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Is aloe vera effective as IBS treatment?

Q - Many patients ask about taking aloe vera for irritable bowel syndrome. What is the evidence that it works and are there any side-effects or contradictions?

A - Aloe vera (A. barbadensis miller) is a cactus-like plant that grows in hot dry climates. It has a long history of medicinal use.

Today, two different Aloe vera preparations are being marketed: gel and juice. The gel is made from the soft centre of the plant and contains mainly polysaccarides. It is used topically.

The juice is produced from the peripheral bundle sheath cells and contains aloin, anthraquinones and barbaloin. It is taken orally and has laxative effects.

In 1999 a colleague and I conducted a systematic review of all controlled clinical trials of aloe. It concluded there was no evidence to demonstrate the effectiveness of any aloe vera product for any indication.

Specifically, for irritable bowel syndrome there is no compelling data that it might help. The laxative properties of aloe vera might reduce constipation, which can be a feature of IBS But this effect is neither specific nor well-documented.

Aloe vera is contraindicated in pregnancy/lactation, for patients with known allergies and for people with intestinal obstructions. Adverse effects include intestinal pain, and fluid or electrolyte loss. Interactions with antiarrhythmics, cardiac glycosides, diuretics and steroids are conceivable.

Professor Edzard Ernst is professor of complementary medicine at the Peninsular Medical School, Exeter

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