Irritable Bowel Syndrome (Holistic)

About This Condition

IBS—not your typical tummy ache. Symptoms may include abdominal bloating and soreness, gas, alternating diarrhea and constipation, backaches, and fatigue. According to research or other evidence, the following self-care steps may be helpful.
  • Find the right fiber

    Try different fiber sources, including high-fiber foods such as flaxseed, rye, brown rice, oatmeal, barley, and vegetables, as well as bulk-forming laxatives like psyllium husk and methylcellulose, to find the right balance of regularity without episodes of diarrhea

  • Avoid problem foods

    Experiment with limiting dairy products and beans, as well as foods containing caffeine, fructose, or sorbitol, to see which restrictions may help reduce your symptoms

  • Try peppermint and caraway oils

    Taking a coated herbal supplement providing 0.2 to 0.4 ml of peppermint oil, preferably combined with 50 mg of caraway oil, three times a day may reduce gas production, ease intestinal cramping, and soothe the intestinal tract

  • Explore food sensitivities

    Work with a specialist to identify other foods that aggravate your condition

About

About This Condition

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that sometimes causes significant discomfort even though it is not a serious health threat. 

The cause of IBS remains unknown. IBS is not related to inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis.

Symptoms

Typical symptoms include abdominal bloating and soreness, gas, and alternating diarrhea and constipation. People with IBS are more likely than others to have backaches, fatigue, and several other seemingly unrelated problems.

Holistic Options

IBS sufferers have increased sensitivity to rectal pain that has been linked to psychological factors.1 Stress is known to increase symptoms of IBS.2 Reducing stress or practicing stress management skills have been reported to be beneficial. In one trial, psychotherapy and relaxation combined with conventional treatment were more effective than conventional treatment alone in two-thirds of people with IBS.3Hypnosis for relaxation has dramatically and consistently relieved symptoms of IBS in some people.4, 5, 6

Traditional Chinese Medicine (TCM), which uses acupuncture and Chinese herbal therapies, has been reported to be helpful in the treatment of IBS,7 although no formal research has evaluated this claim.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation Why
Find the right fiber
Try different fiber sources, including flaxseed, rye, brown rice, oatmeal, barley, and vegetables, to find the right balance of regularity without episodes of diarrhea.

Limited research has suggested that fiber might help people with IBS. However, most studies find that IBS sufferers do not benefit by adding wheat bran to their diets, and some people feel worse as a result of wheat bran supplementation. The lack of positive response to wheat bran may result from a wheat sensitivity, which is one of the most common triggers for food sensitivity in people with IBS.Rye, brown rice, oatmeal, barley, vegetables, and psyllium husk are good sources of fiber and are less likely to trigger food sensitivities than is wheat bran. Except for psyllium, little is known about the effects of these other fibers in people with IBS.
Avoid problem foods
Try replacing dairy products and foods containing fructose and sorbitol with alternative dairy and sweetened products to see which restrictions may help reduce your symptoms.

There is evidence that some people with IBS have greater trouble absorbing the sugars lactose (as found in milk), fructose (as found in high concentration in fruit juice and dried fruit), and sorbitol (as found in some dietetic candy) than do healthy people. In those people, restricting intake of the sugars that they have difficulty absorbing frequently decreases the symptoms of IBS. Fructose and lactose are among the list of foods that contain fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). Other foods high in FODMAPs include wheat, legumes, and foods high in sorbitol. Consumption of a low-FODMAP diet has been found to improve IBS symptoms in a high proportion of cases.

Explore food sensitivities
Work with a specialist to identify foods that aggravate your Condition.

Several trials report that food sensitivities occur in only a small percentage of people with IBS. However, a leading researcher in the field claims at least 3.5 ounces of the offending food need to be consumed at frequent intervals to provoke IBS symptoms, and the amount of test foods used in these studies was generally less than this amount. Therefore, inadequate quantities of food may have affected the outcomes of these trials. Other trials have reported that most IBS sufferers have food sensitivities, and that gas production and IBS symptoms diminish when the offending foods are discovered and avoided. Some researchers report that problem foods need to be eaten at every meal for at least two days to evaluate the potential of food sensitivity.

Researchers have found that standard blood tests used to evaluate allergies may not uncover food sensitivities associated with IBS, because IBS food sensitivities may not be true allergies. The only practical way to evaluate which foods might trigger IBS symptoms is to avoid the foods and then reintroduce them. Such a procedure requires the guidance of a healthcare practitioner. Attempts to find and avoid problem foods without professional help may fail and may aggravate symptoms.

Supplements

What Are Star Ratings?
Supplement Why
3 Stars
Caraway Oil and Peppermint Oil
90 mg of peppermint oil plus 50 mg of caraway oil in enteric-coated capsules taken three times per day
Taking peppermint oil combined with caraway oil may reduce gas production, ease intestinal cramping, and soothe the intestinal tract.

The combination of 90 mg of peppermint oil plus 50 mg of caraway oil in enteric-coated capsules taken three times per day led to significant reduction in IBS symptoms in a double-blind trial. In a similar trial, capsules that were not enteric-coated were as effective as enteric-coated capsules. The same combination has compared favorably to the drug cisapride (Propulsid) in reducing symptoms of IBS. The purpose of enteric coating is to protect peppermint oil while it is passing through the acid environment of the stomach.

Whole peppermint leaf is often used either alone or in combination with other herbs to treat abdominal discomfort and mild cramping that accompany IBS. The combination of peppermint, caraway seeds, fennel seeds, and wormwood was reported to be an effective treatment for upper abdominal complaints in a double-blind trial.
3 Stars
Lactase (Lactose Intolerance)
6,000 to 9,000 IU tablets chewed with a meal containing lactose, or add 1,000 IU in liquid form to 8 ounces of milk
Lactase enzymes taken prior to consuming milk or dairy products may help ease IBS symptoms.

Double-blind research has shown that avoidance of lactose (present in milk and some other dairy products) by people with IBS who are also lactose intolerant will relieve IBS symptoms. Alternatively, lactase enzyme may be used prior to consuming milk. Several different lactase products are commercially available and the amount needed depends on the specific preparation being used.
3 Stars
Probiotics
Refer to label instructions
A daily drink containing probiotics significantly reduced IBS symptoms in one study.
In several double-blind trials, probiotic products have been found to relieve symptoms of IBS. Preparations that have been found to be effective include 1) a combination of Lactobacillus rhamnosus GG, L. rhamnosus Lc705, Propionibacterium freudenreichii ssp. shermanii JS and Bifidobacterium animalis ssp. lactis Bb12; 2) Lactobacillus GG; 3) a combination of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07; and 4) a product known as VSL#3
3 Stars
Psyllium
3.25 grams taken three times per day
Some people with IBS may benefit from bulk-forming laxatives. Psyllium has helped regulate normal bowel activity and improved symptoms in some people with IBS.

Some people with IBS may benefit from bulk-forming laxatives. Psyllium seeds (3.25 grams taken three times per day) have helped regulate normal bowel activity in some people with IBS. Psyllium has improved IBS symptoms in double-blind trials.
2 Stars
Fennel
Refer to label instructions
In a double-blind trial, treatment with a proprietary product containing turmeric and fennel improved symptoms in patients with irritable bowel syndrome.
In a double-blind trial, treatment with a proprietary product containing turmeric and fennel significantly improved symptoms in patients with irritable bowel syndrome. The amount given was 2 capsules twice a day for 30 days.
2 Stars
Melatonin
Take under medical supervision: 3 mg daily at bedtime
Melatonin helps regulate gastrointestinal function and sensation. In one trial, people with irritable bowel syndrome who took melatonin experienced significantly less severe abdominal pain.

Melatonin plays a role in the regulation of gastrointestinal function and sensation. In a double-blind trial, people with irritable bowel syndrome and associated sleep disturbances received 3 mg of melatonin or a placebo at bedtime for two weeks. Compared with the placebo, melatonin significantly decreased the severity of abdominal pain, although it did not affect bloating, stool frequency, or sleep patterns. Melatonin was also effective in another double-blind trial.
2 Stars
Peppermint
0.2 to 0.4 ml in enteric-coated capsules, three times per day
Peppermint oil reduces gas production, eases intestinal cramping, and soothes irritation. It has been reported to help relieve IBS symptoms in two analyses of controlled trials.

In the intestinal tract, peppermint oil reduces gas production, eases intestinal cramping, and soothes irritation. Peppermint oil has been reported to help relieve symptoms of IBS in two analyses of controlled trials. Evidence supporting the use of peppermint oil has come from double-blind trials that typically have used enteric-coated capsules that supply 0.2–0.4 ml of peppermint oil taken two to three times per day. Some trials have found peppermint oil ineffective. However, a pooled analysis (meta-analysis) of 9 randomized controlled trials (with a total of 726 patients) found that enteric-coated peppermint oil capsules are a safe and effective treatment for IBS.

The combination of 90 mg of peppermint oil plus 50 mg of caraway oil in enteric-coated capsules taken three times per day led to significant reduction in IBS symptoms in a double-blind trial. In a similar trial, capsules that were not enteric-coated were as effective as enteric-coated capsules. The same combination has compared favorably to the drug cisapride (Propulsid) in reducing symptoms of IBS. The purpose of enteric coating is to protect peppermint oil while it is passing through the acid environment of the stomach.

Whole peppermint leaf is often used either alone or in combination with other herbs to treat abdominal discomfort and mild cramping that accompany IBS. The combination of peppermint, caraway seeds, fennel seeds, and wormwood was reported to be an effective treatment for upper abdominal complaints in a double-blind trial.
2 Stars
Peppermint, Caraway Seeds, Fennel Seeds, and Wormwood
Refer to label instructions
A combination of peppermint, caraway seeds, fennel seeds, and wormwood was reported to be an effective treatment for upper abdominal complaints in one trial.

Whole peppermint leaf is often used either alone or in combination with other herbs to treat abdominal discomfort and mild cramping that accompany IBS. The combination of peppermint, caraway seeds, fennel seeds, and wormwood was reported to be an effective treatment for upper abdominal complaints in a double-blind trial.

2 Stars
Turmeric
Refer to label instructions
In a double-blind trial, treatment with a proprietary product containing turmeric and fennel improved symptoms in patients with irritable bowel syndrome.
In a double-blind trial, treatment with a proprietary product containing turmeric and fennel significantly improved symptoms in patients with irritable bowel syndrome. The amount given was 2 capsules twice a day for 30 days.
1 Star
Artichoke
Refer to label instructions
In a preliminary study of people with irritable bowel syndrome who took an artichoke leaf extract daily for two months, 26% reported an improvement in symptoms.

In a preliminary study of people with irritable bowel syndrome who took an artichoke leaf extract daily for two months, 26% reported an improvement in symptoms. Because no placebo group was used in this study and because irritable bowel syndrome has a high rate of response to placebo, additional research is needed to confirm this report. The amount of artichoke leaf used in the study was 320 or 640 mg per day of a 1:5 standardized extract.
1 Star
Chamomile
Refer to label instructions
Chamomile’s essential oils may ease intestinal cramping and irritation. The herb is sometimes used by herbalists to relieve alternating bouts of diarrhea and constipation.

Chamomile’s essential oils have eased intestinal cramping and irritation in animals. Chamomile is sometimes used by herbalists to relieve alternating bouts of diarrhea and constipation, though research has yet to investigate these effects. This herb is typically taken three times per day, between meals, in a tea form by dissolving 2–3 grams of powdered chamomile or by adding 3–5 ml of herbal extract tincture to hot water.
1 Star
Evening Primrose Oil (Premenstrual Syndrome)
Refer to label instructions
In one trial, women with IBS who experienced worsening symptoms before and during their menstrual period were helped by taking evening primrose oil.

In one trial, women with IBS who experienced worsening symptoms before and during their menstrual period were helped by taking enough evening primrose oil (EPO) to provide 360–400 mg of gamma linolenic acid (GLA) per day. In that trial more than half reported improvement with EPO, but none was helped in the placebo group. The effects of EPO in other groups of IBS sufferers have not been explored.
1 Star
Fiber
Refer to label instructions
Supplementing with fiber may help you find the right balance of regularity without episodes of diarrhea.
Limited research has suggested that fiber might help people with IBS. However, most studies find that IBS sufferers do not benefit by adding wheat bran to their diets, and some people feel worse as a result of wheat bran supplementation. The lack of positive response to wheat bran may result from a wheat sensitivity, which is one of the most common triggers for food sensitivity in people with IBS. Rye, brown rice, oatmeal, barley, vegetables, and psyllium husks are good sources of fiber and are less likely to trigger food sensitivities than is wheat bran. Except for psyllium, little is known about the effect of these other fibers in people with IBS.
1 Star
Grapefruit Seed Extract
Refer to label instructions
In one study, grapefruit seed extract improved IBS symptoms in 20% of people taking the liquid, while all of the patients taking capsules noted definite improvement of constipation, flatulence, abdominal discomfort, and night rest.

A preliminary trial investigated the effectiveness of grapefruit seed extract in people with eczema and symptoms of IBS. Participants received either 2 drops of a 0.5% oral solution of grapefruit seed extract twice daily or 150 mg of encapsulated grapefruit seed extract three times daily. After a month, IBS symptoms had improved in 20% of those taking the liquid, while all of the patients taking capsules noted definite improvement of constipation, flatulence, abdominal discomfort, and night rest. These results need confirmation in double-blind trials.
1 Star
Wormwood, Ginger, Bupleurum, Schisandra, Dan Shen, and Other Extracts
Take a Chinese herbal formula containing wormwood under the guidance of a qualified practitioner
A standardized Chinese herbal combination containing extracts from plants including wormwood, ginger, bupleurum, schisandra, and dan shen reduced IBS symptoms in one study.

Whole peppermint leaf is often used either alone or in combination with other herbs to treat abdominal discomfort and mild cramping that accompany IBS. The combination of peppermint, caraway seeds, fennel seeds, and wormwood was reported to be an effective treatment for upper abdominal complaints in a double-blind trial.
0 Stars
Magnesium Citrate
Refer to label instructions

References

1. Whitehead WE, Palsson OS. Is rectal pain sensitivity a biological marker for irritable bowel syndrome: psychological influences on pain perception. Gastroenterology 1998;115:1263-71.

2. Dancey CP, Taghavi M, Fox RJ. The relationship between daily stress and symptoms of irritable bowel: a time-series approach. J Psychosom Res 1998;44:537-45.

3. Guthrie E, Creed F, Dawson D, Tomenson BG. AA controlled trial of psychological treatment for the irritable bowel syndrome. Gastroenterology 1991;100:450-7.

4. Harvey RF. Individual and group hypnotherapy in treatment of refractory irritable bowel syndrome. Lancet 1989;i:424-6.

5. Waxman D. The irritable bowel: a pathological or a psychological syndrome? J R Soc Med 1988;81:718-20.

6. Houghton LA, Heyman DJ, Whorwell PJ. Symptomatology, quality of life and economic features of irritable bowel syndrome—the effect of hypnotherapy. Aliment Pharmacol Ther 1996;10:91-5.

7. Pagon A. Treatment by traditional oriental medicine. Irritable bowel syndrome. J Chin Med 1998;58:28-31.

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