Natural treatments for irritable bowel syndrome
Natural treatments for irritable bowel syndrome (IBS) focus on alleviating the symptoms of this chronic condition, which manifests as abdominal discomfort, fluctuations between diarrhea and constipation, and excessive gas, without any identifiable medical cause. Among the principal natural treatments are peppermint oil, flaxseed, and probiotics, each supported by varying degrees of research. Peppermint oil has shown effectiveness in reducing IBS symptoms in several small studies, while flaxseed has outperformed traditional fiber treatments in relieving constipation and bloating. Probiotics, which include beneficial gut bacteria, have been documented in numerous trials to improve overall symptoms, although results can be inconsistent regarding which specific strains are most effective.
Additional natural therapies include traditional Chinese herbal medicine and various dietary adjustments, such as the elimination of allergenic foods. Other complementary approaches, such as acupuncture, hypnotherapy, and relaxation therapy, have been explored, with mixed results regarding their effectiveness. Some studies suggest that regular physical activity, adequate sleep, and stress-reduction techniques can also play a role in managing IBS symptoms. While many natural treatments show promise, it's essential for individuals to consult healthcare professionals to tailor approaches that best suit their specific needs and circumstances.
Natural treatments for irritable bowel syndrome
DEFINITION: Treatment of a chronic colon condition that occurs without an identifiable medical cause.
- PRINCIPAL PROPOSED NATURAL TREATMENTS: Flaxseed, peppermint oil, probiotics, traditional Chinese herbal medicine
- OTHER PROPOSED NATURAL TREATMENTS: Acupuncture, avoidance of allergenic foods, Coleus forskohlii, digestive enzymes (including bromelain and other proteolytic enzymes), fructo-oligosaccharides, glutamine, hypnotherapy, melatonin, relaxation therapy, slippery elm
Introduction
The term irritable bowel syndrome (IBS) is used to describe chronic colon problems that occur in the absence of an identifiable medical cause. Common symptoms include alternating diarrhea and constipation, excess intestinal gas, intestinal cramping, uncomfortable bowel movements, abdominal discomfort following meals, and excessive awareness of the presence of stool in the colon. Despite these distressing symptoms, in IBS, the intestines appear to be perfectly healthy when they are examined. Thus, the condition belongs to a category of diseases that physicians call “functional.” This means that while the function of the bowel seems to have gone awry, no injury or disturbance of its structure can be discovered. (The analogous problem in the stomach is called dyspepsia, and the two conditions frequently overlap.)
Because the cause of IBS is not understood, conventional medical treatment of IBS is highly inadequate. One drug that had shown promise, Zelnorm, was withdrawn from the market for safety issues. Another, Lotronex, was temporarily withdrawn, and then approved again, but only under strict limitations. Other medical treatment approaches for IBS include increased dietary fiber, elimination diets, drugs that reduce bowel spasm, and drugs to address constipation or diarrhea as needed. In addition, various forms of psychotherapy, including hypnosis, have been tried, with some success.
Principal Proposed Natural Treatments
Peppermint. Peppermint oil is widely used for IBS, and the evidence suggests that it is probably useful. Most placebo-controlled studies found peppermint oil to be more effective than placebo. However, most of these studies are small.
Probiotics. Numerous double-blind trials indicate that various probiotics (friendly bacteria) may be helpful for IBS. In a six-week, double-blind, placebo-controlled trial of 274 people with constipation-predominant IBS, in which constipation is a more significant symptom than diarrhea, the use of a probiotic formula containing the bacterium Bifidobacterium animalis significantly reduced discomfort and increased stool frequency. In another randomized trial, 266 women with constipation who consumed yogurt containing B. animalis and the prebiotic fructo-oligosaccharide—a substance that encourage the growth of beneficial bacteria in the colon—twice daily for two weeks experienced significant improvement in their symptoms compared to women consuming regular yogurt as placebo.
Another study examined the effects of four weeks of treatment with the bacterium Lactobacillus plantarum on intestinal gas in sixty people with IBS. This study found benefits that persisted for an entire year after treatment stopped.
Benefits were seen also in eight other small double-blind trials, using L. plantarum, L. acidophilus, L. rhamnosus, L. salivarus, and Bifidobacterium, and proprietary probiotic combinations including various strains.
However, there have also been many negative studies. Two studies that pooled previous randomized trials on the use of probiotics for IBS came to similar conclusions: Probiotics appear to offer some benefit, most notably for global symptoms and abdominal discomfort. However, these two studies were unable to determine which probiotic species were most effective.
Flaxseed. In a double-blind study, fifty-five people with chronic constipation caused by IBS received either ground flaxseed or psyllium seed (a well-known treatment for constipation) daily for three months. Those taking flaxseed had significantly fewer problems with constipation, abdominal pain, and bloating than those taking psyllium. The flaxseed group had even further improvements in constipation and bloating, while continuing their treatment in the three months after the double-blind study ended. The researcher concluded that flaxseed relieved constipation more effectively than psyllium.
Chinese herbal medicine. Chinese herbal medicine is traditionally practiced in a highly individualized way, with herbal formulas tailored to the exact details of each person’s case. In a double-blind, placebo-controlled trial, 116 people with IBS were randomly assigned to receive individualized Chinese herbal treatment, a “one-size-fits-all” Chinese herbal formulation, or placebo. Treatment consisted of five capsules three times daily, taken for sixteen weeks. The results showed that both forms of active treatment were superior to placebo, significantly reducing IBS symptoms. However, individualized treatment was no more effective than the “generic” treatment.
Other Proposed Natural Treatments
One study found evidence that pancreatic digestive enzymes (including proteolytic enzymes plus other enzymes called lipases) might be helpful for reducing the flare-up of IBS symptoms that may follow a fatty meal. Three small studies suggest that the use of the supplement melatonin might reduce symptoms of IBS. It has been suggested that the hormone melatonin may influence the nervous system in the digestive tract.
An herbal combination containing candytuft, matricaria flower, peppermint leaves, caraway, licorice root, and lemon balm has shown some promise for IBS. In one double-blind trial, a combination of lemon balm, spearmint, and coriander showed some promise for reducing symptoms of diarrhea-dominant IBS.
The herbs Coleus forskohlii and slippery elm and the supplement glutamine are also sometimes recommended for IBS, but there is no meaningful evidence that they are helpful. One double-blind study failed to find either the herb fumitory or an herbal relative of turmeric helpful for IBS.
The prebiotic supplement fructo-oligosaccharides has been advocated as a treatment for IBS. However, research results are inconsistent at best. For example, a six-week double-blind study of 105 people with mild IBS compared fructo-oligosaccharides (FOS) taken daily with placebo and returned conflicting results. According to some measures of symptom severity employed by the researchers, the use of FOS led to an improvement in symptoms, but according to other measures, FOS actually worsened symptoms. Conflicting results, though of a different kind, were also seen in a twelve-week, double-blind, placebo-controlled study of ninety-eight people. Treatment with FOS daily, initially worsened symptoms, but over time this negative effect wore off. At no time during the study were clear benefits seen, however. On a positive note, one study did find benefit with a combination prebiotic-probiotic formula.
Food allergies may play a role in IBS, and diets based on identifying and eliminating allergenic foods might offer some benefit. Hypnotherapy has shown some promise for IBS, as has relaxation therapy.
High levels of stress have been correlated with IBS-related changes. Some research suggests that a reduction in stress can be associated with reducing IBS symptoms. Although stress does not cause IBS, it can potentially worsen symptoms. Relaxation techniques such as yoga, meditation, and breathing exercises may help to reduce stress levels. In addition to these techniques, getting seven to eight hours of sleep every night, along with daily moderate exercise, has been found to increase blood flow to the digestive system and reduce abdominal pain.
Acupuncture has been proposed as a treatment for IBS. However, study results have failed to show it is effective. For example, a thirteen-week study of sixty people with IBS found fake acupuncture just as beneficial as traditional acupuncture. A larger trial of 230 adults with IBS found that acupuncture (six treatments over three weeks) was not associated with improved symptoms or severity compared to sham acupuncture.
Intermittent fasting has also been proposed as a treatment for IBS, or the practice of only consuming food in a particular set of hours each day. Restricting calorie windows improves one's blood pressure and insulin sensitivity. In one study, this practice improved seven out of eight IBS symptoms.
Bibliography
Bahrami, Hamid R., et al. “Herbal Medicines for the Management of Irritable Bowel Syndrome: A Systematic Review.” Electronic Physician, vol. 8, no. 8, Apr. 2016, p. 2719-25, doi:10.19082/2719. Accessed 12 Nov. 2024.
Ford, A. C., et al. “Effect of Fibre, Antispasmodics, and Peppermint Oil in the Treatment of Irritable Bowel Syndrome.” British Medical Journal, vol. 337, 2008, p. a2313.
Gawronska, A., et al. “A Randomized Double-Blind Placebo-Controlled Trial of Lactobacillus GG for Abdominal Pain Disorders in Children.” Alimentary Pharmacology and Therapeutics, vol. 25, 2007, pp. 177-84.
"Irritable Bowel Syndrome." Mayo Clinic, 11 Oct. 2024, www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/diagnosis-treatment/drc-20360064. Accessed 12 Nov. 2024.
Lembo, A. J., et al. “A Treatment Trial of Acupuncture in IBS Patients.” American Journal of Gastroenterology, vol. 104, 2009, pp. 1489-97.
McFarland, L. V., and S. Dublin. “Meta-Analysis of Probiotics for the Treatment of Irritable Bowel Syndrome.” World Journal of Gastroenterology, vol. 14, 2008, pp. 2650-61.
Merat, S., et al. “The Effect of Enteric-Coated, Delayed-Release Peppermint Oil on Irritable Bowel Syndrome.” Digestive Diseases and Sciences, vol. 55, 2010, pp. 1385-90.
Nall, Rachel. “Can Stress and Anxiety Worsen IBS Symptoms?” Healthline, 8 Aug. 2024, www.healthline.com/health/irritable-bowel-syndrome/stress-and-anxiety. Accessed 12 Nov. 2024.
Wilhelm, S. M., et al. “Effectiveness of Probiotics in the Treatment of Irritable Bowel Syndrome.” Pharmacotherapy, vol. 28, 2008, pp. 496-505.