Hello doctor, why is it that when someone takes certain herbal medicines like aloe vera and black seed, they develop a running stomach?—Manzi

According to Aiya Catherine Lalam, a pharmacist with the Uganda National Drug Authority, “Aloe vera contains a laxative compound known as aloin, which can irritate the intestines. Black seed oil may have a similar effect, although its exact mechanism is unclear. It is likely that it also irritates the intestines, causing increased fluid secretion and, consequently, diarrhoea.”

Explanation

What is a laxative?
Laxatives are a category of medicines used to relieve constipation. They work by loosening stool and increasing bowel movements. Most function by drawing water into the colon or stimulating the intestines to contract.
There are several types of laxatives, including bulk-forming agents, osmotic laxatives, stool softeners, lubricants, and stimulants.

Aloe vera as a laxative
The laxative effect of aloe vera comes from anthraquinones—naturally occurring compounds found in plants. In aloe vera, the key component is aloin and its breakdown products such as aloe-emodin, mostly present in the plant’s latex.
These compounds increase intestinal water content and stimulate involuntary muscle contractions, helping stool move through the digestive tract faster.
Aloe-emodin-9-anthrone specifically reduces water absorption in the large intestines and increases water secretion, strengthening the laxative effect.