The Anti-Nausea Properties Of Ginger

Introduction

With all the advancements in medical and pharmacological interventions, it is truly remarkable how ginger – used since ancient times - remains one of the most commonly recommended treatments for nausea. Today, ginger may be used in many clinical contexts, including pregnancy and chemotherapy. In this article, we will delve into the anti-nausea and anti-emetic properties of ginger and how to effectively use it.

Understanding nausea

Nausea and vomiting are common complaints throughout all age groups. Either symptom can impede a person’s daily activities and, subsequently, their quality of life. Nausea and vomiting are associated with one another but do not describe the same thing: Nausea refers to the sensation of wanting to vomit, whereas vomiting is the action itself. Depending on the case, nausea does not have to be followed by vomiting, nor does it have to precede vomiting (although it usually does).¹

In many ways, nausea can be considered a defence mechanism to stimuli such as toxins/drugs, pain, strong emotions, or strong/unpleasant smells. Given that nausea is a subjective sensation, current literature is mainly focused on the subsequent reaction to nausea, which is vomiting. Therefore, many sources may use the term “anti-emetic” rather than “anti-nausea”, because ‘emesis’ is the action of vomiting, this has been studied in better detail than the sensation of nausea itself.²

Numerous mechanisms involving several body systems can trigger nausea and vomiting. The vomiting centre receives signals from the cerebral cortex, vestibular apparatus, splanchnic nerves, gastrointestinal tract, and chemoreceptor trigger zone (CTZ). Each of those sites is associated with different triggers³

• Cerebral cortex – Fear, pain, anxiety, smell and raised intracranial pressure.
• Vestibular apparatus – Motion sickness, vestibular neuritis, cerebral tumours, some ear conditions.
• Splanchnic nerves (and vagus nerve) – Gastritis/ gastric irritation, gastrointestinal distention, cardiac ischemia.
• Gastrointestinal tract – Toxins/infections, mechanical stimulation and bloating.
• Chemoreceptor trigger zone – Drugs, radiotherapy, chemotherapy, toxins, pregnancy.

Historical overview of ginger

The scientific name for ginger is Zingiber Officinale. This flowering plant has been used for both medicinal and cooking purposes, but it is the underground stem of the flower, the ‘rhizome’, which is edible. Ginger is best cultivated in warm tropical environments with adequate rainfall and rich volcanic soil; thus, it was primarily grown in places such as India, China, Indonesia, and Peru.⁴

Whilst the origin of ginger can be debated, some of the first documentation of ginger was in southeast Asia and China. Due to the predominance of herbal medicine then, ginger was considered an expensive purchase. In the early 14^th century, a pound of ginger could cost more than one sheep! Interestingly, in the Middle Ages, ginger was also commonly used to protect against/ treat the plague. You may now find ginger in foods, beverages (such as ginger beers, ales and juices), medications, oils and sprays.^5,6

How ginger works against nausea

Scientific research attributes the pharmacological properties of ginger to two components: gingerols and shogaols. Gingerols are found in ginger rhizomes, whereas shogaols are mainly found in dried ginger. These are substances found in the group of non-volatile compounds of ginger. Together with volatile oils, they also give rise to the pungent smell and strong flavour of ginger. Through an array of extensive research, it seems that the primary action of ginger targets the gastrointestinal tract.⁷

If the nausea is due to digestion issues, ginger can help in multiple ways. It increases the saliva and other digestive secretions, which could improve the symptoms of indigestion and bloating. Some literature considers ginger to be effective at reducing functional gastrointestinal disorders (e.g., irritable bowel syndrome and acid reflux) because ginger has some anticholinergic, antiserotonergic and anti-inflammatory properties. As such it can aid in increasing gastric motility and emptying, which could address symptoms of dyspepsia and associated nausea. The inhibitory effects of gingerols and shogaols can also interfere with nerve signalling, which potentially plays a role in reducing nausea.

Ginger is considered safe for human consumption and is listed by authorities such as the U.S Food and Drug Administration (FDA) and British Herbal Compendium for use in managing certain medical conditions and presentations. Ginger can be found in many forms: fresh, dried, pickled, powdered, crystallised, or candied. It may also be bought as capsules, tablets, tea/drinks, or liquid extracts (can be pure). The concentrations of ginger and its active ingredients will vary depending on the form and the manufacturer/supplier. At the moment, the consensus on the minimum or maximum amount of ginger ingestion per day is unspecified, but therapeutic effects concerning nausea are mainly documented for doses below 1000 mg per day.⁷

Is ginger effective at treating nausea?

Pharmacological anti-nausea treatments include Cyclizine, Metoclopramide, Ondansetron, Hyoscine hydrobromide and Levomepromazine. The efficacy of these medications has been extensively researched and thus they are often used in hospitals, clinics and even in the community. Some medications such as hyoscine hydrobromide, which is used to treat motion sickness, can be purchased over-the-counter. However, as with many medications, there are side effects to the use of such pharmacological interventions, and so, in some cases, patients may be advised to try ginger initially.

Several studies have noted the impact of ginger on groups of patients affected by nausea, mainly pregnancy-related and chemotherapy-induced nausea. At the moment, there is a lack of scientific research or trials exploring the effects of ginger on other causes of nausea and vomiting. A systematic review conducted in 2014 highlighted that ginger was more effective at managing pregnancy-related nausea and vomiting when taken at a dose of approximately 1000 mg/day than placebo. The participants in the study used various forms of ginger, such as ginger biscuits, ginger syrup, and ginger capsules. It is important to note that the participants ingested ginger 4 times a day and for at least 4 days. Therefore, ginger may help if taken frequently and consistently.⁸

The findings of ginger vs other medications to treat nausea and vomiting are not always concordant. One study, investigating the efficacy of ginger against an anti-histaminic drug (Dimenhydrinate), concluded that ginger was equally effective as the drug but had fewer side effects. The effects of ginger were not significantly better than those of the medication Metoclopramide in another study. Our current understanding of ginger and how it compares to other anti-emetic medications is still lacking, as the evidence we have is not robust. However, based on patient-reported findings, ginger can help in acute nausea and vomiting, morning sickness/ pregnancy, chemotherapy-induced nausea, and even unexplained nausea.^9,10

Summary

Ginger offers a gentle and effective remedy for individuals seeking relief from the discomfort of nausea and vomiting. Its mechanism of action is centred around modulating digestive processes, which allows for a more natural approach to managing symptoms. It also has fewer side effects relative to pharmacological anti-nausea interventions, but further exploration of its efficacy is required.

FAQs

Is ginger safe for everyone to consume, including children and older adults?

In general, yes! The major exception would be people who are allergic to ginger. Limiting ginger intake to 1000 mg (or 1 gram) would be a safe way of taking ginger daily. If you experience any discomfort or side effects, talk to your doctor.

Does ginger help with post-operative nausea and vomiting?

There isn’t enough significant evidence to show that ginger helps with post-operative nausea and vomiting. The British National Formulary (BNF) only mentions its use in motion sickness, pregnancy, and aromatherapy. It may also be used to relieve pain and osteoarthritis.

Can ginger be used as a preventative measure for nausea or is it more effective for immediate relief?

Both! It can be taken as prophylaxis, especially in “anticipatory nausea”. It also helps as immediate relief (after the onset of nausea and vomiting). Ingesting or smelling ginger can curb away the feeling of nausea.

What forms of ginger are most effective at combating nausea?

There is no specific form of ginger which is better than the others. For some individuals, the aroma of ginger alongside its ingestion can reduce nausea, so fresh ginger or ginger tea might be the most useful. Whereas, if a woman is affected by morning sickness or has hyperemesis gravidarum, taking ginger capsules might be more effective because they can take higher doses of ginger this way.  You can try various forms and find the one you’re most comfortable with.