Irritable Bowel Syndrome - Supplements

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

Also indexed as:

colitis,
IBS,
irritable bowel,
irritable bowel syndrome,
irritable bowel syndrome (IBS),
spastic colitis,
spastic colon

About this treatment

What Are "Star" Ratings?

a7_3star Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

Supplement	Amount	Why
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.
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 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.³⁰ In a similar trial, capsules that were not enteric-coated were as effective as enteric-coated capsules.³¹ The same combination has compared favorably to the drug cisapride (Propulsid) in reducing symptoms of IBS.³² 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.³³

Supplement	Amount	Why
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.
Lactase 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 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.³⁴ 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. What Else Is This Supplement Used For?

Supplement	Amount	Why
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.
Psyllium 3.25 grams taken three times per day 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.³⁵ Psyllium has improved IBS symptoms in double-blind trials.³⁶ ^{, 37} What Else Is This Supplement Used For?

Supplement	Amount	Why
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 Take under medical supervision: 3 mg daily at bedtime 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.³⁸ Melatonin was also effective in another double-blind trial.³⁹ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
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.
Peppermint 0.2 to 0.4 ml in enteric-coated capsules, three times per day In the intestinal tract, peppermint oil reduces gas production, eases intestinal cramping, and soothes irritation.⁴⁰ Peppermint oil has been reported to help relieve symptoms of IBS in two analyses of controlled trials.⁴¹ ^{, 42} 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.⁴³ ^{, 44} ^{, 45} ^{, 46} ^{, 47} Some trials have found peppermint oil ineffective.⁴⁸ ^{, 49} The reason for these conflicting findings remains unclear. 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.⁵⁰ In a similar trial, capsules that were not enteric-coated were as effective as enteric-coated capsules.⁵¹ The same combination has compared favorably to the drug cisapride (Propulsid) in reducing symptoms of IBS.⁵² 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.⁵³ What Else Is This Supplement Used For?

Supplement	Amount	Why
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.
Peppermint, Caraway Seeds, Fennel Seeds, and Wormwood 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.⁵⁴

Supplement	Amount	Why
Probiotics	Refer to label instructions	A daily drink containing probiotics significantly reduced IBS symptoms in one study.
Probiotics In a double-blind trial, daily consumption of 4 ounces of a drink containing probiotics for five months was significantly more effective than a placebo drink at relieving IBS symptoms. The probiotic drink contained Lactobacillus rhamnosus GG, L. rhamnosus Lc705, Propionibacterium freudenreichii ssp. shermanii JS and Bifidobacterium animalis ssp. lactis Bb12.⁵⁵ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
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.
Artichoke 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.⁵⁶ 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. What Else Is This Supplement Used For?

Supplement	Amount	Why
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 Chamomile’s essential oils have eased intestinal cramping and irritation in animals.⁵⁷ 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. What Else Is This Supplement Used For?

Supplement	Amount	Why
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.
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.⁵⁸ 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. What Else Is This Supplement Used For?

Supplement	Amount	Why
Fennel	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.
Fennel 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.⁵⁹ What Else Is This Supplement Used For?

Supplement	Amount	Why
Fiber (All Forms)	Refer to label instructions	Supplementing with fiber may help you find the right balance of regularity without episodes of diarrhea. Learn More
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.
Grapefruit Seed Extract A preliminary trial investigated the effectiveness of grapefruit seed extract in people with eczema and symptoms of IBS.⁶⁰ 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. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
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.
Wormwood, Ginger, Bupleurum, Schisandra, Dan Shen, and Other Extracts Take a Chinese herbal formula containing wormwood under the guidance of a qualified practitioner 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.⁶¹

References

Last Review: 05-11-2011

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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2011.

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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