Internet marketing of the herbal product ginger for use against nausea and vomiting
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Aim: The purpose of the study was to evaluate Internet marketing of ginger for use against nausea and vomiting during pregnancy (NVP) with particular focus on claims related to safety and efficacy in this indication. Method: A systematic study on the Internet using the terms pregnant and nausea", pregnancy and nausea", pregnancy and morning sickness" and morning sickness" was performed on September 14th and 15th and October 26th 2009. The search engines www.google.com and www.yahoo.com were used for all searches. Web sites containing information about NVP and suggested one or more treatment were included. Recommendations of ginger that were included were ginger powder, capsules and root. Sites recommending ginger cookies, candies and similar products were excluded. Ginger retail sites were located using the terms ginger", buy ginger", purchase ginger" and sale ginger" on September 24th 2009. Sites considered relevant were those where ginger products could be purchased directly or by clicking on provided links. On December 17th 2009 the term safety and ginger and pregnancy" was used to gather sites where the safety of ginger in pregnancy was the main topic. Statements on the effectiveness against NVP were also investigated. Results: A total of 255 Web sites were examined in the study. Of these, 88 unique sites fulfilled the criteria's for further study. Ginger was recommended on 30 (61.2 %) of the 54 relevant NVP treatment sites. The majority of sites were commercial. Generally, the information given regarding safety of ginger during pregnancy was scarce and when such information was provided the recommendations varied. Nausea" was given as indication for use on 10 (55.6%) of the 18 ginger retail sites whilst five (27.8%) mentioned morning sickness" or similar. One site stated that ginger product was not to be used during pregnancy and lactation unless a healthcare practitioner had directed it. Another site said it was safe for short term use during pregnancy. The others neglected to give any such information. Six Web sites of scientific interest and 11 sites aiming at the common consumer were found in the ginger safety search. Nine (52.9%) of these 17 sites found that ginger could be used safely by pregnant women. Conclusions: Ginger is frequently recommended on the Internet as a remedy for NVP, but limited information is provided about the safety of ginger in pregnancy unless the word safety is included in the search term. When this is done, the majority of sites state that ginger is effective and safe for use against nausea and vomiting during pregnancy.