SAGES Magazine

THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2022 | VOLUME 20 | ISSUE 1 | 24 3.4. Assessment of risk of bias in included studies Assessment of risk of bias was done using the Cochrane Risk of Bias tool. Of the studies assessed, two were deemed as having high risk of bias due to attrition. Two studies indicated random sequence generation, while the remaining studies did not provide this information. Four studies made clear mention of allocation concealment, while two did not provide details. Two studies reported a high number of dropouts and their risk of attrition bias was ranked as high. Two studies provided details on blinding of outcome assessment and the remaining four did not. Table 3 shows the summary of risk of bias assessment. Number studies were deemed as being of high risk of bias (reference of study). 3.3.4. Effect of Aloe on improving Diarrhoea-predominant IBS symptoms (IBS-D and IBS-M) The single study 13 amongst IBS-D and IBS-M patients, failed to demonstrate effectiveness of Aloe (Aloe only) in relieving symptoms. 3.3.3. Effect of Aloe (Aloe combined) on improving IBS symptoms among constipation-predominant IBS (IBS-C) patients only Compared with placebo, Aloe (Aloe combined) improved symptoms in IBS-C patients (RR, 3.41 (95% CI 2.11 to 4.03), 3 studies, n=199, I2=0%) (Figure 4) 3.3.2. Effect of Aloe (Aloe only) on improving IBS symptoms among all IBS sub-types. Compared with placebo, Aloe (Aloe only) improved symptoms with all subtypes of IBS (RR, 1.89 (95% CI, 1.01 to 3.56); 2 studies, n= 126; I2=0%) (Figure 3). RESEARCH Figure 3: Aloe (only) for improving IBS symptoms (All IBS subtypes) Figure 4: Aloe (Aloe combined) for improving symptoms among constipation predominant IBS patients 3.3. Quantitative data synthesis 3.3.1. Effect of Aloe on improving IBS symptoms among all IBS sub-types Compared with placebo, all Aloe (Aloe only and/or Aloe combined) improved symptoms in IBS patients (all subtypes) (RR, 2.75 (95% CI 1.88 to 4.03), 5 studies, n=325, I2=0%) (Figure 2) Figure 2: : Aloe (all types) for improving IBS symptoms (All IBS subtypes)