Abstract:
Traditional alternative medicine providers are widely patronized in many parts
of Africa. Inflammatory bowel diseases (IBD), anorectal and gastrointestinal
disorders (AGD) usually designated as piles could be signs of early stage
polyposis and are significant risk factors in colorectal cancers. A survey report
reveals that over 20% of adults in Northern Nigeria have piles or symptoms of
IBD or AGD and majority of them consume herbal preparations because they
believed that such disorders are better managed using traditional medicine.
Herbalist as such are important first contact for this particular group with IBD
and AGD in Nigeria. Existing literatures have established that cultural
practices and beliefs contribute to late-stage diagnosis of cancers in Africa.
The study evaluated the ethno-medicinal practices used by herbalist in the
management of piles and their knowledge and perceptions about colorectal
cancers. Survey information including knowledge on colorectal cancer, herbal
remedies used, methods of preparation and administration, as well as
incidence of anal or bowel inflammation or hemorrhage in consulted patients
were collected using a self-administered questionnaire. A total of 145
herbalists selling “pile” remedies in northern Nigeria were sampled for the
study. The results identified 75 plants used for preparation of pile remedies,
many of which contain toxic alkaloids and saponins; with those in the family
leguminosae leading followed by euphorbiaceae and rubiaceae. Literature
searches on these plants indicate that 31% are relatively safe for
consumption, 15% contained quantified toxic phytochemicals with established
toxicity status while the rest (46%) contained toxic phytochemicals with no
evaluated toxicity. The main methods of preparation are infusion and
decoction while main means of administration is by ingestion through oral
route; 15% of respondents however indicated usage of herbs as suppositories
and anal washes. Almost all the respondents (96%) are conversant with the
term “Cancer” , 44% have an idea of what colorectal cancers are, while only
19% have correct knowledge of the sign and symptoms of colorectal cancers
or believed that inflammation and hemorrhages are potential early signs of
polyposis. Knowledge of association between IBD or AGD and colorectal
cancers among herbalist showed weak correlation (r = 0.33). Findings
concluded that there is a poor knowledge on colorectal cancer among
herbalist and a general perception that AGDs are not risk factors for colon
cancers. The study recommends for increased cancer education with
particular attention at enlightenment of herbalist and patients with IBD and
AGD on benefits of clinical treatments and importance of screening for early
detection of colorectal cancers and possible intervention.
