Of all the disorders of the gastrointestinal tract, irritable bowel syndrome (IBS) is the most common, affecting at least 11 percent of all people.
Conventional medicine has struggled to help because it is able to focus only on symptom relief. Nature can do better.
Peppermint Oil
A just published comprehensive review1 that examined the current research on natural remedies explains that peppermint oil has many properties that could contribute to its ability to improve IBS. It says that peppermint oil is “a promising treatment” that has proven its efficacy in multiple controlled studies. And with good reason!
A review of the literature that included seven controlled studies concluded that most studies report improvement in IBS symptoms with peppermint oil compared to placebo or drug.2
The largest, best-designed meta-analysis of enteric coated peppermint oil and IBS has now proven its benefit beyond a doubt. Meta-analysis of seven studies showed that peppermint oil is significantly better than placebo for global improvement of IBS, and meta-analysis of six studies proved it is significantly better for the abdominal pain.3
And it’s not only better than placebo. The combination of peppermint oil and caraway oil is more effective than the drug cisapride.4
Peppermint oil is usually taken in the form of enteric-coated capsules. The nonenteric coated may work just as well, but the enteric-coated ones are better studied and may be better tolerated. The usual dose is 2-4 ml three times a day. Double-blind research has also found that half that dose is effective for helping older children with IBS.5
Curcumin
The comprehensive review also says that curcumin addresses IBS in multiple ways. It highlights a recent systematic review of 26 studies that demonstrated its effectiveness for IBS.6
Fennel & Curcumin
The comprehensive review says that fennel could also be effective for IBS. As evidence, they point to a study of a combination of fennel oil and curcumin. IBS Severity Symptom Score went down significantly more in the herb group: a 50.05 point drop versus 28.85 on placebo. Significantly more people on the herbs were symptom free: 25.9 percent versus 6.8 percent. They also had a significantly greater improvement in abdominal pain: 63.8 percent pain reduction versus 27.1 percent. Quality of Life scores were also significantly higher in the herb group: 17.4 versus 7.7.7
Aloe Vera
The review also gives a positive review to aloe vera. It points to a pooled analysis of two studies that found that aloe extract significantly reduces symptom severity, reduces the severity and frequency of abdominal pain and improves response rates.8
Though not mentioned in the review, another meta-analysis of aloe and IBS that included three controlled studies also found that aloe is superior to placebo with more people responding and a significantly greater improvement in symptoms. And the aloe vera was safe: there were no adverse events in any of the studies. The efficacy and safety of the herb led the researchers to conclude that aloe vera “is effective and safe for the treatment of patients with IBS.”9
Though this important new review focused on herbs, other natural supplements can also help. Among the most important is probiotics.
Probiotics
Studies have shown that probiotics can improve several of the symptoms, including pain, bloating, gas, digestive problems and urgency of bowel movements.10 A systematic review of 28 controlled studies showed that probiotics safely improve overall IBS symptoms and abdominal pain scores.11
Most impressively, a systematic review and meta-analysis of 32 controlled studies that compared probiotics to drugs in the treatment of IBS found that both drugs and probiotics were effective. But the probiotics appeared to be more effective.12 Given the side effects of medications prescribed for IBS, the finding that safe, natural probiotics work at least as well is important.
Vitamin D
Eighty-two percent of people with IBS—that’s almost all of them—are deficient in vitamin D.13 But when people with IBS take vitamin D, they get better. When adolescents with IBS were given 2,000 IU of vitamin D daily for six months, they had significant improvement on irritable bowel severity score compared to kids given a placebo. They also had significant improvement in IBS quality of life and total scores.14
The same is true for adults. A double-blind study of 116 adults found that 50,000 IU of vitamin D a week significantly improves IBS symptom severity scores and quality of life scores compared to placebo.15
Melatonin
Perhaps surprisingly, double-blind research shows that melatonin helps.16,17
Psyllium
It has long been known that psyllium helps adults with IBS.18-20 But new double-blind research extends the benefit to kids. Kids taking psyllium had a significant improvement on the IBS severity scale compared to kids given a placebo. And, while only 9.7 percent of the kids on placebo went into remission, 43.9 percent of the kids on psyllium did.21
There are also other herbs that help.
Boswellia
Boswellia extract is significantly better than standard drug and diet management for all IBS symptoms except “altered bowel movement.” Those on boswellia needed significantly less rescue medication and fewer consultations or hospital admissions. At the end of the six-month study, ultrasounds showed bloating and peristalsis as well as dilated bowel loops in 58.2 percent of the control group but only 17.14 percent of the boswellia group. Boswellia was also safer.22
In a second study, abdominal pain, altered bowel movement, gas and cramps improved on both boswellia and drugs, but the number of people who needed medical attention decreased significantly only in the boswellia group, suggesting that boswellia is better than drugs. Boswellia was also safer.23
Artichoke
Artichoke leaf extract improves symptoms in 26 percent of people with IBS.24 In a study of dyspeptic patients with symptoms of IBS, artichoke significantly relieved abdominal pain, bloating, gas, right side cramps and constipation. All IBS symptoms were significantly reduced in severity, with the improvement ranging from 65 percent to 77 percent. And the improvement was fast: averaging just 10.4 days. Eighty-four percent of both patients and doctors rated the overall effectiveness of artichoke extract as good or excellent.25
Sources:
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25 Phytother Res 2001;1:58-61.
Linda Woolven is a master herbalist, acupuncturist and solution-focused counsellor with a virtual practice in Toronto, ON, Canada. Woolven and Ted Snider are the authors of several books on natural health. You can see their books at www.thenaturalpathnewsletter.com. They are also the authors of the natural health newsletter The Natural Path. The Natural Path is a natural health newsletter specifically designed to help health food stores increase their sales by educating their customers. The Natural Path contains no advertising and never mentions a brand name. Retailers can provide The Natural Path Newsletter to their customers. For more information, contact Snider at [email protected] or (416) 782-8211.
