Just in case you are still trying aloe vera, you should read this article that Heather put in one of her newsletters:
Can aloe vera help my IBS symptoms? Is it safe?"
Because aloe is well-known as a gentle external treatment for minor burns and skin irritations, it's easy to assume that it would be safe for use internally as well. This is not necessarily true. Even though aloe vera is a plant, and thus "natural", it is still classified by the FDA as a Class 1 harsh stimulant laxative. There are substances called anthroquinones and anthrones in aloe, which produce a laxative effect by increasing colonic peristalsis and intestinal water content, by opening chloride channels of the colonic membrane to cause a net reduction of liquid absorption by the colon.
In plain English, this means that aloe causes faster and stronger contractions of the colon - something that people with IBS are already overly prone to, and which can cause violent abdominal cramps, painful spasms, and diarrhea.
The safety of aloe is another concern. All anthranoid laxatives (not just aloe, but senna and cascara sagrada as well) can cause melanosis coli, cathartic colon, and possibly increase the risk of colonic cancer. (In fact, genotoxicity studies show that aloe-containing laxatives pose cancer risks to humans even when used as directed.)
Melanosis coli, normally a benign condition, is characterized by black pigmentation of the colonic wall, and is almost always attributable to anthranoid laxatives such as aloe, cascara, or senna. Melanosis coli usually develops 9 months after initiating the use of anthranoid laxatives, and typically disappears just as quickly after the drug is discontinued. In severe cases, however, it may reduce bowel function and make constipation worse. In advanced cases of melanosis coli, the inside lining of the colon becomes pitch black instead of the normal light pink.
Cathartic colon is the anatomic and physiologic change in the colon that occurs with chronic use of stimulant laxatives such as aloe (chronic use is defined as more than 3 times per week for at least 1 year). Signs and symptoms of cathartic colon include chronic constipation, bloating, a feeling of fullness, abdominal pain, and incomplete fecal evacuation. Radiologic studies of a patient with cathartic colon will show: an atonic colon (the colon lacks the normal muscle tone) and a redundant colon (the laxative use has stretched out the colon to twice the normal length, and the bowel has developed redundant coils of bowel tubing that loop back and forth in the abdominal cavity).
As if this isn't bad enough, chronic use of aloe can also lead to serious medical consequences such as fluid and electrolyte imbalance, steatorrhea, gastroenteropathy, osteomalacia, and vitamin and mineral deficiencies. When aloe is discontinued, radiographic and functional changes in the colon may only partially return to normal because of permanent drug-induced neuromuscular damage to the colon.
What's really scary about aloe is that it's a very common ingredient in all sorts of liquid vitamins, energy boost drinks, and other health supplements, and these product labels won't note that aloe is a laxative. Aloe is even specifically marketed to people with IBS as a "digestive aid", or "soothing to the bowel", with an emphasis on the fact that it's an all-natural plant ingredient, which again just hides the fact that it is without a doubt a harsh stimulant laxative.
It is possible to find aloe from which the anthraquinones have been removed. If this is the case, the label should specifically say so, or something to the effect that "diarrhea-causing ingredients", "harsh latex chemicals", or "aloin and aloe emodin" have been removed from the product. Without these indicators, there is no way of knowing whether an aloe product is safe to take.
At this point, products derived from aloe gel and intended for internal use have not been proven effective against IBS, so I would err on the side of caution.
- Heather
Lori
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