Aloe Vera and Ulcerative Colitis

One part of the aloe plant can be toxic

Aloe vera
Aloe vera has been used to treat many conditions, and it has been studied for use in ulcerative colitis. Image © NoDerog / E+ / Getty Images

Aloe is a succulent plant that has been used for medicinal purposes since the time of the ancient Egyptians. The most common type of aloe is Aloe barbadensis, better known as aloe vera. This versatile plant was first found in southern Africa and now grows throughout Africa, the Mediterranean, and parts of South America.

The parts of the aloe plant that are used medicinally are the gel that is found inside the leaves and the sap (a bitter, yellow, sticky substance [aloe latex]) that is found just inside the leaf surface.

How Aloe Is Used

Aloe is a known antiinflammatory and may even have antibacterial and antifungal properties. The gel from the aloe plant is often used topically on dry, broken, or burned skin as a soothing agent and a pain reliever. In animals, aloe gel has been shown to reduce inflammation. In one study on the use of aloe in ulcerative colitis, ingested aloe gel was shown to be better than placebo in reducing disease activity. However, that study was very small, and there have not been any others that showed the same results. Because of this, it is not considered enough evidence to recommend the widespread use of aloe for treating inflammatory bowel disease (IBD).

Aloe latex is a powerful laxative, and is contraindicated for people with hemorrhoids, ulcerative colitis, Crohn's disease, irritable bowel syndrome, diverticulosis, intestinal blockages, or other gastrointestinal conditions. It is not often used as a laxative because it may cause painful abdominal cramps.

Why Aren't There More Studies On Aloe?

Herbal remedies are difficult to study for several reasons. There can be variations in the quality of the product used, and some preparations might contain other compounds. In these instances, it would be difficult to know how much aloe patients were receiving, and if any imperfections in the quality of the product were responsible for a response (or a non-response), There's also the question of what the dosage should be to achieve an effect.

Another problem is that when patients are being given an herbal preparation, they might not be receiving any other type of treatments, and that could have ethical consequences: what if patients don't get any better with the herbal medicine? As a result, there are very few studies on herbal remedies for diseases like IBD, and even fewer that specifically address aloe and ulcerative colitis.

Interactions With Other Drugs

Aloe latex will decrease the effectiveness of any medication taken at the same time, as it is a laxative, and will cause any medication taken by mouth to move through the digestive system too quickly to be effective.

  • Cisplatin
  • Cyclophosphamide
  • Docetaxel
  • Fluorouracil
  • Methotrexate
  • Paclitaxel

Using Aloe While Pregnant

Aloe latex is not safe during pregnancy, nor should it be used by breastfeeding mothers. Check with your physician about any possible effects aloe might have on an unborn child or an infant.

Warnings About Aloe

Aloe latex, the juice found just inside the leaf of the plant, is a known laxative, which is habit-forming.

Aloe latex works as a laxative because it prevents the absorption of water in the bowel, making the contents of the bowel move faster. Continued use of aloe latex could result in the need for higher doses to achieve the same effects and permanent damage to the muscle in the intestine. Large doses have been known to cause bloody diarrhea and kidney damage.

The Bottom Line

Aloe gel is generally considered safe. Aloe latex is a powerful laxative and can be poisonous in high dosages. Any alternative remedies you are using should always be discussed with your physician or healthcare professional.

Sources:

Langmead L, Feakins RM, Goldthorpe S, et al. "Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis." Aliment Pharmacol Ther Apr 2004; 19:739-747.

National Center for Complimentary and Alternative Medicine. "Aloe Vera." Herbs at a Glance Dec 2006.

Wan P, Chen H, Guo Y, Bai A-P. "Advances in treatment of ulcerative colitis with herbs: From bench to bedside." World Journal of Gastroenterology : WJG. 2014;20:14099-14104. doi:10.3748/wjg.v20.i39.14099.

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