağ 2009; Tuzlacı 2016) Mentha x piperita L. Bünk, Mentol nane, Kedi nanesi, Tıbbi nane Aerial parts Dec., Int. (Akan and Sade 2015) Mespilus germanica L. Rosaceae Beşbıyık, Döngel, Muşmula, Töngel Leaf Fruit Inf., Int. Dec., Int. Eaten (Karcı 2013) (Onar 2006; Tuzlacı 2016) (Bulut 2006; Kural 2012; Güler et al. 2015; Tuzlacı 2016) Morus alba L. Moraceae Akdut, Beyaz dut, Dut Leaf Inf., Int. (Sargın et al. 2013) Musa sapientum L. Musaceae Muz Fruit Eaten (Uysal 2008; Tuzlacı 2016) Myrtus communis L. Myrtaceae Mersin, Murt Leaf Dec., Int. Inf., Int. (Güneş et al. 2017) (Tuzlacı 2016) Olea europaea L.var. sylvestris (Mill.) Lehr. Oleaceae Zeytin Leaf and Stem Bark Inf., Int. (Bulut 2006) Opuntia ficus-indica (L.) Mill. Cactaceae Frenk inciri, Kaynana dili, Tin sabır Fruit Eaten (Güzel et al 2015; Güler et al. 2015) Orchis coriophora L. Orchidaceae Sahlep Root Dec., Int. (Doğan 2014; Tuzlacı 2016) Orchis palustris Jacq. Orchidaceae Sahlep Root Dec., Int. (Doğan 2014; Tuzlacı 2016) Orchis punctulata Steven ex Lindley Orchidaceae Sahlep Root Dec., Int. (Doğan 2014; Tuzlacı 2016) Origanum onites L. Lamiaceae Beyaz kekik, Deli kekik, Eşek kekiği, Güve otu, Karakekik, Kekik Aerial parts Leaf Cooked with +Monk’s pepper, Thyme, Flour, Water, Ext. Inf. or Dec., Int. Aromatic Water, Int. Inf., Int. (Uysal 2008) (Gürdal and Kültür 2013; Tuzlacı 2016) (Tütenocaklı 2014) Botanical name Family Local name b Inula viscosa (L.) Aiton Asteraceae Juglans regia L. Lamiaceae Lamiaceae Plant parts used (Orhan 2011) 37 Istanbul J Pharm 49 (1): 33-44 Table 1. List of the plants used in traditional treatment against diarrhea in Turkey (continued) Botanical name Family Local name Plant parts used Preparation, administration and use Paliurus spinachristi Miller Rhamnaceae Çaltı Fruit Inf., Int. (Bulut and Tuzlacı 2009) Papaver somniferum L.var. somniferum Papaveraceae Afyon, Afyon çiçeği, Haşhaş, Haşhaş kozağı, Yeleğen mavi Fruit Bark Dec., Int. (Sargın et al. 2013; Tuzlacı 2016) a Parietaria judaica L. Urticaceae Duvar reyhanı, Yapışık ot Aerial parts Inf., Int. Eaten (Tuzlaci and Şenkardeş 2011) Phlomis pungens Willd.var. hirta Velen Lamiaceae Ayıkulağı, Calba Aerial parts Eaten (Vural 2008) b Pinus brutia Ten. Pinaceae Çam, Kızılçam Dried Stem Bark and Mastic Crushed, Int. (Güneş et al. 2017) Pinus nigra Aitonsubsp. pallasiana (Lamb.) Holmboe Pinaceae Çam gıdısı, Karaçam Tar Ext. (Arısan 2010) Pinus pinea L. Pinaceae b 38 Reference Fıstık çamı Branches Dec., Int. (Kökçü 2015) Pistacia eurycarpa Yalt. Anacardiaceae Menengeç Fruit Eaten (Doğan 2014; Tuzlacı 2016) Pistacia terebinthus L. Anacardiaceae Menengiç Fruit Pistacia vera L. Kaliki-fıstığa Anacardiaceae (Akan and Sade 2015) Fruit Bark Dec., Int. (Dağlı 2015) Plantago lanceolata L. Plantaginaceae Sinir otu, Sinirli ot Seed Int. Dec., Int. (Genç and Özhatay 2006) (Kolaç 2018) Plantago major L. subsp. major Plantaginaceae Damar otu, Kara kabarcık, Siğilli ot, Sinir otu, Sinirli ot Flower Seed Dec., Int. Dec., Int. +Yoghurt, Int. (Genç and Özhatay 2006) (Karataş 2007) (Kızılarslan and Özhatay 2012) Platanus orientalis L. Platanaceae Çınar, Kavak Fruit Leaf Stem Bark Dec., Int. Inf., Int. Dec., Int. Dec., Int. (Bulut and Tuzlacı 2009; Kökçü 2015; Tuzlacı 2016) (Koçyiğit and Özhatay 2006) (Vural 2008) (Polat 2010) Populus tremula L. Salicaceae Bodur kavak Stem Bark Dec.,Int. (Doğan 2014; Tuzlacı 2016) Potentilla recta L. Rosaceae Acı hayıt, Root Beşparmak otu Dec., Int. (Deniz 2008) Potentilla reptans L. Rosaceae Beşparmak otu Leaf Dec., Int. (Yılmaz 2011; Öztürk 2006; Tuzlacı 2016) Prosopis farcta (Banks and Sol.) J.F.Macbr. Fabaceae Çeti, Hışhaş Fruit Root Eaten Dec., Int. (Gençay 2007; Tuzlacı 2016) (Balos and Akan 2007) Prunus cerasus L. Rosaceae Vişne Fruit Juice, Int. Eaten (Korkmaz and Karakurt 2014) (Metin 2009) Prunus divaricata Ledeb. Rosaceae Dağ eriği, Fruit Gakka, Kuş eriği Juice, Int. (Korkmaz and Karakurt 2014) Prunus x domestica L. Rosaceae Erik Boiled with Turkish Coffee, Int. (Kolaç 2018) Fruit Karahüseyin and Sarı. Plants used in traditional treatment against diarrhea in Turkey Table 1. List of the plants used in traditional treatment against diarrhea in Turkey (continued) Botanical name Family Local name Plant parts used Preparation, administration and use Prunus persica (L.) Batsch. Rosaceae Şeftali Fruit Flower Eaten Inf., Int. Prunus spinosa L. Punica granatum L. a Reference (Korkmaz and Karakuş 2013; Metin 2009; Kolaç 2018) (Kolaç 2018) Rosaceae Dağ eriği Fruit Eaten (Eşen 2008) Punicaceae Hennar, Hınar, Nar Fruit Seed Fruit Bark Juice, Int. Cooked in Cinder, Ext. Eaten Crushed, Int. (Gençay 2007) (Uysal 2008) (Güzel et al 2015) (Balos and Akan 2007) Pyrus amygdaliformis Rosaceae Vill. subsp. amygdaliformis Ahlat, Leaf Çakal armudu, Fruit Çördük armudu, Deli armut, Yaban armudu Dec., Int. Eaten (Uysal 2008) (Deniz 2008; Tuzlacı 2016) Pyrus elaeagnifolia Pall. subsp. elaeagnifolia Dağ armudu, Yabani armut Fruit Eaten (Tuzlaci and Şenkardeş 2011; Tsetsekos 2006; Güldaş 2009; Keskin 2011) Pyrus elaeagnifolia Rosaceae Pall. subsp. kotschyana (Boiss.) Browicz. Ahlat, Ahlet, Deli armut, Taş armut ImmatureFruit Flower Raw, Eaten Inf., Int. (Korkmaz and Karakurt 2014; Tuzlacı 2016) (Yıldırım 2015) Pyrus syriaca Boiss. var. syriaca Rosaceae Çakal armut, Dağ armudu, Yaban armudu Fruit Eaten (Furkan 2016; Tuzlacı 2016) Quercus coccifera L. Fagaceae Kermes meşesi, Gall Piynar Dec., Int. (Metin 2009; Çilden 2011) Quercus ithaburensis subsp. macrolepis (Kotschy) Hedge and Yalt. Fagaceae Meşe palamudu Gall Eaten (Akan and Sade 2015; Tuzlacı 2016) Rhus coriaria L. Anacardiaceae Sımak, Sumak Fruit Seed Leaf Eaten Inf., Int. Dec., Int. Dec., Int. Mac., Int. (Güldaş 2009) (Balos and Akan 2007) (Metin 2009) (Metin 2009) (Furkan 2016) Rosa canina L. Rosaceae İtburnu, İtgülü, Kuşburnu, Öküzgözü Fruit Dec., Int. Inf., Int. Eaten Marmalade, Int. (Sargın et al. 2013; Karataş 2007) (Güneş et al. 2017) (Karagöz and Serteser 2017) (Karagöz and Serteser 2017; Keskin 2011; Tuzlacı 2016) Rosa damascenaMill. Rosaceae Gül Flower Inf., Int. (Güler et al. 2015; Tuzlacı 2016) Rubus canescens DC. var. glabratus (Gordon) Davis and Meikle Böğürtlen, Kapina, Karamık Root Dec., Int. Eaten (Genç and Özhatay 2006; Tuzlacı 2016) (Kayabaşı 2011) a Rosaceae Rosaceae Rubus sanctus Schreb. Rosaceae Böğürtlen Root Dec., Int. (Uysal 2008) Rumex acetosella L. Ekşilik, Kuzukulağı Leaf Eaten (Güler et al. 2015) Polygonaceae 39 Istanbul J Pharm 49 (1): 33-44 Table 1. List of the plants used in traditional treatment against diarrhea in Turkey (continued) Botanical name Family Local name Plant parts used Preparation, administration and use Reference Rumex crispus L. Polygonaceae Ekşi ot, Gıcırgıcır, Labada Root Leaf Seed Dec., Int. Inf., Int. Eaten (Oral 2007) (Oral 2007) (Kökçü 2015) Rumex patientia L. Polygonaceae Ebelik, Kalmuk çayı, Labada, Tırşıka karan, Yılkıkulak Leaf Root Dec., Int. Inf., Int. (Uysal 2008) (Yeşil and Akalın 2009) Salvia tomentosa Mill. Lamiaceae Boğaç otu, Boşçapula, Ellik otu, Sancı otu, Şabıla, Şalpa, Yakı otu Aerial parts Inf., Int. (Sargın et al. 2013) Sanguisorba minor Scop. subsp. magnolii (Spach) Briq. Amel otu, Çayır düğmesi, Kara gömdürme, Kelek otu Aerial parts Raw, Eaten (Furkan 2016) Altın dikeni, Sarıdiken Leaf, Capitulum Dec. Int. (Metin 2009) Rosaceae Scolymus hispanicus L. Asteraceae Secale cereale L. Poaceae Çavdar Seed Inf., Int. (Yıldırım 2015) Sideritis tmolea P.H. Davis Lamiaceae Sarı çiçekli yakı otu Aerial parts with Flower Inf., Int. (Sargın et al. 2013) Silene vulgaris (Moench) Garcke. var. vulgaris Caryophyllaceae Cırvınık Aerial parts Dec., Int. (Doğan 2014; Tuzlacı 2016) Solanum nigrum L. Solanaceae Fruit Cooked with +Thyme, Monk’s pepper, Flour, Water, Ext. (Uysal 2008) Solanum tuberosum L. Solanaceae Gumpir, Kıtola, Tuber Kumpir, Patates, Patati Cooked, Int. (Uysal 2008; Korkmaz and Karakuş 2013; Karakurt 2014; Ayandın 2010; Saday 2009; Yıldırım 2015; Tuzlacı 2016; Kıncal 2018; Kolaç 2018) Sorbus aucuparia L. Rosaceae Kuş üvezi Fruit Jam (Kural 2012) Sorbus domestica L. Rosaceae Hüvez Fruit Eaten (Kökçü 2015) Taraxacum androssovii Schischk. Asteraceae Acıgıcı, Hapşuruk otu, Zeze Capitulum Dec., Int. (Altundağ 2009) Taraxacum farinosum Asteraceae Hausskn. and Bornm. ex Hand.-Mazz. Hindiba, Karahindiba Leaf Inf., Int. (Güneş et al. 2017) b b Taraxacum fedtschenkoi Hand.Mazz. Asteraceae Acıgıcı, Hapşuruk otu, Zeze Capitulum Dec., Int. (Altundağ 2009) Taraxacum macrolepium Schischk. Asteraceae Acıgıcı, Hapşuruk otu, Zeze Capitulum Dec., Int. (Altundağ 2009) Dec., Int. Inf., Int. Dec., Int. (Oral 2007) (Oral 2007) (Alkaç 2013) b Teucrium chamaedrys Lamiaceae L. subsp. chamaedrys 40 Köpek sirkeni Bodur Mahmut, Aerial parts Bodurca Mahmut, Leaf Cüce Mahmut Karahüseyin and Sarı. Plants used in traditional treatment against diarrhea in Turkey Table 1. List of the plants used in traditional treatment against diarrhea in Turkey (continued) Botanical name Family Local name Plant parts used Teucrium polium L. Lamiaceae Acı Yavşan, Aerial parts Egzama otu, Leaf and Flower Kırmızı ballıbaba, Leaf Mayasıl otu, Meryemkot, Oğlan otu Tribulus terrestris L. Preparation, administration and use Reference Dec., Int. Inf., Int. Boiled with Molasses, Ext. Inf., Int. Inf., Int. (Han and Bulut 2015) (Akan and Sade 2015; Tuzlacı 2016) (Metin 2009) (Bulut 2006) (Tetik et al. 2013) Zygophyllaceae Çakır dikeni, Fruit Çoban çökerten, Demir diken, Deve çökerten Dec., Int. Inf., Int. (Doğan 2014; Tuzlacı 2016) (Tetik et al. 2013) Trifoliumpratense L. Fabaceae Yonca Aerial Parts Dec., Int. (Hayta et al. 2014; Tuzlacı 2016) Triticum sp. Poaceae Buğday Seed Flour, Int. (Günbatan et al. 2016) Urtica dioica L. Urticaceae Isırgan otu Leaf with Seed Dec., Int. (Uysal 2008) Vaccinium arctostaphylos L. Ericaceae Ayı üzümü, Lifos, Likarba Leaf Dec., Int. (Kural 2012) Viburnum lantana L. Caprifoliaceae Germeşo, Germişek Fruit Dec., Int. (Altundağ 2009; Tuzlacı 2016) Vicia faba L. Fabaceae Bakla, Pakla Seed Eaten (Yıldırım 2015) Viscum album L. b Loranthaceae Vitex agnus-castus L. Verbenaceae a Vitis vinifera L. Vitaceae Ökse otu Leaf Dec., Int. (Saraç et al.2013) Hayıt Seed Branches Dec., Int. Swallowed, Int. Crushed, Int. Poultice, Ext. (Sargın et al. 2013) (Polat 2010; Tuzlacı 2016) (Uysal 2008) (Gürdal and Kültür 2013) Üzüm, Asma, Tevek Fruit Juice, Int. (Furkan 2016) Int: Internal, Dec: Decoction, Ext: External, Fac: Fruits are crushed, Inf: Infusion, Mac: Maceration RESULTS AND DISCUSSION Families An ac ar di ac ea As e te Cu rac ea pr e es sa ce Fa ae ba ce ae Fa ga c La eae m ia ce O ae rc hi da ce ae Ro sa ce So ae la na ce ae 30 25 20 15 10 5 0 Families Figure 1. Graph of main families used in traditional treatment against diarrhea in Turkey MATERIALS AND METHODS In this study, a thesis search was carried ot at the National Higher Education Center alongside an analysis of ethnobotanical studies conducted in various parts of Turkey with selecting regional plants used for the treatment of diarrhea. Plants have always been an important source for not only nutrition but also therapeutic use against a considerable number of human diseases. Recent phytochemical studies on medical plants have supported the effectiveness of folkloric medicines. Since ancient times, plants have been used for curing various diseases and infections (Singh et al. 2017). Turkey has an extraordinary plant diversity and varies by region. Its flora consists of about 10,000 vascular plants and approximately one third of its flora (34.4 %) is endemic to the country (Demirci and Özhatay 2012; Gürdal and Kültür 2013). Recently, the use of ethnobotanical information obtained from medicinal plant research has gained attention all around the world. For this reason, numerous ethnobotanical studies have recently been published and much has been written about medicinal plants in our country (Gürdal and Kültür 2013). Since these medicinal plants have been used in folk medicine by the public for many years, the information about how to use these plants in the treatment of illnesses has been passed down for generations. In this study, we compiled 133 plant species used in folk medicine for the treatment of diarrhea in Turkey from the ethnobo- 41 Istanbul J Pharm 49 (1): 33-44 tanical studies and the theses published at the National Higher Education Center between the years of 2002-2018. Accordingly, this study reveals that Achillea wilhelmsii C. Koch., Parietaria judaica L., Punica granatum L., Rubus canescens DC. var. glabratus (Godron) Davis and Meikle, Vitex agnus-castus L, shown as a in the table, are used for the treatment against diarrhea in both humans and animals. Moreover, some species such as Helleborus orientalis L., Inula viscosa(L.) Aiton, Phlomis pungens Willd. var. hirta Velen, Pinus brutia Ten., Taraxacum androssovii Schischk.,Taraxacum fedtschenkoi Hand.-Mazz., Taraxacum macrolepium Schischk., Viscum album L. which are marked as b in the Table 1 are only used for the treatment of diarrhea in animals. In Figure 1, there is a graph of the main families used in the treatment of diarrhea in Turkey. The plants used for the treatment of diarrhea are mainly from Rosaceae, Asteraceae, Lamiaceae, Fabaceae, Anacardiaceae, Orchidaceae, Cupressaceae, Fagaceae and Solanaceae families (Figure 1). The plants of these families mainly take bioactive molecule groups in their different parts such as fruit, seed, root, aerial parts (Bilaloğlu and Harmanar 1999). Phytomedicines have a significant role, both as traditional home remedies and as galenic preparations, in the symptomatic treatment of diarrhea. Three groups of preparations are particularly important: tannin-containing herbs, pectins, and a special strain of live dried yeast (Schulz et al. 2004). Since diarrhea may occur because of fungal, bacterial, viral, and non-infectious causes and many of the plants reported in this study contain pharmaceutically bioactive compounds, including flavones, flavonoids, phenolic acids, tannins, anthocyanin compounds, volatile oil, minerals, vitamins, and polysaccharides (Bilaloğlu and Harmandar 1999). In these molecule groups, tannins especially are medicinally significant because of their astringent properties. Inwardly tannins are administered in cases of diarrhea, intestinal catarrh and as an antidote in cases of heavy metal poisoning (Adhikari and Kundu 2017). They can provide short-term healing and anti-inflammatory effects on the gut wall, though they are likely to rapidly reduce in transit through the tract unless they are in a slowly dispersing solid form. Effects on the bowel, can be significant if the symptom is a reflex consequence of irritation in the gastric or upper enteric passages. The use of tannins is not to be recommended as a long-term solution. Because when they are used as long-term therapy, they can cause constipation, iron deficiency anemia and malnutrition. Therefore long-term therapy with high doses of tannins is to be avoided (Bone and Mills 2013). In this study, Potentilla, Quercus, Camellia, Vaccinium and Alchemilla sp. are known as plant remedies traditionally used for tannin constituents (Schulz et al. 2004; Bone and Mills 2013). 42 For centuries, physicians have used preparations containing flavonoids as basic physiologically active components and lay healers attempt to treat human diseases (Cushnie and Lamb 2005). Up till today, plant-derived flavonoids have showed nu- merous biological activities, including antiallergic, antibacterial, antidiabetic, antiinflammatory, antiviral, anti-proliferative, antimutagenic, antithrombotic, anticarcinogenic, hepatoprotective, oestrogenic, insecticidal, and antioxidant activities (Cushnie and Lamb 2005; Orhan et al. 2010). Flavonoid containing poultices, infusions, spices and balms have been used in many cultures based on ethnomedicinal use for centuries (Cushnie and Lamb 2011). As stated above, there are many kinds of diarrhea and some are caused by infections. In this way, flavonoids in terms of having antimicrobial activities might show a strong ability to cure the pathogenesis. As a result, flavonoids can also be used as a drug to treat diarrhea. 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