Aloe vera (Aloe barbadensis Miller) is an herb traditionally used externally to promote the normal wound healing of wounds, burns, and skin irritations. While aloe vera may cool and soothe damaged cells on the body’s surface, research is investigating its potential to soothe the gastrointestinal tract (GI) internally. Aloe vera may potentially promote bowel regularity and promote normal immune and inflammatory responses in the GI tract. 

Aloe vera is a large succulent adapted to live in areas with little water, originating from the dry regions of Africa, Asia, and southern Europe. The plant stores excess water in the tissues of its leaves, which contain a thin, clear, jelly-like gel. 

One compound in aloe vera that may promote bowel regularity is called barbaloin. When aloe vera is consumed, intestinal bacteria metabolize barbaloin into aloe-emodine-9-anthrone (AE-anthrone), which helps to promote intestinal motility and increase paracellular permeability. AE-anthrone may also influence the release of prostaglandin-like compounds and stimulate mucus secretions in the colon. Consequently, aloe vera may increase the amount of water in the intestinal lumen, which may be clinically relevant to individuals with occasional constipation. 

In a randomized, double-blind, placebo-controlled (RCT) pilot study, 68 adults with irritable bowel syndrome (IBS) were given aloe vera extract or a placebo. After four weeks of treatment, the experimental group exhibited reductions in the overall severity of IBS symptoms compared to the placebo, with no serious adverse effects. A meta-analysis by Hong et al. further explored the effects of aloe vera on patients with IBS, including three prospective RCTs and 151 patients. Individuals receiving aloe vera administration showed significantly improved IBS symptom scores and response rates compared to those receiving a placebo.  

Hutchings et al. reported contradictory conclusions in a randomized, cross-over, placebo-controlled study, where no beneficial effects of aloe vera versus placebo were observed in individuals with IBS. The researchers concluded that this may be due to the large number of dropouts (only 47 out of 110 patients fully completed the trial), along with other confounding factors that may have impacted the power of the study to detect a clinically important difference. 

In a rat model of IBS, aloe vera used in combination with German chamomile (Matricaria recutita) effectively reduced tumor necrosis factor-alpha, lipid peroxidation, and myeloperoxidase activity, and also delayed gastric emptying and bowel transit time. This suggests that aloe vera may be a helpful adjunct for individuals with occasional diarrhea. Human clinical trials are needed on this topic before definitive conclusions can be drawn.  

More research is necessary to fully understand aloe vera's effects on bowel regularity. However, it holds promise in promoting gastrointestinal health by promoting healthy inflammatory and immune responses in the GI tract. 

By Danielle Moyer Male, MS, CNS, LDN