The use of Ginger in the prevention of motion sickness
Date First Published:
September 15, 2011
Last Updated:
October 17, 2011
Report by:
An-Yi Wang, Emergency Physician (National Taiwan University Hospital )
Search checked by:
Zui-Shen Yen, National Taiwan University Hospital
Three-Part Question:
Does [ginger] prevent or reduce [the severity of motion sickness] in [young adults]?
Clinical Scenario:
A 28-year-old woman experiencing dizziness, vertigo, nausea, and vomiting after riding a boat is brought to the emergency department. She has no systemic disease or diarrhea and denies being pregnant; her vital signs are normal. Her symptoms improve a lot after resting. She enquires about methods to prevent the motion sickness. You wonder whether natural ginger extracts could help prevent or reduce severity of motion sickness.
Search Strategy:
Medline 1948 to August 2011
Cochrane Library
CINAHL
Cochrane Library
CINAHL
Search Details:
Medline 1948 to August 2011: (motion sickness.mp. OR exp Motion Sickness OR seasickness.mp.) AND (ginger.mp. OR exp Ginger OR Zingiber.mp.)
Cochrane Library: ginger AND motion sickness
CINAHL: ginger AND motion sickness
Cochrane Library: ginger AND motion sickness
CINAHL: ginger AND motion sickness
Outcome:
Medline: Twenty-five papers were found, 6 of which were original research articles and were considered to be related to our topic of interest. An additional paper was mentioned in a review article. No additional relevant articles were found in the Cochrane Library. Thus, we were able to find a total of 7 papers that discussed the use of ginger for preventing or treating experimental and clinical motion sickness. (Table 1).
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Motion sickness, ginger, and psychophysics. Mowrey DB, Clayson DE. 1982 USA | 36 volunteers (age, 18–20 years) with high susceptibility to motion sickness took ginger root capsule, dimenhydrinate, or placebo 20–25 min before sitting in a rotatory chair. | Randomized controlled trial | Durable time in the rotatory chair (seconds) | Placebo:90.0 ± 12.2;Ginger (940 mg): 335.8 ± 8.2 (p < 0.001);Dimenhydrinate (100 mg): 216.2 ± 10.0 (p < 0.001) | Small number of participants Suboptimal randomization |
| Comparison of efficacy of ginger with various antimotion sickness drugs. Wood CD, Manno JE, Wood MJ, et al. 1988 USA | 8 volunteers (age, 18–35 years) were given fresh ginger, ginger, dimenhydrinate, promethazine, scopolamine, d-amphetamine (in this sequence) 120 min before sitting in a rotatory chair. | Quasi-experimental study | Number of head movements required to achieve a score of 16 points on the Graybiel scale of motion sickness symptoms | Placebo：baseline for comparison;Fresh ginger (1000 mg): +1 (p = N.S.);Ginger (500 mg):-8 (p = N.S.);Ginger (1000 mg):-4 (p = N.S.);Ginger (500 mg):-8 (p = N.S.);Dimenhydrinate (50 mg):+79 (p < 0.05);Promethazine (25 mg):+81 (p < 0.05);Scopolamine (0.6 mg):+81 (p < 0.05);Scopolamine (1 mg): +183 (p < 0.05);d-Amphetamine (1 mg):+118 (p < 0.05) | Small number of participants Not a randomized controlled trial Volunteers would develop tolerance under repeated stimuli |
| The anti-motion sickness mechanism of ginger: A comparative study with placebo and dimenhydrinate. Holtmann S, Clarke AH, Scherer H, et al. 1989 Germany | 38 candidates (age, 22–34 years) took ginger root capsule, dimenhydrinate, or placebo (decided randomly) 90 min before sitting in a rotatory chair. | Quasi-experimental study | Post-rotatory response intensity | Baseline:6.71 ± 1.85;Placebo:6.65 ± 1.96;Ginger (1000 mg):6.81 ± 2.33 (p < 0.05);Dimenhydrinate (100 mg):5.50 ± 2.22 (p < 0.05) | Small number of participants no clinical outcomes, not a randomized controlled trial, and volunteers would develop tolerance under repeated stimuli. |
| Effects of ginger on motion sickness susceptibility and gastric function. Stewart JJ, Wood MJ, Wood CD, et al. 1991 USA | 28 volunteers (age, 18–40 years) participated in the experimental protocol. 8 volunteers took ginger root capsule, scopolamine, or placebo (on separate days); other 8 volunteers took fresh ginger an hour before sitting in a rotatory chair. |
Quasi-experimental study | Number of head movements required to achieve a score of 16 points on the Graybiel scale of motion sickness symptoms | Placebo:baseline for comparison;Ginger (500 mg):-8.8 ± 30.4 (p = N.S.);Ginger (1000 mg):-3.1 ± 16.5 (p = N.S.);Fresh ginger (1000 mg):-0.4 ± 11.5 (p = N.S.);Scopolamine (0.6 mg): 147.5 ± 22.1 (p < 0.01) | Small number of participants Not a randomized controlled trial Volunteers would develop tolerance under repeated stimuli |
| Effects of ginger on motion sickness and gastric slow-wave dysrhythmias induced by circular vection. Lien HC, Sun WM, Chen YH, et al. 2002 Taiwan | 18 volunteers (age, 18–40 years) with a history of motion sickness took ginger root capsule or placebo 60 min before sitting in a rotatory chair. | Quasi-experimental study | Nausea score(0–3; no nausea to severe nausea) | Placebo:2.5 ± 0.2;Ginger (1000 mg):1.7 ± 0.3 (p < 0.05);Ginger (2000 mg):1.8 ± 0.2 (p < 0.05) | Small numbers of participants Unclear randomization |
| Durable time in the rotator chair (minutes) | Placebo:5.6 ± 0.6;Ginger (1000 mg):8.5 ±1.1 (p < 0.05);Ginger (2000 mg):9.7 ±1.1 (p < 0.05) | ||||
| Ginger root against seasickness: A controlled trial on the open sea. Grøntved A, Brask T, Kambskard J, et al. 1988 Denmark | 80 healthy naval cadets (age, 16–19 years) who were not accustomed to the high seas took ginger root capsule (1000 mg) or placebo when at heavy seas during cruise. | Randomized clinical trial | Incidence of motion sickness(%) | Ginger: 60% (24/40) ;Placebo: 61.5% (24/39) | Small numbers of participants No power calculation Unclear randomization |
| Score sum of all symptom categories reported at 4th hour(Nausea: 0–3 ;Vertigo: 0–3;Vomiting: 0–2;Cold sweating: 0–1) | Placebo:35;Ginger (1000 mg):18 (p < 0.05) | ||||
| Comparison of seven commonly used agents for prophylaxis of seasickness. Schmid R, Schick T, Steffen R, et al. 1994 Norway | 1741 tourist volunteers (age, 16–65 years) took ginger root capsule, dimenhydrinate/caffeine, or domperidone/cinnarizine 2 hr prior to the boat’s departure and were instructed on when to take the second dose, if required. |
Randomized clinical trial | Degree of seasickness (none, slight, moderate, severe malaise, or vomiting) | Ginger root (500 mg); 2 doses:None: 78.3% (p = N.S.);Slight/moderate: 12.3% (p = N.S.);Severe/vomiting: 9.4% (p = N.S.);Vomiting: 7.9% (p = N.S.);Dimenhydrinate (50 mg)/Caffeine (50 mg); 1 dose:None: 81.4% (p = N.S.);Slight/moderate: 10.8% (p = N.S.);Severe/vomiting: 7.8% (p = N.S.);Vomiting: 4.1% (p = N.S.);Cinnarizine (20 mg)/Domperidone (15 mg); 2 doses:None: 77.7% (p = N.S.);Slight/moderate: 16.6% (p = N.S.);Severe/vomiting: 5.7% (p = N.S.);Vomiting: 4.8% (p = N.S.) | Unclear blinding method Did not have intention-to-treat analysis |
Author Commentary:
Motion sickness is an unpleasant sensation. Currently available anti-motion sickness medication may induce antimuscarinic and antihistamine effects such as dry mouth, lethargy, and drowsiness. Ginger root, a traditional herb, may be used as an alternative remedy for motion sickness. Although the mechanism by which motion sickness is prevented is unknown, studies show that ginger root probably acts on the gastrointestinal system rather than the central nervous system, which means that ginger does not have sedative effects.
The findings of this short review of the literature show that ginger root capsules have mixed effects in preventing motion sickness under experimental conditions. Studies on clinical motion sickness show that ginger has the tendency to reduce the severity of motion sickness or is as effective as other anti-motion sickness medications. No significant adverse effects of ginger have been reported. However, properly conducted randomized clinical trials are needed to study clinical motion sickness.
The findings of this short review of the literature show that ginger root capsules have mixed effects in preventing motion sickness under experimental conditions. Studies on clinical motion sickness show that ginger has the tendency to reduce the severity of motion sickness or is as effective as other anti-motion sickness medications. No significant adverse effects of ginger have been reported. However, properly conducted randomized clinical trials are needed to study clinical motion sickness.
Bottom Line:
Ginger root capsules could be useful in preventing motion sickness, more so, if there are concerns about the sedative effects of traditional anti-motion sickness medication.
Level of Evidence:
Level 3: Small numbers of small studies or great heterogeneity or very different population
References:
- Mowrey DB, Clayson DE.. Motion sickness, ginger, and psychophysics.
- Wood CD, Manno JE, Wood MJ, et al.. Comparison of efficacy of ginger with various antimotion sickness drugs.
- Holtmann S, Clarke AH, Scherer H, et al.. The anti-motion sickness mechanism of ginger: A comparative study with placebo and dimenhydrinate.
- Stewart JJ, Wood MJ, Wood CD, et al. . Effects of ginger on motion sickness susceptibility and gastric function.
- Lien HC, Sun WM, Chen YH, et al. . Effects of ginger on motion sickness and gastric slow-wave dysrhythmias induced by circular vection.
- Grøntved A, Brask T, Kambskard J, et al. . Ginger root against seasickness: A controlled trial on the open sea.
- Schmid R, Schick T, Steffen R, et al. . Comparison of seven commonly used agents for prophylaxis of seasickness.