Herbal Remedies and Their Gastrointestinal Side Effects: an In-Depth Analysis

Abstract

The use of herbal remedies is globally increasing due to the supposed advantages of being natural means of health. Serious concerns regarding the safety and efficacy of these remedies, especially gastrointestinal (GI) side effects, have arisen. A literature search was done using Google Scholar, Web of Science, and PubMed databases with recent time frame (2002 to 2025). This review presents a comprehensive analysis of the mechanisms, prevalence, and clinical implications of herbal-induced GI disturbances. It draws critical attention to herbal medicines' increase worldwide in popularity, supported by statistical findings on their use and adverse effects, particularly of some common herbs such as Senna alexandrina Mill., Aloe vera (L.) Burm.f., and Pulicaria burchardii Hutch. This review illustrates the mechanisms causing herbal-induced GI disturbances, including mucosal irritation, immune-mediated inflammation, dysbiosis, oxidative stress, pharmacological toxicity. In addition, herb-herb, food-herb, and drug-herb interactions convey considerable challenges for herbal supplements, given the current lack of standardization and regulation. Mitigation strategies for GI side effects are proposed. Key research gaps are identified, along with recommendations for future research, including rigorous clinical trials, pharmacokinetic studies, and standardized quality-control protocols. The review concludes by advocating rigorous research and collaborative endeavors to inject the application of herbal remedies into modern health care with some level of assurance.