Diarrhoea Due to Alcoholic Herbal Drinks; My Explanation of the Mechanism

“Mama, can I get fifty naira worth of agbo-jedi”. This single statement was what got me into trouble last Saturday. I used my own money to buy and bring distress into my life. Permit me to share my experience of the alleged stomach-washer called agbo-jedi in my local language but, before I start with that, let me introduce the concept of jedi.

Agbo-jedi the “stomach washer” is an herbal drink prepared by the Yoruba people in Southwestern part of Nigeria. It’s supposed to “clear” the body off jedi-jedi totally when used. This condition called jedi-jedi is described as an “excess of sugar” in the body (not in the blood) and its symptoms associated with it are “limitless”. My people link that condition to almost “any non-infection” complaints.

Some of its common symptoms are backache, “unnecessary and smelly farts” during urination and defecation, and perceived lack of “sexual power”. Once you experience a little backache and you complain to a typical Yoruba man or woman, a sure diagnostic response is “that must be jedi-jedi”. They reply with an hundred percent confidence as if they ran a test to confirm the same. This herbal drink however, has had a lot of people testifying to its “goodness”.

Sincerely, I also did once or twice, I am not innocent. Some men do take it every single day as a daily medication. “It keeps me sexually active!” is an answer you will certainly get to the question “why do you take this drink every day?”

Okay, back to myself. I was experiencing backache and smelly farts (Oh! you need to be present when as I was doing my thing). So I set my cultural practice into play, diagnosed myself of jedi-jedi. And I decided to get the only treatment I knew, agbo-jedi.

Oh, I forgot to add that a known side effect of the herbal drink is diarrhoea, both “simple” and “complex” ones. This should be included in the second paragraph but I am feeling a little lazy to place it there. Will you kindly help me with that in your mind? Thanks! And let’s continue.

Local herbal drinks (Agbo-jedi) are mixtures of whole or powdered plant parts including roots, barks, seeds, leaves, underground stems among others. The active components of these materials are usually extracted with either ordinary water or alcohol. So there are basically two types of the drink. The aqueous (water) and the alcoholic type.

“I do not want the type that will make me visit the comfort zone more than thrice in a day” I could remember telling the woman hawking the drink. “Oh! No problem with that, I do not sell such. Which do you prefer, the water type or alcoholic?” she asked. “Alcoholic” I answered in a low tone contemplating whether it is religiously right for me to take alcohol even on herbal grounds. Well, I have always wanted to taste that thing called gin alcohol but, for scientific reasons ONLY!

However, I got the drink, drank it (like an hour after lunch), and after four hours I could easily define and write an extensive article on DIARRHOEA. It was so frequent I had to pitch my tent near the comfort zone. It was like my weight dropped to zero kilogram. After experiencing the suffering that accompanies frequent diarrhoea for the whole day, I got the scientific me to work.

The alcoholic type is said to be more potent as a “sugar-washer” than that extracted with water. However, what people meant was that it causes more pronounced diarrhoea especially when it is taken after a meal. But why is this?

I have a habit of trying to provide explanations to concepts or problems by cross-linking various thoughts. It keeps me active! But consumes my foodstuffs (brain devours more). Anyways, I will attempt to explain this one too. However, let us do this together!

For us to be on virtually same page, let me answer the question “what is diarrhoea?”

I prefer its definition as stated by the World Health Organization; “the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual)”^source.

There are different types of diarrhoea based on its duration, and the mechanism involved which is a direct consequence of the causative agent. Considering this, I must then first identify the most probable type of diarrhoea that I experienced. Equipped with that knowledge, I may then go ahead and identify the cause of the same.

During digestion, water is secreted in the small intestine to aid the process of selective absorption of nutrients form churned food materials undergoing digestion. This water is reabsorbed in the large intestine. When either of the secretion or absorption of water in the two intestines respectively are tampered with, such as a case of excess secretion and little or no absorption, watery stool (diarrhoea) results. This type is called secretory diarrhoea.

In case of diarrhoea caused by one of the conditions mentioned above, that is excess secretion of water into the lumen of the small intestine, arising as a result of osmotic imbalance, the type is called an osmotic diarrhoea.

• The other types of diarrhoea include exudative diarrhoea (characterized with blood and pus in the stool)^source,
• inflammatory diarrhoea (as a result of mucosa lining damage hence a problem with absorption of water in the large intestine)^source
• and dysentery (also characterized with blood which is a result of bowel invasion by pathogens)^source.

I had no visible blood in my stools (WAIT! Do not try to imagine how I knew this, especially if you are “eat-reading” this post). I am also quite sure there was no mucosal damage neither since I did not experience any other symptom that could point to pathogen invasion. So let us rule out the last three types of diarrhoea as mentioned earlier.

It had to be either secretory or osmotic diarrhoea, meaning it was a problem of excess secretion of inhibited absorption. But which of these two was the actual one I experienced. First let us talk about the most probable cause of the watery stool which is the alcoholic extract type of agbo-jedi.

Mahoob and Haleem in their research titled “Effect of Ethanol on Serum Electrolytes and Osmolarity” explained how that ethanol was a cause of increased hyperosmolarity in rats’ serum. They reported an acute drop in the concentration of serum ions like sodium, potassium, chloride, and magnesium following alcohol administration ^source.

This knowledge about alcohol-driven hyperosmolarity, please hold it in thought, we will get back to it soon.

Water is secreted into the lumen of the small intestine and absorbed in the large intestine in an attempt to maintain osmotic balance between the cytoplasm of intestinal cells and extracellular fluids.

After the stomach is done with its own part of the digestion process, the resulting material called chyme (semi-fluid partly digested food material) is released into the small intestine, where nutrients are absorbed and the material further digested. From the small intestine, the chyme move on to the large intestine where water is absorbed from it and it becomes formed (that is more solidified).

On initial entrance into the small intestine, chyme’s osmolarity (the concentration of an osmotic solution – Merriam-Webster Dictionary) is normally not as high as when it has undergone few digestive processes. That is its osmolarity increases after larger molecules have been broken down. Because of this increase in osmmolarity of chyme, water is secreted by intestinal cells to mix with chyme. This follows the definition of osmosis (liquid movement from region of low concentration to one of high concentration through a permeable membrane).

However, alcohol from the herbal drink (as discovered in the research highlighted above) ensures that the osmolarity of chyme in my intestine is not raised as it should by decreasing the concentration of active ions. And so, little or no secretion of water by intestinal cells. This affects uptake of nutrients or supposed osmotically active molecules. Because of this, chyme sent to the large intestine has a “higher” osmolarity than it should since nutrients that ought to be taken care of in the small intestine still exist in the chyme.

Higher osmolarity than the cellular fluids in the large intestine means little or no absorption of water but more of secretion, as water moves from low region of low concentration to that of higher concentration. Your guess is as right as mine. A watery stool is the result, the duration of which depends on when the alcoholic herbal drink wears off completely from the digestive system.

The active components of the plant extracts that makes up the drink must be well researched before clear explanations can be made about their contribution to the usual aftermath which is diarrhoea. I however made effort to know some of the plant materials used in making this drink. They include;

• konafuru (clove - Syzygium aromaticum)
• cafra pelebe (camphor)
• ata ile pupa (turmeric - Curcuma longa)
• ayu (garlic - Allium sativum) and
• alubosa elewe (shallot - Allium ascalonicum) among many others.

Some of which have diarrhoea listed as part of their side effects when ingested in large quantities, examples in the category are garlic, turmeric, camphor and shallot.

Due to the activity of alcohol in the intestine, Alcohlic agbo-jedi is considered a more potent type of the herbal drink, as it results to more frequent washing away of the contents of the stomach and intestine, hence a better "sugar washer" as my people would rather refer to it.

This is just an attempt to provide a "scientific" explanation to what I experienced. You have other explanations for this condition? Kindly share below in the comment section.

Thanks for reading!!!

REFERENCES

• Diarrhoea
• Effect of ethanol on electrolytes and osmolality
• Seceretion in the small intestine

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