Browse > Article
http://dx.doi.org/10.5056/jnm18077

Aloe vera Is Effective and Safe in Short-term Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-analysis  

Hong, Seung Wook (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Chun, Jaeyoung (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Park, Sunmin (Department of Food and Nutrition, Hoseo University)
Lee, Hyun Jung (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Im, Jong Pil (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Kim, Joo Sung (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
Publication Information
Journal of Neurogastroenterology and Motility / v.24, no.4, 2018 , pp. 528-535 More about this Journal
Abstract
Background/Aims To evaluate the efficacy and safety of Aloe vera (AV) in patients with irritable bowel syndrome (IBS). Methods We searched the MEDLINE, EMBASE, and Cochrane databases for studies dated between 1st January 1960 and 30th December 2017. Eligible randomized controlled trials (RCTs) compared AV to placebo in patients with IBS. The primary outcome was standardized mean difference of the change in severity of IBS symptoms as measured by patient-rated scales. Secondary outcomes included response rate of IBS symptoms and adverse events. Heterogeneity among studies was assessed using Cochrane's Q and $I^2$ statistics. Results Three RCTs with a total of 151 patients with IBS were included. The meta-analysis showed a significant difference for patients with AV compared to those with placebo regarding improvement in IBS symptom score (standardized mean difference, 0.41; 95% CI, 0.07-0.75; P = 0.020). Using intention-to-treat analysis, the AV patients showed significantly better response rates of IBS symptoms compared to placebo (pooled risk ratio, 1.69; 95% CI, 1.05-2.73; P = 0.030). No adverse events related with AV were found in included studies. There was no significant heterogeneity of effects across studies (P = 0.900; $I^2=0%$). Conclusion AV is effective and safe for the treatment of patients with IBS compared to placebo.
Keywords
Aloe; Irritable bowel syndrome; Meta-analysis; Review;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Soares RL. Irritable bowel syndrome: a clinical review. World J Gastroenterol 2014;20:12144-12160.   DOI
2 Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA 2015;313:949-958.   DOI
3 Hussain Z, Quigley EM. Systematic review: complementary and alternative medicine in the irritable bowel syndrome. Aliment Pharmacol Ther 2006;23:465-471   DOI
4 Eamlamnam K, Patumraj S, Visedopas N, Thong-Ngam D. Effects of Aloe vera and sucralfate on gastric microcirculatory changes, cytokine levels and gastric ulcer healing in rats. World J Gastroenterol 2006;12:2034-2039.   DOI
5 Werawatganon D, Rakananurak N, Sallapant S, et al. Aloe vera attenuated gastric injury on indomethacin-induced gastropathy in rats. World J Gastroenterol 2014;20:18330-18337.   DOI
6 Davis K, Philpott S, Kumar D, Mendall M. Randomised double-blind placebo-controlled trial of Aloe vera for irritable bowel syndrome. Int J Clin Pract 2006;60:1080-1086.   DOI
7 Hutchings HA, Wareham K, Baxter JN, et al. A randomised, crossover, placebo-controlled study of Aloe vera in patients with irritable bowel syndrome: effects on patient quality of life. ISRN Gastroenterol 2011;2011:206103.
8 Akaberi M, Sobhani Z, Javadi B, Sahebkar A, Emami SA. Therapeutic effects of Aloe spp. in traditional and modern medicine: a review. Biomed Pharmacother 2016;84:759-772.   DOI
9 Storsrud S, Ponten I, Simren M. A pilot study of the effect of aloe barbadensis mill. extract (AVH200(R)) in patients with irritable bowel syndrome: a randomized, double-blind, placebo-controlled study. J Gastrointestin Liver Dis 2015;24:275-280.
10 Dinan TG, Quigley EM, Ahmed SM, et al. Hypothalamic-pituitarygut axis dysregulation in irritable bowel syndrome: plasma cytokines as a potential biomarker? Gastroenterology 2006;130:304-311.   DOI
11 Langmead L, Feakins RM, Goldthorpe S, et al. Randomized, doubleblind, placebo-controlled trial of oral Aloe vera gel for active ulcerative colitis. Aliment Pharmacol Ther 2004;19:739-747.   DOI
12 IARC. Aloe vera. In: Some drugs and herbal products. IAC Monographs 2016;108:37-71.
13 Yokohira M, Matsuda Y, Suzuki S, et al. Equivocal colonic carcinogenicity of Aloe arborescens Miller var. natalensis berger at high-dose level in a Wistar Hannover rat 2-y study. J Food Sci 2009;74:T24-T30.   DOI
14 Modi RM, Hussan H. Melanosis coli after long-term ingestion of cape aloe. ACG Case Rep J 2016;3:e157.   DOI
15 Murakami K, Habukawa C, Nobuta Y, Moriguchi N, Takemura T. The effect of Lactobacillus brevis KB290 against irritable bowel syndrome: a placebo-controlled double-blind crossover trial. Biopsychosoc Med 2012;6:16.   DOI
16 Radha MH, Laxmipriya NP. Evaluation of biological properties and clinical effectiveness of Aloe vera: a systematic review. J Tradit Complement Med 2015;5:21-26.   DOI
17 Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009;339:b2535.   DOI
18 Higgins JP, Altman DG, Gotzsche PC, et al. The cochrane collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928.   DOI
19 Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. Version 5.1.0 (updated March 2011). The Cochrane Collaboraton 2011.
20 Shelton RM. Aloe vera. Its chemical and therapeutic properties. Int J Dermatol 1991;30:679-683.   DOI
21 Ishii Y, Tanizawa H, Takino Y. Studies of aloe. V. Mechanism of cathartic effect. (4). Biol Pharm Bull 1994;17:651-653.   DOI
22 Che QM, Akao T, Hattori M, Kobashi K, Namba T. Isolation of a human intestinal bacterium capable of transforming barbaloin to aloeemodin anthrone. Planta Med 1991;57:15-19.   DOI
23 Capasso F, Mascolo N, Autore G, Duraccio MR. Effect of indomethacin on aloin and 1,8 dioxianthraquinone-induced production of prostaglandins in rat isolated colon. Prostaglandins 1983;26:557-562.   DOI
24 O'Sullivan M, Clayton N, Breslin NP, et al. Increased mast cells in the irritable bowel syndrome. Neurogastroenterol Motil 2000;12:449-457.   DOI