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Aloe barbadensis Mill. extract improves symptoms in IBS patients with diarrhoea: post hoc analysis of two randomized double-blind controlled studies
Abstract
Background: Aloe barbadensis Mill. (Aloe) extract was found to be well-tolerated, safe and showed beneficial effects in subsets of irritable bowel syndrome (IBS) patients in two randomized, double-blind, controlled studies. However, the individual studies were underpowered to perform subgroup analyses. We therefore determined the effect of Aloe extract in IBS subgroups in a post hoc analysis combining the results from the two studies. Methods: Data from the two controlled studies comparing Aloe and control treatment taken orally for 4 weeks, were pooled. Both studies included IBS patients fulfilling the ROME III criteria and IBS Symptom Severity Score (IBS-SSS) was assessed. We analysed the effect of Aloe extract on IBS symptom severity and the proportion of responders (IBS-SSS reduction ⩾ 50) in IBS subgroups. Results: In total, 213 IBS patients were included in the post hoc subgroup analyses. A reduction in overall symptom severity, primarily driven by effect on pain severity and frequency, comparing baseline versus end of treatment, was recorded in IBS patients with diarrhoea (IBS-D) receiving Aloe ( n = 38, p < 0.001) but not control treatment ( n = 33, p = 0.33), with difference between the treatment groups ( p = 0.01). Moreover, the frequency of responders was higher in IBS-D patients receiving Aloe ( n = 22, 58%) compared to control treatment ( n = 10, 30%) ( p = 0.02). The effect of Aloe extract treatment on IBS symptom severity was not superior to control treatment in the other IBS subtypes. Conclusion: Aloe extract improves symptom severity in IBS-D patients and can be regarded as a safe and effective treatment option for this patient group.
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“A pooled analysis of two controlled studies suggests that the treatment with Aloe barbadensis extract significantly reduces symptom severity and improves response rates in IBS-D patients primarily by reducing abdominal pain severity and frequency, even though the mechanisms underlying these effects remain unclear [91].”
From Natural Remedies for Irritable Bowel Syndrome: A Comprehensive Review of Herbal-Based Therapies (2025) · cites this paper as [91]
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“Other agents, including Aloe vera, flavonoids, St John’s wort, and ginger, exhibit mixed or inconsistent results, reflecting heterogeneity in study designs and underlying mechanisms.”
From Plant-Derived Treatments for IBS: Clinical Outcomes, Mechanistic Insights, and Their Position in International Guidelines (2026) · cites this paper as [77]
In the citing paper
“A post hoc analysis of two randomized, double-blind, controlled studies involving 213 patients also showed symptomatic improvement and confirmed that Aloe vera (500 mg Aloe extract + 780 mg inulin per day, per os for four weeks) was safe and well tolerated [77].”
From Plant-Derived Treatments for IBS: Clinical Outcomes, Mechanistic Insights, and Their Position in International Guidelines (2026) · cites this paper as [77]
In the citing paper
“Some meta-analyses suggest a potential benefit, although the overall evidence remains inconsistent and not robust.”
From Plant-Derived Treatments for IBS: Clinical Outcomes, Mechanistic Insights, and Their Position in International Guidelines (2026) · cites this paper as [77]
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Cited by
Natural Remedies for Irritable Bowel Syndrome: A Comprehensive Review of Herbal-Based Therapies
Abalo, R., Gallego-Barceló, P., & Gabbia, D. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26199345 · Cited by 5
Pastras, P., Aggeletopoulou, I., Bali, M., & Triantos, C. (2026) · Nutrients · doi:10.3390/nu18020183 · Cited by 1
Metadata
- Authors
- Ahluwalia, B., Magnusson, M. K., Böhn, L., Störsrud, S., Larsson, F., Öhman, L., & Simrén, M.
- Affiliations
- Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
- Research and Development, Calmino Group AB, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden
- Venue
- Therapeutic Advances in Gastroenterology
- Publisher
- SAGE Publications
- Published
- 2021-01
- Volume
- 14
- ISSN
- 1756-2848
- Cited by
- 11
- References
- 5
- Language
- en
- Funders
- Calmino group AB, Sweden
- sahlgrenska akademin
- AFA Försäkring
- Swedish Medical Research Council (13409, 2015-02317, 2019-01052, 21691, 21692)
- Regional Executive Board, Region Västra Götaland (VGFOUREG-931919)
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