Aloe vera not effective for irritable bowel syndrome

General

Clinical Question:
Is aloe vera effective in the treatment of irritable bowel syndrome?

Bottom Line:
An aloe vera formulation, made up of almost 100% polysaccharides, did not significantly improve irritable bowel syndrome (IBS) symptom scores more than placebo. (LOE = 2b)

Reference:
Davis K, Philpott S, Kumar D, Mendall M. Randomized double-blind placebo-controlled trial of aloe vera for irritable bowel syndrome. Int J Clin Pract 2006;60:1080-1086.  [PMID:16749917]

Study Design:
Randomized controlled trial (double-blinded)

Funding:
Industry

Allocation:
Concealed

Setting:
Outpatient (specialty)

Synopsis:
Complementary treatments are often used in the management of IBS. These investigators enrolled 58 patients, aged 18 years to 65 years, who met the Rome 2 criteria for IBS. All of the patients were initially seen in specialty clinics and had already failed conventional management with antispasmodics, bulking agents, and dietary interventions. Therefore, caution is advised in generalizing these results to patients seen in primary care. Eligible subjects randomly received (concealed allocation assignment) either the active treatment (aloe vera) or matched placebo 4 times daily for 1 month. The aloe vera came from the Natural Living Products formulation. In this preparation, the alloin (which can cause diarrhea) is almost completely removed, leaving only the polysaccharides. A previously validated questionnaire used to assess IBS symptoms was administered by individuals blinded to treatment group assignment. Complete follow-up occurred for 71% of patients at 3 months. Subjects withdrawing from the study were assumed in the analysis to be nonresponders; an equal number withdrew from each group. Using intention-to-treat analysis, there were no significant differences in symptom scores between the 2 groups at both 1 month and 3 months of follow up. The study was 80% powered to detect a 40% difference in response rates, a difference determined to be clinically relevant by the authors. A subgroup analysis of patients with diarrhea-prominent IBS also failed to find a significant difference between the 2 groups.

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