Myths and Realities: Ginger Ale in Treating Nausea and Vomiting

September 3, 2009

gingeraleChau Che MD

Faculty peer reviewed

Despite the numerous medications available for the treatment of nausea and vomiting, some patients and doctors insist that ginger ale will alleviate gastrointestinal symptoms. As early as the first century AD, the Greek physician Dioscorides praised ginger root because it “gently stimulates the gut and is profitable for the stomach” (4). During the 16th century, the physician Lonicerus similarly wrote, “Ginger does good for a bad stomach” (4). Ginger has long medicinal roots in both India and China and is still used in those countries as a remedy for nausea and vomiting. In the United States today, patients with abdominal complaints often report self-medicating with ginger ale at home. Even at Memorial Sloane Kettering Cancer Institute, chemotherapy patients recline in their rooms with multiple anti-emetics by the bedside, including metoclopramide, compazine, ondansetron, and usually a can of ginger ale as well.Several active ingredients in ginger have been hypothesized to relieve nausea and vomiting. Potent compounds, known as gingerols, and their dehydrated derivatives, shoagols, simultaneously enhance gastrointestinal peristalsis and suppress gastric contraction (1,2,5,7). Galanolactose produces an anti-emetic effect by interfering with serotonin signaling via competitive inhibition of 5-HT3 receptors and also by acting as an antioxidant that neutralizes the free radicals responsible for emesis (5). Some speculation exists that ginger may also exert a central nervous system effect through an unknown mechanism (2,6).

Studies examining the use of ginger as an adjunct to pharmacologic anti-emetics have produced mixed results. Ginger has been shown to reverse the inhibitory effect of cisplatin on gastric emptying in rats (7). However, a study in 162 oncology patients demonstrated no additional benefit of ginger in reducing the prevalence or severity of both acute and delayed chemotherapy-induced nausea and vomiting when given with serotonin receptor antagonists or the anti-emetic aprepitant (7). This finding correlates with a study in gynecologic oncology patients that showed no improvement in symptoms with ginger (5). Conversely, a randomized-controlled trial found ginger powder to be as successful as metoclopramide for the control of chemotherapy-induced nausea and vomiting (5, 7). More results favoring the use of ginger come from Borrelli et al., who conducted a systematic review of 33 studies examining the use of ginger as an anti-emetic in pregnant women. They found a total of six double-blind randomized-controlled trials. Four showed ginger to be superior to placebo. The other two showed ginger to be comparable to vitamin B6, which in previous studies has demonstrated efficacy in pregnancy-induced nausea (1). Unfortunately, the small sample size and variable findings in the above studies make it difficult to draw definitive conclusions regarding the use of ginger across a spectrum of settings. Double-blind clinical trials are currently underway to help clarify the role of ginger treatment in medicine (3).

What about the anti-emetic properties of a drink made from ginger extract? Studies have found effective doses anywhere from 250-mg to 1-g taken one to four times a day (1,6). Unfortunately, commercial ginger ale today does not contain ginger extract, but artificial flavoring. Ginger ale as a clinical treatment for nausea and vomiting can only be seen as a myth. Nevertheless, if my patients want ginger ale in addition to their medications, I will continue to prescribe it and simply take advantage of the placebo effect rather than the ginger effect.

 Peer reviewed by Barbara Porter, MD MPH,  Clinical Assistant Professor of Medicine, NYU Medical Center

Dr. Che is a second year resident in internal medicine at NYU Medical Center.

[1] Borrelli F., Capasso R., Aviello G., et al. Effectiveness and Safety of Ginger in the Treatment of Pregnancy-Induced Nausea and Vomiting. Obstetrics and Gyne¬cology, 2005; 105(4): 849-56.

[2] Ernst E., Pittler M., Efficacy of Ginger for Nausea and Vomiting: a Systematic Review of Randomized Clinical Trials. British Journal of Anaesthesia, 2000; 84(3): 367-371.

[3] Hickok, A., Roscoe, J., et al. Phase II/III Randomized, Placebo-Controlled, Double-Blind Clinical Trial of Ginger (Zingiber officinale) for Nausea Caused by Chemotherapy for Cancer: A Currently Accruing URCC CCOP Cancer Control Study. Supportive Cancer Therapy, 2007; 4(4): 247-250.

[4] Langner, E., Greifenberg S., et al. Ginger: History and Use. Advances in Therapy, 1998; 15(1): 25-44.

[5] Manusirivithaya, S., Sripramote, M., Tangjitgamol, S., et al. Antiemetic Effect of Ginger in Gynecologic Oncology Patients Receiving Cisplatin. International Journal of Gynecological Cancer; 2004; 14: 1063-1069.

[6] White, B. Ginger: An Overview. American Family Physician, 2007; 75(11): 1689-1691.

[7] Zick S., Ruffin, M., Lee, J. et al. Phase II Trial of Encapsulated Ginger as a Treatment for Chemotherapy-Induced Nausea and Vomiting. Supportive Care in Cancer, 2009; 17: 563-572.

9 comments on “Myths and Realities: Ginger Ale in Treating Nausea and Vomiting

  • Avatar of oscar
    oscar on

    Canada dry, the one pictured in this article does in fact contain real ginger. Its listed as “natural flavors” on the label. Same with seagrams.

  • Avatar of JJ
    JJ on

    Well I have sea sickness since forever, I spent 14 years in the Navey 3/4 of that time was at sea. I would not have made it without fresh ginger root. Every time we hit port. I would refresh my supply of roots. When we hit rough seas I would cut a quarter size slice of ginger root about every 4 hours and chew it up very well and swallow root and juice. Work everytime Also work well for the bowel and upset stomach from drinking the water in oversea country. It makes a great tea also for calming nerves after a hard day. extra note/// the meds they gave in sick bay for sea sickness did not work at all for me.

  • Avatar of Jon Frick
    Jon Frick on

    This article implies there are only a few causes of nausea and vomiting, as addressed by the research that dismisseses ginger as a viable treatment. What about other causes of nausea and vomiting?

    What about the relief that is provided by the carbination?

    The title of this article cleary does not correlate with the text of the article. The article speaks to the use of ginger in specific circumstances, Not ginger ale in all cases as implied by the title.

  • Avatar of martin blair
    martin blair on

    If there is no commercial gin ale with ginger extract, where can I find a drink that contains the ginger extract? After gall bladder removal I experience nausea every day. Thanks for your assist.–Martin

  • Avatar of Dan
    Dan on

    Oscar, “Natural Flavoring” only means that the flavors come from natural sources. It could come from anything from unrelated plant material, insect secretions (i wish I was lying), and sometimes animal byproducts. Unless the ingredients list specifically says “Ginger root” or “Ginger extract,” then you should assume it contains none. Old Dominion makes a natural Ginger Ale with real ginger. A 6-pack will run you about 7 or 8 bucks and it’s DELICIOUS. There is absolutely no comparison between REAL ginger ale and Canada Dry. It’s like the difference between fresh-pressed Florida OJ and Sunny D

  • Avatar of david
    david on

    That’s strange. As I type I’m drinking a can of Schweppes Ginger beer, which claims to include “ginger root extract. It’s also doing wonders for my upset stomach. Must be the placebo effect I guess.

  • Avatar of JP
    JP on

    A couple of things here. First off, could it be possible that since Canada Dry is lower in sugar (as the name indicates), the amount of carbonation and perhaps even the a psychological association with the ginger flavor (presuming it is artificial, which hasn’t been proven one way or the other; and by psychological, I do not mean the placebo effect, but rather a relationship with the flavor itself, i.e. smells and tastes can effect the stomach) could have an effect? Evidence for and against Canada Dry regarding their ingredients needs to be brought forth.

    Secondly, there are ginger ale beverages that are completely natural, such as Reed’s Ginger Ale. I have personally found it soothing not only when my stomach is upset but also with instances of heart burn. I also drink 7-Up to sooth my stomach. I do not know if it contains any trace of natural lemon, but I notice a difference with other sodas such as Sprite, 7-Up seems to work best.

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