Irritable bowel syndrome natural therapy with vitamins, herbs, fiber and supplements
March 4 2018 by Ray Sahelian, M.D. health food and healing information

Irritable bowel syndrome is a problem with the intestines. In people with this condition, the intestines squeeze too hard or not hard enough and cause food to move too quickly or too slowly. IBS is also called functional bowel syndrome, irritable colon (the large intestine is also called the colon), spastic bowel and spastic colon. It's not the same as inflammatory bowel diseases like Crohn's disease.
   Patients with irritable bowel syndrome are at increased risk for migraine headache, depression or fibromyalgia.

Natural treatment for irritable bowel syndrome by Ray Sahelian, M.D.
Studies regarding the benefits of natural alternatives have had promising results, but research in this area is still quite early. Thus far, certain clinical trials suggests that some nutrients may be beneficial in reducing symptoms of irritable bowel syndrome in certain individuals. These nutrients include artichoke leaf extract, psyllium fiber, turmeric or curcumin, fish oils, melatonin, and certain probiotics. Food allergy elimination should also be tried, for instance elimination of gluten. Eating smaller portions could help reduce the severity of symptoms. Avoid large, heavy meals in favor of smaller, lighter ones.

Artichoke leaf extract has been studied for this condition
Artichoke leaf extract reduces symptoms of irritable bowel syndrome and improves quality of life in otherwise healthy volunteers suffering from concomitant dyspepsia: a subset analysis.
J Altern Complement Med. 2004.
Does artichoke leaf extract lessen symptoms of Irritable bowel syndrome in otherwise healthy volunteers suffering concomitant dyspepsia? A subset analysis of a previous dose-ranging, open, postal study, in adults suffering dyspepsia. Two hundred and eight (208) adults were identified post hoc as suffering with irritable bowel syndrome. Irritable bowel syndrome incidence, self-reported usual bowel pattern, and the Nepean Dyspepsia Index (NDI) were compared before and after a 2-month intervention period. There was a significant fall in irritable bowel syndrome incidence of 26% after treatment. A significant shift in self-reported usual bowel pattern away from "alternating constipation / diarrhea" toward "normal" was observed. NDI total symptom score significantly decreased by 41% after treatment. Similarly, there was a significant 20% improvement in the NDI total quality-of-life score in the subset after treatment.

Artichoke leaf extract reduces symptoms of irritable bowel syndrome in a post-marketing surveillance study.
Phytother Res. 2001.
A sub-group of patients with IBS symptoms was identified from a sample of individuals with dyspeptic syndrome who were being monitored in a post-marketing surveillance study of artichoke leaf extract for 6 weeks. There were reductions in the severity of symptoms. The vast majority of patients rated artichoke leaf extract as better than or at least equal to previous therapies administered for their symptoms, and the tolerability was very good.

Fish oils or eating fish could be of help
While you increase your intake of omega-3 fatty acids, decrease your intake of fast foods, sweets, and simple carbohydrates.

Serum fatty acid profile in subjects with irritable bowel syndrome.
Scand J Gastroenterol. 2010. Department of Medical Biochemistry, University of Tampere, Finland.
We wanted to investigate subjects with IBS for signs of disturbed intestinal absorption of fatty acids, as reflected in serum composition. Material and methods. Serum samples were obtained from 32 adults with IBS, and from 59 controls. Serum fatty acids were analyzed by capillary gas-liquid chromatography. Results. Especially the proportions of arachidonic acid (20:4 n-6) and the long-chain polyunsaturated fatty acids of the n-3 family docosapentaenoic acid (22:5 n-3) and docosahexaenoic acid (22:6 n-3) were decreased in subjects with IBS. The proportions of unsaturated and monounsaturated fatty acids were generally increased in IBS compared to controls. Although organic disease has been ruled out in patients with IBS, they presented signs of inadequate supply of long-chain fatty acids. Supplementation with n-3 fatty acids may be implicated.

Melatonin, the sleep hormone, has shown some promise
World J Gastroenterology 2014. Melatonin for the treatment of irritable bowel syndrome. Melatonin is a hormone produced by the pineal gland and also large number by enterochromaffin cells of the digestive mucosa. Melatonin plays an important part in gastrointestinal physiology which includes regulation of gastrointestinal motility, local anti-inflammatory reaction as well as moderation of visceral sensation. Melatonin is commonly given orally. It is categorized by the United States Food and Drug Administration as a dietary supplement. Melatonin treatment has an extremely wide margin of safety though it may cause minor adverse effects, such as headache, rash and nightmares. Melatonin was touted as a potential effective candidate for IBS treatment. Putative role of melatonin in IBS treatment include analgesic effects, regulator of gastrointestinal motility and sensation to sleep promoter. Placebo-controlled studies in melatonin suffered from heterogeneity in methodology. Most studies utilized 3 mg at bedtime as the standard dose of trial. However, all studies had consistently showed improvement in abdominal pain, some showed improvement in quality of life of IBS patients. Melatonin is a relatively safe drug that possesses potential in treating IBS.

Pectin fiber
Zhonghua Wei Chang Wai Ke Za Zhi. 2015. Efficacy of pectin in the treatment of diarrhea predominant irritable bowel syndrome. To evaluate the efficacy of pectin, a kind of soluble dietary fiber, in diarrhea predominant irritable bowel syndrome (IBS). A total of 87 patients with IBS-D were selected in the Jinling Hospital between July 2011 and December 2013. Using a randomized, controlled trial, the efficacy of pectin for IBS was prospectively evaluated. Subjects were randomly assigned to receive 24 g pectin powder/d or a placebo. Pectin acts as a prebiotic in specifically stimulating gut bifidobacteria in IBS-D patients and is effective in alleviating clinical symptoms, balancing colonic microflora and relieving systemic inflammation. In view of its ability to re-establish a healthy gut ecosystem, pectin has the potential of being a therapeutic agent in IBS.

Peppermint oil
Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial.
J Gastroenterology. 1997.
To determine the efficacy and tolerability of an enteric-coated peppermint-oil formulation (Colpermin), we conducted a randomized, double-blind, placebo-controlled clinical study in 110 outpatients (66 men/44 women; 18-70 years of age) with symptoms of irritable bowel syndrome. Patients took one capsule (Colpermin or placebo) three to four times daily, 15-30 min before meals, for 1 month. In this trial, Colpermin was effective and well tolerated.

Probiotic supplements
There is now increasing evidence linking alterations in the gastrointestinal bacteria and IBS.
 

Probiotics Antimicrob Proteins. 2018. Effect of a Preparation of Four Probiotics on Symptoms of Patients with Irritable Bowel Syndrome: Association with Intestinal Bacterial Overgrowth. Five patients with IBS and SIBO (small intestinal bacterial overgrowth) and 21 patients with IBS without SIBO were administered an oral capsule containing Saccharomyces boulardii, Bifidobacterium lactis, Lactobacillus acidophilus, and Lactobacillus plantarum (Lactolevure®) every 12 h for 30 days. Benefit was observed from probiotic intake regarding certain symptoms of patients with diarrhea-predominant and constipation-predominant IBS.

J Gastroenterol Hepatology. 2013. Effect of multi-species probiotics on irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial.

A probiotic preparation containing the beneficial microbe Bifidobacterium infantis relieves symptoms of irritable bowel syndrome. In contrast, treatment with another probiotic microbe, Lactobacillus salivarius, appears to have no effect. Previous studies of probiotic preparations have been small and yielded inconsistent results. For the current study, 75 irritable bowel syndrome patients were randomly assigned to take L. salivarius or B. infantis mixed in a malted milk drink or the malted milk drink alone every morning for 8 weeks. Patients kept track of their symptoms on diary cards collected weekly for analysis. The B. infantis mixture was better than the malted drink alone at reducing overall symptoms, abdominal pain and discomfort, and bloating. In contrast, the L. salivarius mixture was no better than the malted drink alone in reducing symptoms. The investigators point out that the symptom relief achieved with B. infantis was comparable to that seen with Zelnorm (tegaserod) and Lotronex (alosetron), two drugs that have been recently approved for the treatment of irritable bowel syndrome. Gastroenterology, 2005.

Email, testimonial
I just thought you might be interested that after a year or more of suffering with irritable bowel syndrome symptoms, I tried probiotics and in two weeks have suffered no further symptoms.

Psyllium fiber should be tried

Psyllium is rich in dietary fiber, a common and effective treatment for constipation. A recent study tried to determine the effectiveness of increasing the dietary content of soluble fiber or insoluble fiber in patients with irritable bowel syndrome. The trial included 275 patients between the ages of 18 and 65 years with IBS who were randomly assigned to one of three groups: The first received daily supplements of soluble fiber (10 grams of psyllium), the second group received insoluble fiber (10g bran), and the third group received placebo (10g rice flour) for three months. Patients who supplements with psyllium experienced a 90 point reduction in the severity of their symptoms, which was almost double the levels observed in the placebo group. There was a reduction in the severity of symptoms in the group assigned bran, but this group experienced a high level of early drop-out following a worsening of IBS symptoms. It appears that adding soluble fiber to the diet may improve symptoms associated with irritable bowel syndrome, but insoluble fiber may worsen the effects at least temporarily. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ. 2009.

Fiber testimonial
I suffered with IBS since childhood. A GI doc suggested eating a one cup bowl of Fiber One or All Bran daily. Half cup didn't work for me. It worked within about 6 days. I ate this daily for 6 years, rain or shine. Brought it with me on vacation. Then one day got very , very weary of Fiber One and I actually prayed for a different way! My answer: Calcium / Magnesium blend tablets after thinking about how much they helped my menstrual cramps. I took 2 in the morning, 2 with dinner. My son has this same issue since early childhood, and when I discovered the calcium / magnesium trick, I gave it to him and he has no trouble unless he skips it. 

Turmeric or curcumin
Turmeric extract may improve irritable bowel syndrome symptomology in otherwise healthy adults: a pilot study.
J Altern Complement Med. 2004.
To assess the effects of turmeric (Curcuma longa) extract on irritable bowel syndrome symptomology in otherwise healthy adults. Design: Partially blinded, randomized, two-dose, pilot study. Subjects: Five hundred (500) volunteers were screened for irritable bowel syndrome using the Rome II criteria. Two hundred and seven (207) suitable volunteers were randomized. Interventions: One or two tablets of a standardized turmeric extract taken daily for 8 weeks. Outcomes measures: irritable bowel syndrome prevalence, symptom-related quality of life and self-reported effectiveness. Results: irritable bowel syndrome prevalence decreased significantly in both groups between screening and baseline (41% and 57%), with a further significant drop of 53% and 60% between baseline and after treatment, in the one- and two-tablet groups respectively. A post-study analysis revealed abdominal pain/discomfort score reduced significantly by 22% and 25% in the one- and two-tablet group respectively, the difference tending toward significance. There were significant improvements in all bar one of the irritable bowel syndrome quality of life scales of between 5% and 36% in both groups, approximately two thirds of all subjects reported an improvement in symptoms after treatment, and there was a favorable shift in self-reported bowel pattern. There were no significant differences between groups. Conclusions: Turmeric may help reduce irritable bowel syndrome symptomology. Placebo controlled trials are now warranted to confirm these findings.

Iberogast is a combination of several medicinal herbal extracts that has shown some early promise.

St. John's wort herb not effective
A Mayo Clinic research study published in the January 2010 issue of the American Journal of Gastroenterology finds that St. John's wort herb is not an effective natural treatment for irritable bowel syndrome (IBS).

I have heard some reports of people taking yacon to help with dealing with irritable bowel syndrome symptoms. Is there any research with yacon and this condition?
   I have not come across any research regarding irritable bowel syndrome and yacon. A Medline search was done with these words and no research studies came up.

Advice from the American Dietetic Association
Create a schedule for meals, and stick to it.
Instead of three large meals, eat smaller meals throughout the day.
Chew your food carefully and eat slowly.
Eat foods high in fiber, such as whole grains, vegetables and fruits.
Drink plenty of water, while avoiding caffeine and alcohol.

Symptom
Irritable bowel syndrome is characterized by a group of symptoms — crampy abdominal pain, bloating, constipation, and diarrhea.

Irritable bowel syndrome diet
It's difficult to come up with a diet that would work in most people with irritable bowel syndrome. However, consider making some of the following diet changes: cut back on sugar, cut back on dairy products, especially milk, and consider eliminating certain foods.
   People with irritable bowel syndrome have high levels of antibodies that indicate they are allergic to common foods like wheat, beef, pork, and lamb. The idea of food allergy as a cause is supported by studies that systematically eliminated certain dietary components and then reintroduced them to see how symptoms were affected. In one study, researchers compared levels of antibodies to common foods in 108 patients with irritable bowel syndrome and a comparison group of 43 unaffected "control" subjects. As well as the antibody measurements, the researchers also conducted skin prick testing to 16 common foods including milk, eggs, cheese, wheat, rice, potatoes, various meats, and soya beans. Antibody levels to wheat, beef, pork, lamb and soya beans were significantly higher in IBS patients, and tended to be higher for egg yolk and egg white. However,  there was no significant correlation between symptom severity and frequency and antibody levels. Nonetheless, the researchers note that elevated levels of food-specific antibodies have been seen in asthma, which suggests there could be a similar process going on in irritable bowel syndrome. American Journal of Gastroenterology, 2005.

Food allergies and genes that raise your odds of getting allergic diseases might play roles in some people's irritable bowel syndrome. Allergic asthma, rhinitis, and eczema go hand-in-hand with diarrhea and bad digestive reactions to food in certain people with IBS; American College of Allergy, Asthma & Immunology (ACAAI) 2015 Annual Scientific Meeting, Nov. 5-9, 2015, San Antonio.
 

Many patients report improvement in symptoms of irritable bowel syndrome after avoiding type 4 food allergens identified by skin patch testing.

Irritable bowel syndrome treatment
Many people turn to natural treatments to relieve irritable bowel syndrome symptoms because there is no one traditional medical treatment or medication for this GI disease that works for everyone.

Expert Opin Drug Metab Toxicol. 2013. Metabolic and toxicological considerations for the latest drugs used to treat irritable bowel syndrome. Some evaluated drugs, such as ramosetron (5-HT3 antagonist) and pexacerfont (CRF1 receptor antagonist), have shown some benefits in diarrhea-predominant IBS (D-IBS), while, prucalopride and mosapride (5-HT4 agonist) with prokinetic effect were found useful in constipation-predominant IBS (C-IBS). Besides, dexloxiglumide, lubiprostone and linaclotide have shown beneficial effects in C-IBS patients. Melatonin regulates GI tract motility and, asimadoline, gabapentin and pregabalin show reduction of pain threshold and visceral hypersensitivity. Glucagon-like peptide analog, calcium-channel blockers and neurokinin receptor antagonists have shown benefits in pain attacks.

Cause of IBS, factors that aggravate it
Scientists have yet to pinpoint the exact cause of irritable bowel syndrome, but food allergies are one possibility. Irritable bowel syndrome (IBS) is a condition causing constipation or diarrhea (or sometimes both, cyclically), cramping and generalized gut discomfort. Because no clear physical cause has been discovered, it has been thought that stress and mental disorders play a role in some individuals.
   People who experience high levels of stress and anxiety appear to be more likely to develop irritable bowel syndrome following a severe gastric or intestinal infection.
   Rotating shift work can wreak havoc with bodily functions such as sleep and bowel movements. Rotating work schedules may also increase risk for this bowel condition. American Journal of Gastroenterology, 2010.
   Irritable bowel syndrome (IBS) does seem to run in families. People with IBS are three times as likely as people without the condition to have a relative who also had the disorder. The American Journal of Gastroenterology, 2010.
   Individuals with allergies are more likely to have irritable bowel syndrome than do those without allergies. People with allergic conditions such as hay fever, eczema, and asthma are more likely than other patients to have IBS. Annals of Allergy, Asthma and Immunology, 2008.
   A serious bout with a stomach bug can raise a child's risk of having irritable bowel syndrome (IBS) later on. The American Journal of Gastroenterology, 2010.
   A small percentage of adults have IBS following a serious gastrointestinal infection.
   Perhaps medications can cause IBS in some patients but little is known about this at this time. Suspected medications that can aggravate IBS symptoms include antibiotics, non steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, or statin drugs such as Lipitor or Zocor that lower cholesterol.
   IBS symptoms can also be exacerbated by stress. Smoking or alcohol in moderation do not seem to have a major influence.

Triggers, foods that may trigger symptoms
These factors may trigger IBS symptoms:
Certain foods, particularly dairy, chocolate, cabbage, cauliflower, beans, fruit, broccoli, high-fat foods, alcohol and carbonated beverages.
Emotional stress can worsen IBS symptoms, but may not cause them.
Changes in hormone levels, such as during menstruation.
Conditions such as gastroenteritis, or excess bacteria in the gut.

Irritable bowel syndrome and pelvic pain
Researchers have observed in rats that acute irritation of the urinary bladder leads to increased sensitivity in the colorectum, and conversely, irritation of the colorectum leads to sensitization of the urinary bladder. There appears to be neural cross-talk and bidirectional cross-sensitization of the colon and lower urinary tract. This cross-sensitization may account for the substantial overlap of chronic pelvic pain disorders. Irritable bowel syndrome and interstitial cystitis are two very common clinical conditions that affect primarily women of reproductive age. While these two conditions are often treated as separate entities, in actuality, as many as 40% of women suffer from both conditions.