title: Traditional uses of medicinal plants in gastrointestinal disorders in Nepal.
abstract: BACKGROUND
  Gastrointestinal disorders cause morbidity and can lead to mortality, especially in the developing world where sanitation is deficient. A large part of the human population relies on medicinal plants for treating various diseases, including gastrointestinal disorders. The present review summarizes the traditional uses of medicinal plants of Nepal used to treat gastrointestinal disorders, and evaluates their bio-efficacy based on a review of the available phytochemical and pharmacological literature.
  
  
  METHODS
  We searched different electronic databases and libraries for the literature on medicinal plants used in Nepal to treat gastrointestinal disorders. For each species, we also searched the literature for information on conservation status, as well as for phytochemical and pharmacological studies in support of the ethnobotanical information. We used principal component analysis to explore the relation among disorders and plant families, plant life forms, plant parts and preparation modes. We also performed permutation tests to determine if botanical families were used more often than expected considering their availability in the Nepali flora.
  
  
  RESULTS
  We documented a total of 947 species belonging to 158 families and 586 genera used to treat gastrointestinal disorders in Nepal. Diarrhea was the disorder treated by the highest number of species (348), followed by stomachache (340) and dysentery (307). Among the reported species, five were endemic to Nepal, whereas 16 orchid species were protected under CITES Appendices II and III. The randomization test showed that species belonging to 14 families were used less often than expected, whereas plants belonging to 25 families were used more often than expected. The PCA scatter plot showed distinct groups of gastrointestinal disorders treated with similar plant life forms, plant parts, and/or preparation modes. We found 763 phytochemical studies on 324 species and 654 pharmacological studies on 269 species.
  
  
  CONCLUSIONS
  We showed the diversity and importance of medicinal plants used to treat gastrointestinal disorders in the traditional health care system of Nepal. As such disorders are still causing several deaths each year, it is of the utmost importance to conduct phytochemical and pharmacological studies on the most promising species. It is also crucial to increase access to traditional medicine, especially in rural areas. Threatened species need special attention for traditional herbal medicine to be exploited sustainably.
authors.affiliation: Institute of Botany, Academy of Sciences of the Czech Republic, Zamek 1, CZ-252 43 Průhonice, Czech Republic; Department of Biodiversity Research, Global Change Research Centre (ASČR), Na sádkách 7, České Budějovice 37005, Czech Republic. Electronic address: rokayamaan@gmail.com.
authors.forename: Maan B
authors.initials: MB
authors.lastname: Rokaya
authors.affiliation: Himalayan Research and Development Centre - Nepal, Kathmandu, Nepal; Canada Research Chair in Aboriginal Forestry, Université du Québec en Abitibi-Témiscamingue, 445 Boulevard de l'Université, Rouyn-Noranda, Quebec, Canada J9X 5E4.
authors.forename: Yadav
authors.initials: Y
authors.lastname: Uprety
authors.affiliation: Nepal Academy of Science and Technology, Molecular Biotechnolgy Unit, GPO. No. 3323, Lalitpur, Nepal.
authors.forename: Ram C
authors.initials: RC
authors.lastname: Poudel
authors.affiliation: Department of Biodiversity Research, Global Change Research Centre (ASČR), Na sádkách 7, České Budějovice 37005, Czech Republic; Institute for Environmental Studies/Department of Botany, Faculty of Science, Charles University, Benatska2, 128 01 Prague, Czech Republic.
authors.forename: Binu
authors.initials: B
authors.lastname: Timsina
authors.affiliation: Institute of Botany, Academy of Sciences of the Czech Republic, Zamek 1, CZ-252 43 Průhonice, Czech Republic; Institute for Environmental Studies/Department of Botany, Faculty of Science, Charles University, Benatska2, 128 01 Prague, Czech Republic.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Münzbergová
authors.affiliation: Canada Research Chair in Aboriginal Forestry, Université du Québec en Abitibi-Témiscamingue, 445 Boulevard de l'Université, Rouyn-Noranda, Quebec, Canada J9X 5E4.
authors.forename: Hugo
authors.initials: H
authors.lastname: Asselin
authors.affiliation: Himalayan Research and Development Centre - Nepal, Kathmandu, Nepal; Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Menglun Mengla Yunnan 666603, China; Department of Botany, Tri-Chandra College, Tribhuvan University, Nepal.
authors.forename: Achyut
authors.initials: A
authors.lastname: Tiwari
authors.affiliation: Himalayan Research and Development Centre - Nepal, Kathmandu, Nepal.
authors.forename: Shyam S
authors.initials: SS
authors.lastname: Shrestha
authors.affiliation: Key Laboratory of Tibetan Environment Changes and Land Surface Processes, Institute of Tibetan Plateau Research, Chinese Academy of Sciences, Beijing, China.
authors.forename: Shalik R
authors.initials: SR
authors.lastname: Sigdel
mesh_terms: D019448:Ethnobotany; D020834:Ethnopharmacology; D005767:Gastrointestinal Diseases / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008519:Medicine, Traditional; D009390:Nepal; D028321:Plant Preparations / Q000627:therapeutic use*; D010946:Plants, Medicinal / Q000737:chemistry*
chemical_list: D028321:Plant Preparations
keywords: Drug development; Ethnomedicine; Medicinal plants; Principal component analysis; Randomization test