Phytotherapy Used in Ailments of the Digestive System by Andean Inhabitants of Pampas, Huancavelica, Peru

1. Introduction

There are a large number of disorders of the digestive system, which impose a substantial influence on morbidity and mortality rates, throughout the world. These disorders of the digestive system, known collectively as gastrointestinal disorders, are most frequently cited in communities living in areas of the Andes, where poor sanitation practices are more common [1]. These disorders range from short-term indigestion or flatulence to long-term structural abnormalities and chronic diseases that have a substantial influence on morbidity and mortality. According to the World Health Organization (WHO), gastrointestinal disorders caused nearly 1 million adult deaths worldwide during 2019, with diarrhea alone responsible for 370,000 deaths in children under 5 years of age [2].

During recent years, there has been a global trend in renewed interest in a traditional system of treatments [3,4,5,6,7]. Studies of ethnomedicinal plants have become of particular interest and increasingly valuable in the development of health care and conservation programs in different parts of the world, where the WHO has recognized the role of traditional medicine in the health care system. primary health [8]. In developing countries, medicinal plants continue to be a major source of medicines. It has been estimated that approximately 88% of people in underdeveloped countries rely primarily on traditional medicine for their primary form of health care [7].

The use of herbs as medicines to treat digestive tract ailments is widespread [2,9]. In digestion, food and drink are transported in the digestive tract, broken down into small parts, called nutrients, which the body can absorb and use as energy and building blocks for cells. Digestive diseases are disorders of the digestive or gastrointestinal tract, which interfere with the digestive process that includes ingestion, propulsion, mechanical or physical digestion, chemical digestion, absorption and defecation [2,3,5,9,10]. Considering that disorders of the digestive system are often closely interrelated, medicinal plants used for treatment tend to have multiple purposes and can be used for a variety of digestive symptoms and disorders [10].

Thus, people can treat many problems related to the digestive system by regularly using herbal preparations in the diet that can improve the function of the digestive system [2,3,5,9,11]. These herbal digestive preparations work in various ways, for example, healing the lining of the intestine, activating the digestive process and promoting easy bowel movements, increasing the frequency of bowel movements, detoxification and elimination of toxins, helps calm discomfort stomach and reduces gas, bloating and digestive discomfort [11].

Peru has a variety of ecological floors, presenting diverse climates, thus conserving a high biodiversity of flora and fauna; with a variety of medicinal plants, used mostly by Andean inhabitants [8,12]. The Peruvian Andes preserve their traditions and culture regarding the usefulness of medicinal plants, using language to transfer their knowledge through generations [13,14].

Reason that motivated the present study, whose objective was to identify the medicinal plants used in the therapy of ailments of the digestive system by the Andean inhabitants of Pampas, in the Huancavelica region of Peru; which is very far from the big cities of the country, being abandoned by the rulers, presenting high levels of poverty and extreme poverty [15], frequently resorting to the use of nature to treat their health problems, using plants to do so. medicinal in the therapy of various ailments or diseases presented by the inhabitants.

2. Materials and Methods

Study area

Study carried out in the Andean community of Pampas, Tayacaja province, Huancavelica region, Peru; located in the mountains of the center of the country, at 3276 meters above sea level, surface of 109.07km2, 12°23'42'' L.S. and 74°'52'02'' L.W., presenting a temperate climate with moderate rains and dry winters, annual rainfall ranges from 500 – 1500 mm, with its main source of income being livestock and agriculture.

Sample

The sample consisted of 370 inhabitants (n), determined through the population and unknown variance, where the population was 10,061 inhabitants (N), margin of error of 0.05 (d), confidence level of 0.95 (Z), success of 0.50 (p) and q=1-p [16].

$$\frac{\mathbf{N}{\mathit{Z}}^2\mathit{p}\mathit{q}}{{\mathit{d}}^2\left(\mathit{N}-1\right)+{\mathit{Z}}^2\mathit{p}\mathit{q}}$$

Sampling method

The sampling was of the non-probabilistic type, selecting the study subjects to be surveyed, comprising mostly buyers and sellers of medicinal plants from the markets of the community of Pampas; considering the inclusion criteria, such as being an inhabitant over 20 years of age and using medicinal plants in the therapy of their digestive system ailments; and, the exclusion criterion, are those inhabitants who do not meet the inclusion criteria or present signs of falsehood in their answers.

The surveys were carried out monthly from January 2021 to December 2022, obtaining information on the medicinal plants used in the therapy of ailments of the digestive system. Using the “snowball” technique, which included asking questions to the first respondent, classifying him as “knowledgeable”, at the end of the interview he proposed the name of the next inhabitant to be interviewed, calling him “knowledgeable” and following that methodology until finishing the 370 surveys [17].

Technique and instrument of collecting information

Using semi-structured interviews, where prior to this the validation and reliability of the instrument was carried out. Then, the collection of medicinal plants made known by the inhabitants was carried out, with taxonomic determinations being carried out in the Department of Botany and in the Herbarium Truxillensis of the National University of Trujillo; collecting information regarding the use of medicinal plants of the Andean inhabitants of Pampas in the therapy of ailments of the digestive system, regarding the Classification of diseases and conditions of the World Health Organization (WHO) [18].

Analysis of data

The information was organized in Microsoft Excel spreadsheets; complemented through various sources in the area of interest [19].

Ethical aspects

In this research, the informed consent of the Andean inhabitants of Pampas was obtained, maintaining the anonymity of the respondents.

3. Results

16 families, 33 genera and 34 species are reported; used in phytotherapy for ailments of the digestive system by the Andean inhabitants of Pampas; where the families that have the greatest number of species are Asteraceae, Lamiaceae and Apiaceae with 6, 6 and 5 species respectively; and, the families that have the smallest number of species are Amaranthaceae, Bromeliaceae, Fabaceae, Gentianaceae, Monimiaceae, Plantaginaceae, Rubiaceae, Rutaceae, Solanaceae and Xanthorroeaceae, with one species each; Likewise, the ethnomedicinal usefulness of each reported species is detailed (Table 1).

Figure 1 details the percentage of ethnobotanical families reported by the Andean inhabitants of Pampas, in the therapy of their ailments presented in the digestive system; where the families Lamiaceae (32.8%; 121 reports) and Asteraceae (28.4%; 105 reports) are the widely used ones; and, the families with the least use are the Rubiaceae, Plantaginaceae, Monimiaceae, Bromeliaceae and Brassicaceae with 0.7% and 3 reports each.

Figure 2 reports the ethnobotanical species used in the therapy of ailments of the digestive system by the Andean inhabitants of Pampas; where the most used species are Minthostachys mollis (11.9%; 44 reports), Aloe vera (10.4%; 37 reports), Clinopodium bolivianum (9%; 33 reports), Artemisia absinthium (9%; 33 reports) and Matricaria chamomilla (8.2%; 30 reports); and, the species of lesser use are Uncaria tormentosa, Tillandsia cacticola, Smallanthus sonchifolius, Rorippa nasturtium-aquaticum, Plantago major, Piper aduncum, Pimpinella anisum, Peumus boldus, Petroselinum crispum, Peperomia inaequalifolia, Hedeoma mandoniana, Foeniculum vulgare, Eryngium foetidum, Cynara cardunculus, Corryocactus odoratus and Austrocylindropuntia floccosa with 0.7% and 3 reports each.

4. Discussion

34 species of plants were identified to be used in the therapy of ailments of the digestive system; such as stomach pain, constipation, gallbladder ailments, gastritis, gastrointestinal and liver diseases (table 1; figure 2). The results suggest that locals prefer herbal remedies for the treatment of ailments of the digestive system, as in most cases, herbal preparations provide instant relief without any significant side effects. One of the reasons associated for the excessive use of plants for the treatment of digestive system ailments is a taboo related to certain ailments; such as the case of people who often hesitate to share some ailments with doctors, such as intestinal gas and piles. Instead, they consult family elders, who recommend using locally available medicinal plants or a herbal remedy for the multi-plant preparation according to their folklore. Other reasons include the remoteness of the area and the lack of modern sanitation facilities [20].

Likewise, of the 16 families reported, those most used by locals are the Lamiaceae and Asteraceae (figure 1); However, Asteraceae and Lamiaceae have also been recorded as families widely used in traditional medicine in other ethnomedicinal studies in the rest of the world. The predominance of these families could be due to their herbaceous life, extensive distribution form and richness in the study area, and the members of this family are well known for their aromatic quality. Despite their diversity, members of each family are distinguished by their ability to synthesize secondary metabolites with potentially significant biological activity. As a result, they are used in a variety of ways in the traditional health system, such as in the therapy of ailments of the digestive system [20].

The recurrent use of medicinal plants by local communities in the region can be interpreted as a result of the rich diversity of herbs they present [20]. People who use medicinal plants in their health system believe that materials collected from deep forests and regions less accessible to humans have more curative properties for different types of diseases [21].

Recently, ailments of the digestive system have attracted the attention of the scientific community and a new conception of the brain-gut-functional axis has emerged to maintain the balance of nature's well-being [21]. The role of plants and their derivatives is reiterated in some way not only for the treatment of ailments of the digestive system, but also for the mitigation of various neurological disorders and known psychological conditions that could be aggravated by intestinal discomfort. Therefore, there is a need to extend research on medicinal plants to deduce tangible results for human well-being in a holistic manner [2].

However, the present studies have shown that in addition to the use of these plants for the cure of gastrointestinal disorders, they have wide applications in the local treatment and management of many ailments such as dermatological disorders, urogenital diseases, respiratory tract infections, musculoskeletal disorders, etc [9]. In fact, on many occasions, the study observed that Andean inhabitants value plants more for their ethnomedicinal uses than others; Therefore, Andean peoples developed several ways to collect, process and administer preparations of these medicinal plants, in the cure of different ailments related to the stomach [11].

5. Conclusions

A diversity of medicinal flora was identified, used by the Andean inhabitants of Pampas, in the therapy of ailments of the digestive system, the most used species being Minthostachys mollis, Aloe vera, Clinopodium bolivianum, Artemisia absinthium and Matricaria chamomilla. Likewise, the Lamiaceae and Asteraceae families are the most widely used.

The evidence provided by the Andean inhabitants of Pampas, based on medicinal plants, encourages further research in anticipation of developing alternative treatments for digestive diseases.

The present information about these medicinal plants can serve as reference data to initiate research for the discovery of new compounds and the biological activities of these possible plant remedies.