Betel (Piper betle) has been used traditionally in various parts of South and Southeast Asia as a remedy for several ailments, including gastrointestinal disturbances such as diarrhea and cholera. The use of betel leaves in cholera is primarily rooted in folk medicine practices, where its astringent, antimicrobial, and stimulant properties are believed to help manage symptoms like diarrhea, dehydration, and abdominal discomfort. Historical texts and ethnobotanical surveys indicate that betel leaf was often chewed or used in decoctions as part of supportive care during cholera outbreaks, especially before the advent of modern rehydration and antibiotic therapies.

Scientifically, some studies have demonstrated that betel leaf contains compounds with antimicrobial activity, such as chavicol and eugenol, and may act against certain bacteria and fungi. However, direct evidence supporting its efficacy against Vibrio cholerae (the causative agent of cholera) in humans is lacking. The majority of available studies are in vitro and do not establish clinical benefits in treating or preventing cholera. As such, while the traditional use of betel for cholera exists and is documented, there is insufficient scientific validation, and its role should not replace evidence-based treatments like oral rehydration therapy and antibiotics.

In summary, the use of betel for cholera is based on traditional medical practices rather than robust scientific evidence, and it should be regarded as a historical or complementary approach rather than a primary treatment method.