Medicinal Plants Effective on Preventing and Treating Bowel Dysfunction after Cesarean Section: A Systematic Review of Clinical Trials

Document Type : Review Article

Authors

1 M.Sc. in Midwifery, Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran. M.Sc. in Midwifery, Department of Midwifery, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.

2 M.Sc. in Midwifery, School of Hazrat Zeinab Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Assistant Professor, Department of Midwifery, Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran. Assistant Professor, Department of Midwifery, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.

10.22038/ijogi.2025.84264.6278

Abstract

Introduction: Bowel dysfunction is one of the complications of cesarean section. Various methods have been investigated for the prevention and treatment of bowel dysfunction after cesarean section, but their clinical results have been limited and non-general. One of these methods is the use of medicinal plants. This study was conducted with aim to systematically review the studies related to the effect of herbal products in the prevention and treatment of bowel dysfunction after cesarean delivery.
Methods: In this systematic review, the relevant studies were searched according to PRISMA principles from databases including PubMed, Cochrane, Web of Science, Scopus, ProQuest, and Magiran, and SID. The keywords used for searching were Cesarean section, Bowel movements, Bowel function, gastrointestinal function, herbal medicine, complementary medicine, alternative care, and their Persian equivalent without a time limit until August 2024. The quality assessment of the articles was done using ROB2 tool. Data were analyzed qualitatively.
Results: Finally, 13 clinical trials which met the inclusion criteria were included in the study. These studies assessed six types of medicinal plants, including coffee, mint, chamomile, cumin, dill, and ginger, with a sample size of 2,024 participants. The results of these articles showed that most of the plants studied had positive results in the treatment and prevention of intestinal dysfunction after cesarean section.
Conclusion: Most of the investigated plants were effective on treatment and prevention of bowel dysfunction after cesarean section. Scientific and accurate decision-making for suggesting these herbs requires more well-designed studies on the form and dosage of the products.

Keywords

Main Subjects

References

  1. Niazi A, Moradi M, Askari VR, Sharifi N. Effect of complementary medicine on pain relief and wound healing after cesarean section: A systematic review. Journal of Pharmacopuncture 2021; 24(2):41.
  2. Betran AP, Ye J, Moller AB, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ global health 2021; 6(6):e005671.
  3. Babadi E, Abbaspoor Z, Ghanbari S, Mohammadi S, Javadnoori M. Rate of Cesarean Section in Hospitals Affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran. Journal of Clinical Care and Skills 2024; 5(1):33-9.
  4. Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 25nd New York: McGraw-Hill Education; 2018.
  5. Yaghmaee M, Arbabi-Kalati F, Behzadian A. Comparison of oral intake profiles at 2 and 8 hours following cesarean section under spinal anesthesia. Zahedan Journal of Research in Medical Sciences 2010; 11(4).
  6. Nimarta, Singh NV, Shruti, Gupta R. Effectiveness of chewing gum on bowel motility among the patients who have undergone abdominal surgery. Nursing & Midwifery Research Journal 2013; 9(3):108-17.
  7. Rychter J, Clavé P. Intestinal inflammation in postoperative ileus: pathogenesis and therapeutic targets. Gut 2013; 62(11):1534-5.
  8. Hübner M, Scott M, Champagne B. Postoperative ileus: prevention and treatment. The SAGES/ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery 2015: 133-46.
  9. Sun W, Li M, Lin T, Sun Z, Zhuang Z, Wen J, et al. Effectiveness of acupuncture for recovery of flatulence after cesarean section: a case report. Medicine 2018; 97(50):e13352.
  10. Khawaja ZH, Gendia A, Adnan N, Ahmed J, Khawaja Z, Ahmed J. Prevention and management of postoperative ileus: a review of current practice. Cureus 2022; 14(2).
  11. Holte K, Kehlet H. Postoperative ileus: a preventable event. British Journal of surgery 2000; 87(11):1480-93.
  12. Lewis SJ, Andersen HK, Thomas S. Early enteral nutrition within 24 h of intestinal surgery versus later commencement of feeding: a systematic review and meta-analysis. Journal of Gastrointestinal Surgery 2009; 13(3):569-75.
  13. Brunicardi F, Andersen D, Billiar T, Dunn D, Hunter J, Matthews J, et al. Schwartz's principles of surgery. 10nd McGraw-hill; 2014.
  14. Shang H, Yang Y, Tong X, Zhang L, Fang A, Hong L. Gum chewing slightly enhances early recovery from postoperative ileus after cesarean section: results of a prospective, randomized, controlled trial. American journal of perinatology 2010; 27(05):387-91.
  15. Quah HM, Samad A, Neathey AJ, Hay DJ, Maw A. Does gum chewing reduce postoperative ileus following open colectomy for left‐sided colon and rectal cancer?–a prospective randomized controlled trial. Colorectal disease 2006; 8(1):64-70.
  16. Zaghari Tafreshi M, Rasouli M, Tabatabaee A, Golmakani E, Mortazavi H. Utilization of complementary and alternative medicine in nursing with emphasis on the touch therapy. Journal of North Khorasan University of Medical Sciences 2014; 6(1):207-13.
  17. Khadem E, Shirazi M, Janani L, Rahimi R, Amiri P, Ghorat F. Effect of topical chamomile oil on postoperative bowel activity after cesarean section: A randomized controlled trial. Journal of research in pharmacy practice 2018; 7(3):128-35.
  18. Tianthong W, Phupong V. A randomized, double-blind, placebo-controlled trial on the efficacy of ginger in the prevention of abdominal distention in post cesarean section patients. Scientific reports 2018; 8(1):6835.
  19. Yousefi SS, Sadeghpour O, Hamzehgardeshi Z, Sohrabvand F. The effects of Carum carvi (Bunium persicum Boiss) on early return of bowel motility after Caesarean section: double-blind, randomized, placebo-controlled trial. Journal of family & reproductive health 2019; 13(1):35.
  20. Kane TD, Tubog TD, Schmidt JR. The use of coffee to decrease the incidence of postoperative ileus: a systematic review and meta-analysis. Journal of PeriAnesthesia Nursing 2020; 35(2):171-7.
  21. Vahed SH, Afiat M, Dadgar S. Peppermint drop effect on ileus following cesarean section. Journal of family medicine and primary care 2022; 11(4):1435-42.
  22. Yousefi Z, Yousefzadeh S, Mousavi Vahed SH, Hamedi SS. The Effect of Anethum graveolen seed extract on Intestinal Function after cesarean section: a single-blind randomized clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility 2021; 24(4):81-9.
  23. Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane database of systematic reviews 2019; 2019(10):ED000142.
  24. Zamanabadi MN, Alizadeh R, Gholami F, Aryafar M. Effect of caffeine on postoperative bowel movement and defecation after cesarean section. Annals of Medicine and Surgery 2021; 68.
  25. Nadim AA, Ghanem RM, Benyamine MG, Abdallah FN, Abbas AM. The effect of caffeine ingestion in prevention of post-operative ileus after caesarean section: a randomized controlled trial. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2019; 8(12):4808-15.
  26. Niaki MT, Atarod Z, Omidvar S, Zafari M, Aghamohammadi A, Asadi T, et al. Comparing the effects of Cumin, Peppermint, and Milk of Magnesia on gastrointestinal complications after caesarean section. Global Journal of Health Science 2016; 8(12):78-86.
  27. Sakhavar N, Mirteymouri M. Comparison of cuminum cyminum with milk of magnesia in prevention of gastrointestinal discomforts after emergentcesarean section. J Babol Univ Med Sci 2009; 10(6):42-48.
  28. Fazeli N, Tafazoli M, Ramezani M, Esmaeili H. The effect of supermint oil on the flatulence intensity after cesarean section. J Ardabil Univ Med Sci 2004; 4(4):41-46.
  29. Fazel N. The effect of Mint Essence on Gastrointesrinal Disorder after Cesarean Section. Iran Journal of Nursing 2004; 17(38):8-15.
  30. Tharwat AA, Gomaa ME, Elghareeb NA. Impact of Sugarless Chewing gum Versus Peppermint on First Bowel Movement after Cesarean Section: Randomized Controlled Trial. The Egyptian Journal of Hospital Medicine 2021; 85(1):3359-63.
  31. Rabiepoor S, Yas A, Navaei J, Khalkhali HR. Does coffee affect the bowel function after caesarean section?. European Journal of Obstetrics & Gynecology and Reproductive Biology 2018; 220:96-9.
  32. Harnsberger CR, Maykel JA, Alavi K. Postoperative ileus. Clinics in colon and rectal surgery 2019; 32(03):166-70.
  33. Watanabe J, Miki A, Koizumi M, Kotani K, Sata N. Effect of postoperative coffee consumption on postoperative ileus after abdominal surgery: an updated systematic review and meta-analysis. Nutrients 2021; 13(12):4394.
  34. Echeverri D, Montes FR, Cabrera M, Galán A, Prieto A. Caffeine′ s Vascular Mechanisms of Action. International journal of vascular medicine 2010; 2010(1):834060.
  35. Mattioli AV, Nasi M, Farinetti A, Gelmini R. Effects of caffeine on colon: A potential clinical use of coffee in surgical patients. Digestive Surgery 2020; 37(3):265-6.
  36. Cui WQ, Wang ST, Pan D, Chang B, Sang LX. Caffeine and its main targets of colorectal cancer. World journal of gastrointestinal oncology 2020; 12(2):149.
  37. Kanza Gül D, Şolt Kırca A. Effects of acupressure, gum chewing and coffee consumption on the gastrointestinal system after caesarean section under spinal anaesthesia. Journal of Obstetrics and Gynaecology 2021; 41(4):573-80.
  38. Liu D, Jing X, Cao S, Liu X, Tan X, Jiang H, et al. Impact of drinking Chinese green tea on postoperative short outcomes for gastric cancer: a randomized controlled trial. European journal of clinical nutrition 2021; 75(11):1568-77.
  39. Ribeiro EM, Alves M, Costa J, Ferreira JJ, Pinto FJ, Caldeira D. Safety of coffee consumption after myocardial infarction: A systematic review and meta-analysis. Nutrition, Metabolism and Cardiovascular Diseases 2020; 30(12):2146-58.
  40. McKay DL, Blumberg JB. A review of the bioactivity and potential health benefits of peppermint tea (Mentha piperita L.). Phytotherapy Research: An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives 2006; 20(8):619-33.
  41. Cappello G, Spezzaferro M, Grossi L, Manzoli L, Marzio L. Peppermint oil (Mintoil®) in the treatment of irritable bowel syndrome: A prospective double blind placebo-controlled randomized trial. Digestive and liver Disease 2007; 39(6):530-6.
  42. Spirling LI, Daniels IR. Botanical perspectives on health peppermint: more than just an after-dinner mint. The journal of the Royal Society for the Promotion of Health 2001; 121(1):62-3.
  43. Micklefield G, Jung O, Greving I, May B. Effects of intraduodenal application of peppermint oil (WS® 1340) and caraway oil (WS® 1520) on gastroduodenal motility in healthy volunteers. Phytotherapy Research: An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives 2003; 17(2):135-40.
  44. Gruenwald J, Brendler T, Jaenicke C. PDR for herbal medicines. Thomson, Reuters; 2007.
  45. Vissiennon C, Goos KH, Arnhold J, Nieber K. Mechanisms on spasmolytic and anti-inflammatory effects of a herbal medicinal product consisting of myrrh, chamomile flower, and coffee charcoal. Wiener Medizinische Wochenschrift (1946) 2017; 167(7-8):169-76.
  46. Agah S, Taleb A, Moeini R, Gorji N, Nikbakht H, Soltani-Kermanshahi M. Chamomile efficacy in patients of the irritable bowel syndrome. Der Pharma Chemica 2015; 7(4):237-41.
  47. Zadak RS, Khalili G, Motamedi M, Bakhtiari S. The effect of chamomile on flatulence after the laparoscopic cholecystectomy: A randomized triple-blind placebo-controlled clinical trial. Journal of Ayurveda and Integrative Medicine 2023; 14(3):100735.
  48. Rabiei Z, Rafieian M. A review on the pharmacological effects of Matricaria chamomilla. Iranian Journal of Physiology and Pharmacology 2018; 2(4):248.
  49. Srivastava JK, Shankar E, Gupta S. Chamomile: A herbal medicine of the past with a bright future. Molecular medicine reports 2010; 3(6):895-901.
  50. Sándor Z, Mottaghipisheh J, Veres K, Hohmann J, Bencsik T, Horváth A, et al. Evidence supports tradition: The in vitro effects of roman chamomile on smooth muscles. Frontiers in Pharmacology 2018; 9:323.
  51. Agah S, Taleb AM, Moeini R, Gorji N, Nikbakht H. Cumin extract for symptom control in patients with irritable bowel syndrome: a case series. Middle East journal of digestive diseases 2013; 5(4):217.
  52. Okeola VO, Adaramoye OA, Nneji CM, Falade CO, Farombi EO, Ademowo OG. Antimalarial and antioxidant activities of methanolic extract of Nigella sativa seeds (black cumin) in mice infected with Plasmodium yoelli nigeriensis. Parasitology research 2011; 108:1507-12.
  53. Singh KK, Goswami TK. Mechanical properties of cumin seed (Cuminum cyminum Linn.) under compressive loading. Journal of Food Engineering 1998; 36(3):311-21.
  54. Gautam P, Singh K, Kalra S, Khanna D, Paliwal YK, Mehan S. Dill herb: Wall against dysfunctions: An updated profile. Int J Recent Adv Pharm Res 2013; 4:1-8.
  55. Gharib Naseri MK, Haeidari A. Spasmolytic effect of Anethum graveolens (dill) fruit extract on rat ileum. Physiology and Pharmacology 2006; 10(2):99-105.
  56. Jafarzade P, Mohseni Mehran SM, Moladoust H, Norasfard MR, Ghorbani A, Abedinzade M. Effect of hydroalcoholic extract of anethum graveolens l. Seed on tracheal smooth muscle contractions in male rats. Journal of Mazandaran University of Medical Sciences 2018; 28(160):146-50.
  57. Aregawi LG, Gebremeskel TG, Zoltan C. Preventive and therapeutic effects of ginger on bowel disease: A review of clinical trials. Pharmacological Research-Modern Chinese Medicine 2024: 100457.
  58. Mashhadi NS, Ghiasvand R, Askari G, Hariri M, Darvishi L, Mofid MR. Anti-oxidative and anti-inflammatory effects of ginger in health and physical activity: review of current evidence. International journal of preventive medicine 2013; 4(Suppl 1):S36.
  59. Hu MingLuen HM, Rayner CK, Wu KengLiang WK, Chuah SengKee CS, Tai WeiChen TW, Chou YehPin CY, et al. Effect of ginger on gastric motility and symptoms of functional dyspepsia. World Journal of Gastroenterology 2011; 17(1):105-110.
  60. Yamahara J, HUANG Q, LI Y, XU L, FUJIMURA H. Gastrointestinal motility enhancing effect of ginger and its active constituents. Chemical and pharmaceutical bulletin 1990; 38(2):430-1.
  61. Micklefield GH, Redeker Y, Meister V, Jung O, Greving I, May B. Effects of ginger on gastroduodenal motility. International journal of clinical pharmacology and therapeutics 1999; 37(7):341-6.
  62. Nikkhah Bodagh M, Maleki I, Hekmatdoost A. Ginger in gastrointestinal disorders: A systematic review of clinical trials. Food science & nutrition 2019; 7(1):96-108.
  63. Kubra IR, Rao LJ. An impression on current developments in the technology, chemistry, and biological activities of ginger (Zingiber officinale Roscoe). Critical reviews in food science and nutrition 2012; 52(8):651-88.
  64. Semwal RB, Semwal DK, Combrinck S, Viljoen AM. Gingerols and shogaols: Important nutraceutical principles from ginger. Phytochemistry 2015; 117:554-68.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 4
June 2025
Pages 76-92

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