Ryan JL, et al. Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients. Support Care Cancer. 2012 Jul;20(7):1479-89.
This double-blind multicenter trial was conducted by the University of Rochester Cancer Center Community Clinical Oncology Program to evaluate whether ginger could help reduce severity of chemotherapy (CT)-induced nausea on CT-Day 1. Investigators randomized 744 cancer patients who reported nausea from a previous chemotherapy cycle to one of four arms: ginger 0.5 g, 1.0 g, or 1.5 g daily, or placebo, starting 3 days before CT-Day 1 of cycles 2 and 3. All patients also received a 5-HT(3) receptor antagonist antiemetic on CT-Day 1 of all cycles. Patients reported nausea severity four times daily (morning, afternoon, evening, and night) for Days 1-4 during each cycle (baseline, cycle 2, and cycle 3). In the final analysis of evaluable data (n=576; mostly women), all doses of ginger significantly reduced acute nausea severity compared with placebo on CT-Day 1 (p=.003), with the largest reduction occurring in the 0.5 g (p=.017) and 1.0 g (p=.036) groups. However, there was a lack of effect on delayed nausea and quality of life. There were 9 study-related adverse reactions including Grade 2 heartburn, bruising/flushing, and rash, for which those patients withdrew from the study. Investigators concluded that ginger 0.5 g–1.0 g daily significantly reduced acute CT-induced nausea severity in adult cancer patients, but the higher dose of 1.5 g did not increase effectiveness, which supports the idea of 5-HT3 receptor saturation also suggested by other studies (53). The authors cite lack of controls for high vs low emetogenic regimens and nausea severity levels before enrollment as potential contributors to the small effect size for nausea severity.
Wu KL, et al. Effects of ginger on gastric emptying and motility in healthy humans. Eur J Gastroenterol Hepatol 2008;20(5):436-440.
The influence of ginger on gastric emptying and motility was assessed in this randomized, double-blind, controlled study of 24 healthy participants. Following an 8-hour fast, participants received placebo or ginger 1200 mg. After 1 hour, participants consumed a low-nutrient soup (500 mL) after which dimensions of the antrum and fundus and antral contractions were analyzed. In participants who received ginger, the antral area was reduced and contractions were more frequent. The authors suggest using more sensitive three-dimensional ultrasound or MRI to further define the exact stomach areas affected by ginger. Because this study analyzed healthy individuals, the effect of ginger on gastric emptying and motility in individuals with gastrointestinal symptoms such as dyspepsia remains unknown.
Smith C, et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol. 2004 Apr;103(4):639-45.
A total of 291 women who were less than 16 weeks pregnant were randomly assigned to receive either 1.05 grams of ginger or 75 mg of vitamin B6 daily for 3 weeks. Nausea and vomiting scores were measured weekly. Women receiving ginger had similar reductions in nausea, vomiting and retching as those receiving vitamin B6. In addition, women in both groups had similar outcomes of pregnancy suggesting that ginger is a safe and effective treatment for nausea and vomiting due to pregnancy. However, due to other papers and guidelines cited, it is recommended that ginger supplements be avoided during pregnancy (27) (47) (48).