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Randomized clinical trial: Effects of Aloe barbadensis Mill. extract on symptoms, fecal microbiota and fecal metabolite profiles in patients with irritable bowel syndrome

Journal article
Authors Bani Ahluwalia
Maria K Magnusson
Lena Böhn
Stine Störsrud
F. Larsson
O. Savolainen
A. Ross
Magnus Simrén
Lena Öhman
Published in Neurogastroenterology and Motility
ISSN 1350-1925
Publication year 2020
Published at Institute of Biomedicine
Institute of Medicine
Language en
Links dx.doi.org/10.1111/nmo.13860
Keywords Aloe, fecal metabolites, gastrointestinal microbiota, gastrointestinal, symptoms, irritable bowel syndrome, prebiotic, placebo-controlled trial, double-blind, alternative medicine, vera gel, complementary, inulin, avh200(r), system, Gastroenterology & Hepatology, Neurosciences & Neurology
Subject categories Gastroenterology and Hepatology, Neurosciences

Abstract

Background Aloe barbadensis Mill. (Aloe) with potential prebiotic effects has been suggested to reduce symptoms in patients with irritable bowel syndrome (IBS). We therefore aimed to determine the effects of an Aloe extract on symptoms of IBS, and evaluate whether effects may be mediated by fecal microbiota and metabolites in a randomized, double-blind, controlled trial. Methods Patient with IBS diagnosed according to the ROME III criteria (all subtypes), received Aloe or control treatment (inulin) for 4 weeks. IBS Symptom Severity Score (IBS-SSS) was assessed, and fecal samples collected before and at end of treatment. Fecal microbiota composition and metabolomic profile were determined. Key results In total, 160 IBS patients completed the study. The overall severity of IBS symptoms was reduced in both Aloe and control treatment groups (P < .001, both groups, comparing baseline vs end of treatment), without difference between groups (P = .62). The frequency of responders (IBS-SSS reduction >= 50) did not differ between Aloe treatment (n = 33, 39%) and control (n = 34, 45%) (P = .49). However, fecal microbiota and metabolite profiles differed between Aloe, but not control treatment responders and non-responders both before and after treatment. Conclusion In a mixed group of IBS patients, Aloe was not superior to control treatment, although it showed potential to reduce IBS symptom severity in subsets of IBS patients which could be predicted by fecal microbiota and metabolite profiles. ClinicalTrials.gov no: NCT01400048.

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