02/17/2014 11:56 EST | Updated 04/19/2014 05:59 EDT

Revisiting An Age-Old Thai Therapy to Relieve Diarrhea

Back in 1913, the Thai Army suffered from an outbreak of dysentery and searched for any possible option to control the scourge. At the time, a local traditional medicine expert offered the troops what he called Krisanaklan Trakilane.Ninety-nine years later, the components of the wonder drug were finally isolated.

We've all been there. One moment, we're gregarious; the next, we're grim. It begins with grumbling, foreshadowing the inevitable. Soon, gas forces us to start the search for a preferably private toilet. Eventually, the ignominious gurgles occur and within moments, the contractions and rush begin. It all ends with a few seconds of grief as what was once a happy gut becomes a convulsive cannon, exploding with an odorous output that leaves us repulsed by the occurrence and relieved that it's finally out.

Diarrhea is an unfortunate reality of our human existence and happens to people on average at least three times per year. The mechanisms behind the egregious expulsion have been known for quite some time and are rather complex involving a combination of factors that force the cells of the gut to become imbalanced. When they do, they respond accordingly, by secreting water into the gut. Once this happens, there is little that can be done to prevent the offensive onslaught.

For many, diarrhea is a short-term inconvenience that resolves itself. However, in many cases, such as cholera and rotavirus infection, the effects can last for days if not weeks and can even be life-threatening. The main reason for these medical emergencies is dehydration as a result of a continual loss of fluids. In developed countries, this is an easily treatable condition; however in developing countries, where there is no means to provide such therapy, diarrhea is a leading cause of illness and death, particularly in children under five years of age.

The concern has led public health researchers on a near 50-year quest to find both causes and effective solutions. The most obvious answer was found in the 1970s through the use of oral rehydration liquids. The treatments have since been tested and optimized and are now considered an easy option for management. Other directions found over the years include the use of a variety of chemicals, including the pink coloured bismuth subsalicylate, the immobilizing agent loperamide, antibiotics and most recently, probiotics, especially those that contain Lactobacillus.

Yet, while the medical community continues to find options, there is a smaller group of researchers focusing on dealing with diarrhea through cultural traditions. The majority of these ethnomedical studies have focused on either herbal mixtures or individual plant extracts preferred by indigenous societies for centuries. The practice is fascinating as these scientists attempt to explain the effects of non-Western medicines in a Western fashion, incorporating not only visual effects but also biochemical ones. The number of articles in the scientific literature pale in comparison to the usual medical and clinical studies. Yet their impact can offer possible ideas for prevention, management and treatment of diarrhea - and other diseases - using products given to us by Mother Earth.

The latest offering comes from a team at the University of California, San Francisco (UCSF) in an article published last week. The group wanted to learn more about a Thai herbal remedy for diarrhea called Krisanaklan. While the name may seem as enigmatic as its pronunciation, it has a very interesting past as one of the go-to options for diarrhea. Back in 1913, the Thai Army suffered from an outbreak of dysentery and searched for any possible option to control the scourge. At the time, a local traditional medicine expert offered the troops what he called Krisanaklan Trakilane. The herbal treatment was not only effective, it was hailed.

Ninety-nine years later, the components of the wonder drug were finally isolated and the potential mechanism of action was hypothesized. Based on the findings, the herbal preparation was able to stop two of the necessary steps in the development of diarrhea. The treatment halted the rush of fluid from the cells into the gut and prevented contraction of the muscle cells known for causing the well-known peristaltic push. However, the testing was all performed in the lab, not in an actual living creature.

Now the team from UCSF has given us that evidence and much as expected, the treatment is extremely effective. In one of the many experiments they performed, mice were provided oral supplementation of Krisanaklan and then infected with rotavirus. Sure enough, the treatment prevented diarrhea. Taking a closer look at the process, the group revealed that the effect of the herbs overwhelmed the attempts by the virus. The same effect applied to cholera as well.

This study should not only offer hope to those who would like to prevent diarrhea naturally, but also give even more credence to the growing science of ethnomedicine. There are numerous troubles facing the future of Western medicine, including antibiotic resistance, increases in chronic illness and an ever-increasing cost to develop new treatments. The idea of exploring centuries-old remedies provides a rather inexpensive route to better understand how humans once managed to deal with the onslaught of disease. What's more, such as the case of Krisanaklan, many may prove to be not only effective in use, but also in the lab. When this union of two different worlds occurs, we will all inevitably win.


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