Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases, being characterized as a chronic, recurrent and progressive disease associated with a wide variety of esophageal complications. Its symptomatology includes complaints of heartburn, food and acid regurgitation, flatulence, eructation, dysphagia, nausea and vomiting. That is, mucosal damage caused by gastric reflux means that GERD occasionally presents symptoms similar to those of irritable bowel syndrome, and diagnoses can be commonly confused.
For the treatment of GERD, medications that act as proton pump inhibitors or H2 receptor blockers are usually prescribed. However, despite its proven effect and widespread use, they can induce the development of conditions such as hypochlorhydrys and cardiac conditions, making it necessary to identify natural remedies that can effectively control the symptoms of GERD and prevent such complications.
In this context, Aloe vera gel has been shown to have several antioxidant, anti-inflammatory actions as well as analgesic, antiproliferative and antidiabetic properties. In addition, A. vera also has anti-ulcer, healing and anti-microbial effects, which may be relevant for the treatment of GERD and its comorbidities.
A randomized, open-and-controlled trial recruited patients aged between 18 and 65 years diagnosed with GERD, dividing them into three groups. For these, syrup was offered A. vera (10mL once daily), omeprazole capsule (20 mg once daily) and ranitidine tablet (150 mg fasting in the morning and 150 mg 30 minutes before bedtime) for a period of 4 weeks, and at the end the evaluation of treatment efficacy was symptom-based.
The frequencies of all GERD symptoms were reduced at week 2 and 4 of treatment in group A. vera with a tendency of additional and significant improvement in the frequencies of heartburn, flatulence and belching. In the omeprazole group, the frequencies of all symptoms evaluated were significantly reduced at both time points (weeks 2 and 4), however, the frequencies of heartburn, flatulence, belching and acid regurgitation showed additional reductions only at week 4 compared to week 2. And in the ranitidine group, the frequencies of heartburn, flatulence, belching, nausea, vomiting and acid regurgitation were significantly reduced at week 2 compared to baseline.
Reflux and Aloe Vera
From the administration of A. vera it is possible to observe a reduction in gastric inflammation and the size of ulcers as well as increased proliferation of epithelial cells and growth of the gastric gland. In addition, oxidative stress and inflammation are key factors in the pathophysiology of GERD and, since the efficacy of A. vera gel in reducing GERD symptoms can be partially attributed to its antioxidant and anti-inflammatory ingredients, it is proposed that the mechanisms responsible for this antioxidant action include the elimination of free radicals, reduction of lipid peroxidation and positive regulation of antioxidant enzymes.
In addition, it is observed that leukocyte infiltration and circulating concentrations of TNF-y are reduced and its reducing effect on gastric acid secretion occurs due to the action of lectins present in A. vera, which instill the uptake of aminopyrin by parietal cells, thus reducing acid secretion.
According to the results analyzed in the randomized controlled trial, the efficacy of A. vera gel syrup in reducing the common symptoms of GERD is clear, and A. vera preparations are relatively inexpensive and easily found. It should also be considered its therapeutic activity in other disorders that may accompany GERD such as irritable bowel syndrome, ulcerative colitis, type II diabetes, and dyslipidemia.
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Proton Pump Inhibitors (IBPs)
Panahi Y, Khedmat H, Valizadegan G, Mohtashami R, Sahebkar A. Efficacy and safety of Aloe vera syrup for the treatment of gastroesophageal reflux disease: a pilot randomized positive-controlled trial.
J Tradit Chin Med. 2015 Dec;35(6):632-6. Doi: 10.1016/s0254-6272(15)30151-5. PMID: 26742306.