Remedies for Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is a common digestive disorder characterized by abdominal pain, cramping, and changes in normal bowel function, including bloating, gas, diarrhea, and constipation. About 12% of adults in the United States have irritable bowel syndrome (IBS).

So far, scientific support for the claim that any remedy can treat IBS is fairly lacking, but several of them are frequently used.

Enteric-Coated Peppermint Oil

Enteric-coated peppermint oil is widely used for irritable bowel syndrome. It is purported to reduce abdominal pain and bloating. Peppermint is considered a carminative herb, which means that it is used to eliminate excess gas in the intestines. It also has anti-inflammatory and muscle relaxing properties that may be helpful.

Although further research is needed, studies published in 2019 indicate that it may ease symptoms of IBS. Although peppermint oil is available in many forms, it should only be used in enteric-coated capsules, which don't dissolve until they reach the intestines, because otherwise the oil can relax the lower esophageal sphincter and cause heartburn.

In its 2021 guidelines for diagnosing and treating IBS, the American College of Gastroenterology recommended peppermint oil for easing abdominal pain and global symptoms of IBS.

Peppermint oil, in excessive doses, may result in nausea, loss of appetite, heart problems, nervous system disorders, and lead to kidney failure and even death.

Peppermint oil should not be taken internally by children or pregnant or nursing women. Peppermint oil may interact with the drug cyclosporine (used to prevent organ transplant rejection and for rheumatoid arthritis and psoriasis), so they should not be combined unless under medical supervision.

Probiotics

Probiotics are "friendly" bacteria in the digestive system that play a role in promoting a healthy, balanced gut and immune system. Probiotics are naturally occurring in certain foods, including yogurt, cottage cheese and fermented foods, and are also available in supplement form for purchase at your local pharmacy or grocery store.

While the exact cause of IBS is not well understood, research has suggested that an imbalance in gut bacterial communities, also called “dysbiosis,” could be a contributing factor. This suggests that effort to promote balance, such as increasing probiotics, can help alleviate symptoms—and there is a growing body of research that does support the positive link between probiotics and IBS relief.

Increased research and significant interest notwithstanding, most doctors still do not formally recommend probiotics in treating irritable bowel syndrome. The American Gastroenterology Association's (AGA) 2020 clinical practice guidelines do not recommend the use of probiotics in children and adults with irritable bowel syndrome except in the context of a clinical trial. The ACG also recommends against probiotics.

Partially Hydrolyzed Guar Gum

Partially hydrolyzed guar gum (PHGG) is a water-soluble, non-gelling fiber that may help to reduce constipation and to a lesser extent diarrhea and abdominal pain in people with irritable bowel syndrome. PHGG is purported to promote the growth of beneficial bacteria, lactobacilli, and bifidobacteria in the intestines.

One 2002 study compared PHGG (5 grams per day), wheat bran (30 grams per day), and a placebo in 199 people with irritable bowel syndrome. After 12 weeks, both the PHGG and wheat bran resulted in an improvement in abdominal pain and bowel habits, but the PHGG was better tolerated and preferred.

The ACG's 2021 guidelines recommend soluble fiber, which includes PHGG, be gradually increased in the diet.

Food Intolerances

According to some alternative medicine practitioners, food intolerances may play a role in irritable bowel syndrome, possibly by triggering immune responses in the gut leading to low-grade inflammation and an imbalance of intestinal bacteria.

Although not scientifically proven, the most common food intolerances associated with irritable bowel syndrome are dairy, wheat, and gluten. 

A growing body of research points to the effectiveness of the low-FODMAP diet for IBS. FODMAPs are specific types of carbohydrates that are difficult to digest. The ACG recommends a limited trial of this diet as part of its treatment protocol.

Other Remedies

Stress may play a role in irritable bowel syndrome. Several remedies that may be used to help relieve stress include:

• Cognitive behavioral therapy (CBT) can help with healthy habits and the emotional components of IBS. It's recommended by the ACG.
• A form of hypnosis called gut-directed hypnotherapy may also help people cope with the stresses and lifestyle changes of IBS.
• Acupuncture has been explored for irritable bowel syndrome with some promising results.

Symptoms

Irritable bowel syndrome is a group of symptoms that involves abdominal pain or discomfort along with two of the following three characteristics:

• Pain or discomfort relieved by defecation
• Change in the frequency of bowel movements
• Change in the appearance of stools

Using Natural Remedies

If you're considering using any form of alternative medicine for IBS, make sure to consult your physician first. Self-treating IBS (or any condition) and avoiding or delaying standard care may have serious consequences.