Zafar et al Journal of Drug Delivery & Therapeutics.

2019; 9(3-s):754-757

Available online on 15.06.2019 at http://jddtonline.info

Journal of Drug Delivery and Therapeutics

Open Access to Pharmaceutical and Medical Research
© 2011-18, publisher and licensee JDDT, This is an Open Access article which permits unrestricted
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Open Access Case Report

Efficacy of Unani Formulation in Patients with GERD: A Case Series
Maryam Zafar,1* Tabassum Latafat 2 , Mursaleen Naseer3 , Hina Talat4
1&4 P.G Scholar, Department of Moalejat, AKTC, AMU, Aligarh, India
2 Associate Professor, Department of Moalejat, AKTC, AMU, Aligarh, India
3 Assisstant Professor Department of Moalejat AKTC, AMU, Aligarh, India

ABSTRACT
Objective: Gastro-oesophageal reflux disease (GERD) is defined as the backward flow of gastric contents into the oesophagus. A small amount of
reflux occurs in normal individuals. It is a common disease with a prevalence as high as 10% - 20% in the western world. The disease may
develop typical, atypical oesophageal and extra-oesophageal symptoms, complications, and can adversely affect an individual's quality of life.
Management of GERD may involve lifestyle modification, medical therapy with PPIs, and anti - reflux surgery. But this is having adverse effects.
So, the present study aims to assess the safety and efficacy of unani formulation in the treatment of GERD.
Material & Methods: We conducted this study on ten clinically diagnosed cases of GERD attending the Moalejat OPD at AKTCH, AMU Aligarh.
Results: All the symptoms like heartburn, regurgitation, nausea, water brash, sleeplessness were significantly improved after the 45 days
treatment with this Unani formulation. The result was analyzed and shown on Likert’s scale.
Conclusion: The preliminary findings indicate that this Unani drug formulation is effective in patients with GERD.
Keywords: GERD, Unani formulation, PPIs.

Article Info: Received 05 May 2019; Review Completed 01 June 2019; Accepted 09 June 2019; Available online 15 June 2019
Cite this article as:
Zafar M, Latafat T, Naseer M, Talat H, Efficacy of Unani Formulation in Patients with GERD: A Case Series, Journal of Drug
Delivery and Therapeutics. 2019; 9(3-s):754-757 http://dx.doi.org/10.22270/jddt.v9i3-s.3109

*Address for Correspondence:

Maryam Zafar, P.G Scholar, Department of Moalejat, AKTC, AMU, Aligarh, India

INTRODUCTION lifestyle, tobacco, smoking, alcohol drinking, coffee, and tea

consumption, as well as regular use of aspirin and other non-
Gastroesophageal reflux disease (GERD) is defined as steroidal anti-inflammatory drugs, have all been proposed to
symptoms and/ or complications resulting from reflux of be risk factors for reflux. 7,5,8
gastric contents into the oesophagus and more proximal
structures.1It is the most common oesophageal disorder, Two cardinal esophageal symptoms signalize the GERD, i.e.,
accounting for nearly 75% of all patients with oesophageal heartburn, a burning sensation in the retrosternal and
disorder. Transient lower esophageal sphincter relaxation is regurgitation, a perception of the flow of gastric contents
one of the most important causes for GERD.2 into the mouth or hypopharynx. The prevalence of these two
symptoms is 75% to 98% and 48% to 91% respectively.
GERD is prevalent worldwide, and the disease burden may Above two symptoms can diagnose GERD without the need
be increasing. Prevalence estimates show considerable for endoscopy. 2
geographic variation, but only East Asia shows ratings
consistently lower than 10%.3 Extra-esophageal symptoms such as non-cardiac chest
(epigastric) pain, dental erosion, cough, laryngitis, and
Monozygotic and dizygotic twins showed that genetic factors asthma are associated with but are not specific for GERD. It is
might contribute by 31% to the etiology of typical also commonly associated with lower quality of life, poor
GERD.4Although genetic factors are involved, reflux is likely quality of sleep, and decreased work productivity.
to be caused mainly by environmental factors.4 Obesity has Complications of GERD include reflux esophagitis (most
recently been established as a risk factor of the internal often), esophageal stricture, Barrett’s esophagus, and
environment, particularly among women5,6. External esophageal adenocarcinoma 9, 10
environmental factors include various exposures related to

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Zafar et al Journal of Drug Delivery & Therapeutics. 2019; 9(3-s):754-757

In a significant proportion of patients, symptom control and After taking proper history, it was found that she was fond of
maintained quality of life can only be attained by either taking coffee and spicy foods. Patient was advised to stop
continuous proton pump inhibitors (PPIs) therapy or drinking coffee and also to take easily digestible and non
antireflux surgery (ARS), both in the short and long term. 11,12 spicy diet during the course of the treatment with test drug
,13,14 formulation. Subsequently, she got relief in all the symptoms
after 45 days of treatment.
Unani Description:
Case 3: A 36-year-old male, a businessman came with
GERD is a new term in this era, classical literature does not complaints of restlessness, heartburn, water brash, anorexia,
give the description of term on one hand, but the clinical epigastric pain. On taking the history, it was found that he
features mentioned under the headings of sue hazm was in stress for some family problem. He was advised to
(Dyspepsia), bad hazmi (Indigestion), Hazm-ki-khraabi take test formulation. After 45 days of treatment, he got
(Digestion disorder) in various books correspond with the subsequent dilution in his symptoms.
signs and symptoms of GERD.15, 16, 17, 18
Case 4: A 26-year-old married woman came to OPD with the
Some scholars described the term Zauf-e-meda, Zauf-e-Hazm, chief complaints of, flatulence, epigastric pain, regurgitation,
Sue-Hazm (Dyspepsia) and Tukhma (Indigestion) in nausea, water brash. We advised her to take the test
agglomeration,15 in which deleterious effects occur in the formulation. After 45 days of treatment, she reported
process of digestion of food. Food particles remain in the gradual relief in symptoms.
stomach and become the cause of nausea, abdominal pain,
vomiting, belching, flatulence, water brash, heartburn, Case 5: A 58 years old female patient came to OPD with
etc.15,17 complaints of regurgitation, heartburn, sore throat along
with a history of acid reflux into the mouth for two years. On
Its common causes include malfunctioning of the stomach, the per abdomen, tenderness of mild grade was found in the
the diet has taken disproportionately, and food particles are epigastric region. After 45 days of treatment with Unani
not chewed congruously. While alcohol, tobacco, tea, coffee, formulation, she got partial relief in her symptoms.
ice cubes etc if taken in inadequate amount may be its rare
causes. Sometimes, it occurs due to heavy physical and Case 6: A 22 years old female student having complaints of
mental work, anxiety and depression.15, 16. mild regurgitation, water brash, nausea. She was fond of
eating junk food. We advised her to quit junk food and to
Unani scholars have been treating this disease since ages. A take easily digestible diet along with test formulation. There
large number of single and compound drugs have been was found gradual easement in her symptoms on 2 nd follow
documented for their efficacy in heartburn, regurgitation, up.
dyspepsia, etc. This unani formulation contains various
ingredients like heel kalaan (Amomum Case 7: A 53-year-old male, serviceman came to OPD with
subulatum),tabaasheer (Bambusa arundinacea), kishneez the complaints of heartburn, regurgitation, nausea, sore
khusk (Coriandrum sativum), gul-e-surkh (Rosa damascene) throat, epigastric pain. On investigation, it was found that he
and baadiyaan (Foeniculum vulgare) all in equal amount. It is was on anxiolytics for seven months. He was advised to
mainly used as Dafa e humoozat e meda. So present case continue the same treatment and to take test formulation.
series was carried out with the aim to explore the effect of After 45 days, his symptoms were found mitigated except
this unani formulation on patients with GERD. regurgitation.

MATERIAL AND METHODS Case 8: A 33-year-old male patient visited OPD with the
complaints of nausea, heaviness in the abdomen after meal,
Informed consent was taken from all the patients. The study regurgitation. He was found alcoholic on the investigation.
was conducted on the patient attending Moalejat OPD-4 at We advised him to stop drinking alcohol and treat him with
Ajmal Khan Tibbiya College & Hospital, AMU, Aligarh. the test formulation for 45 days. He got partial relief in
symptoms.
Intervention
Case 9: A 26-year-old male presented the OPD with
We enrolled ten patients in this case series. The Unani
complaints of acid reflux into the mouth, pain in the
formulation was supplied in a powdered form and given to
epigastric region, and nausea. He takes tea seven times per
the patients of GERD twice daily after the meal in a dose of 6
day. We advised him to reduce the number of cups per day
gram for 45 days with fortnightly follow up. Patients were
and treat him with test formulation. After treatment, he
also advised lifestyle modifications. Diagnosis was made on
reported a subsequent reduction in his symptoms.
the basis of clinical symptoms compatible with the classical
description of the disease. Case 10: A 40-year-old male visited OPD with the complaints
of regurgitation, heartburn, water brash. He was advised to
Case Presentations take Unani formulation. He got relief in all the symptoms
Case 1: A 42-year-old female, housewife came to Moalejat after the completion of the trial.
OPD of AKTCH AMU with the complaints of nausea, vomiting,
belching, heartburn, water brash, pain in the epigastric
RESULT
region. She was advised to take the formulation along with Based on the clinical symptoms, ten cases were analyzed. It
dietary and lifestyle modifications. She got alleviation in her was found that regurgitation and heartburn were prominent
clinical features after 45 days of treatment. symptoms in all cases. Whereas nausea, water brash,
epigastric pain and sleeplessness were the associated
Case 2: A newly married 20 years old female visited Moalejat
symptoms. After 45 days of treatment, patient found
OPD of AKTCH AMU with the chief complaints of
alleviation in the symptoms which were analyzed and graded
regurgitation, heartburn, epigastric pain, loss of appetite.
on Likert Scale.

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Zafar et al Journal of Drug Delivery & Therapeutics. 2019; 9(3-s):754-757

Grading of Symptoms on Likert Scale

S.No. Regurgitation Heartburn Nausea Water brash Epigastric pain
P1 P2 P1 P2 P1 P2 P1 P2 P1 P2
1. 0 0 2 1 2 0 1 0 1 0
2. 1 0 2 0 1 0 0 0 2 0
3. 0 0 3 1 0 0 1 0 2 0
4. 2 0 0 0 3 1 2 0 2 0
5. 3 2 2 1 0 0 0 0 1 0
6. 1 0 0 0 2 0 2 0 0 0
7. 3 1 2 0 2 0 0 0 2 0
8. 3 2 2 1 2 1 0 0 0 0
9. 0 0 0 0 2 1 3 1 2 0
10. 1 0 1 0 0 0 2 0 0 0
0=Nil, 1=Mild, 2=Moderate, 3=Severe , P1=Pre-treatment P2=Post-treatment

Composition of Test Drug Formulation

S.No. Drug name Botanical name Medicinal properties 21,22
1. Heel kalaan Amomum subulatum Stomachic, antiemetic, antibilious, astringent,
alexipharmic; used for the treatment of indigestion,
biliousness, abdominal pains, vomiting, in congestion
of the liver. Pericarp-in headache and stomatitis.
2. Tabaasheer Bambusa arundinacea stomachic, antiemetic, desiccant, absorbs the
dampness of stomach.
3. Gul-e-surkh Rosa damascene Desiccant, astringent to stomach muscle, analgesic,
resolvent, cardiac tonic, laxative.
4. Kishneez khushk Coriandrum sativum Stomachic, carminative, anti-inflammatory, diuretic,
hypoglycemic, analgesic, antispasmodic. Used in
dyspepsia and gastroenteritis.
5. Baadiyan Foeniculum vulgare Carminative,stomachic,antispasmodic,
emmenagogue, galactagogue, anti-inflammatory,
diuretic. Relieves bloating, nausea, settles the
stomach, and stimulates the appetite. Also used in
amenorrhoea and enuresis.

DISCUSSION Given the findings of result and discussion, it can be

concluded that the test formulation provided significant
GERD symptoms have a profound impact on health-related improvement in the sign and symptoms of the patient of
quality of life. So this case series was designed to determine GERD. It is economically fair treatment without any non-
the effect of this unani formulation in the treatment of GERD. compliance. Therefore further studies may be performed to
In the present study, almost all the patients showed a good know the effectiveness & mechanism of action of this
response during and after the treatment of 45 days, which formulation in GERD with a control group on a large scale.
was analyzed and shown on Likert’s scale.
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