About Herbs

Bottom Line: Ginger is effective against nausea and vomiting but whether it helps nausea and vomiting after cancer treatment is not clear.

Ginger root contains compounds that may help relieve or prevent nausea and vomiting. These substances can increase the flow of saliva and digestive juices. They may also help to calm the stomach and intestine. Scientists are still unsure exactly how ginger exerts these effects. In humans, studies have shown that eating fresh ginger (but not dried ginger) in high doses can "thin" the blood by preventing the platelets from sticking together. In addition, one laboratory study suggested that ginger can protect brain cells from the plaques that cause Alzheimer's disease, but this effect has not been studied in humans.

Nausea and vomiting during pregnancy:
To test the ability of ginger to treat pregnancy-related nausea and vomiting, researchers randomly gave 70 women early in their pregnancy (less than 17 weeks along) either one gram of ginger or a placebo. All of the patients had episodes of vomiting 24 hours prior to starting the study. After four days of therapy with ginger or a placebo, women taking ginger reported significantly fewer episodes of nausea and vomiting than women taking the placebo. In addition, women taking ginger had no more problems with their pregnancies than women taking the placebo, suggesting that ginger is safe of pregnant women to take.

Another trial of ginger involved 291 women less than 16 weeks pregnant. The women were randomly assigned to receive either ginger or vitamin B6 (a vitamin that is known to reduce nausea and vomitind during pregancy) daily for three weeks. Women receiving ginger had similar reduction in nausea, retching and vomiting.

Post-surgery nausea and vomiting:
Many patients experience nausea and vomiting after general anesthesia for surgery. A randomized, controlled trial compared ginger root to a placebo pill and to metoclopramide, a prescription anti-vomiting drug, to prevent post-operative nausea and vomiting. One hundred and twenty women who were undergoing laparoscopic outpatient surgery enrolled in the study. After surgery, ginger performed as well as metoclopramide in preventing nausea and vomiting, and both did better than the placebo pill.

In a similar study, 60 women who were undergoing major gynecological surgery took ginger root, metoclopramide, or a placebo pill to test their effects on post-surgical nausea and vomiting. As in the last study, ginger performed as well as metoclopramide, and both fared better than the placebo pill at preventing nausea and vomiting.

Zingiberis rhizoma, zingiberaceae, ginger root, shen jiang

Derived from the rhizome of the plant, ginger is native to Asia. It has been used as food and as medicine primarily for gastrointestinal symptoms. In vitro studies suggest that ginger has antiemetic ⁽¹⁸⁾, anticancer ^{(8) (9) (10)}, anti-inflammatory ⁽²³⁾, and hypoglycemic effects ⁽²³⁾ and may protect against Alzheimer's disease ⁽¹¹⁾. The antiemetic action of ginger is attributed to its constituents, shogaol and gingerol, and their interactions with 5HT-3 receptors ⁽¹⁸⁾.
Clinical trials indicate that ginger can effectively reduce nausea and vomiting due to pregnancy ^{(3) (4)}, motion sickness ⁽⁶⁾ and following surgery ⁽²⁾. However, it is not clear whether it can control chemotherapy-induced nausea and vomiting ^{(20) (21)}. More studies are warranted.
Conclusions from a systematic review suggest moderate efficacy of ginger for treating osteoarthritic and chronic low back pain ⁽²²⁾. Ginger also influences gastric emptying in healthy individuals ⁽⁷⁾.

The antiemetic action of ginger is attributed to the shogaol and gingerol constituents found in the rhizome. They are believed to stimulate the flow of saliva, bile, and gastric secretions. Additional activities include the suppression of gastric contractions and improvement of the intestinal muscle tone and peristalsis ⁽¹⁷⁾. Constituents in ginger are thought to interact with 5HT-3 receptors and may be partially responsible for the antiemetic activity ⁽¹⁸⁾. Ginger has been shown to inhibit thromboxane formation and inhibit platelet aggregation ⁽¹⁵⁾; however, this effect appears dependent on dose and formulation (e.g., dried, fresh, or extract) ⁽¹⁹⁾. An in vitro study suggests that ginger may have therapeutic effects against Alzheimer's disease by protecting neuronal cells from beta-amyloid insult ⁽¹¹⁾. Apoptosis of gastric cancer cells by gingerol is mediated through TRAIL-dependent caspase 3/7 activation while shogaol alone reduces in vivo tumor growth ⁽⁸⁾. Gingerol inhibits cell cycle progression by reducing cyclin D1 expression and induces apopotsis in colorectal cancer cells ⁽⁹⁾ , and inhibits secretion of angiogenic cytokines such as VEGF and IL-8 in ovarian cancer cells ⁽¹⁰⁾.

Common: Heartburn and dermatitis ⁽¹²⁾.

Anticoagulants / Antiplatelets: Because ginger can inhibit thromboxane formation and platelet aggregation, concomitant use with anticoagulants may increase the risk of bleeding ⁽¹⁴⁾.
Hypoglycemics / Insulin: Ginger may cause additive reductions in blood glucose ⁽²³⁾.

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 1200 mg of ginger. 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 that received ginger, 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 should also be assessed in individuals with gastrointestinal symptoms such as dyspepsia.

Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol 2001;97:577-82.
Administration of ginger to women less than 17 weeks pregnant and experiencing related nausea and vomiting were included in this study. Seventy women (32 ginger, 38 placebo) were enrolled and administered the study medication four times a day for 4 days. All patients had episodes of vomiting 24 hours prior to enrollment. Nausea and vomiting scores were significantly reduced on the fourth day of treatment with ginger as compared to placebo. On day 4, 12 of 32 patients receiving ginger compared to 23 of 35 on placebo had at least one episode of vomiting. No difference in outcome of pregnancy was noted between the groups. This study suggests that ginger is effective for short term management of nausea and vomiting associated with pregnancy.

Smith C, Crowther C, Willson K, Hotham N, McMillian V. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol. 2004 Apr;103(4):639-45.
291 women less than 16 weeks pregnant participated in this study of ginger and the nausea and vomiting due to pregnancy. The women were randomly assigned to receive either 1.05 grams of ginger or 75 mg of Vitamin B6 daily for three 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.