These alternatives to potent prescription IBS drugs may offer relief without side effects.
When you have irritable bowel syndrome (IBS), whether it’s marked by frequent bouts of diarrhea (IBS-D), constipation (IBS-C), or mixed symptoms (IBS-M), you might be willing to try anything for relief.
Prescription medications may come with side effects and aren’t always as effective as advertised, though. If you’re concerned about going that route for relief, natural remedies may be helpful. In fact, they may be all you need to manage your IBS symptoms long-term.
“Some natural and over-the-counter remedies can completely put some IBS patients in remission,” says Brenda Powell, MD, the medical director at Lower Elwha Klallam Tribe Health Department in Port Angeles, Washington.
Keep in mind that you should always talk to your doctor about any treatment to make sure it’s safe for you. Once you’re given the all clear from a medical professional, talk to your doctor about these six natural ways to find relief from IBS pain.
The llatest guidelines on IBS from the American College of Gastroenterology (ACG), published in January 2021, suggest a low-FODMAP diet, which cuts out certain foods that are difficult to digest. While this diet may seem daunting because it eliminates so many foods you may be used to eating, research shows that it effectively improves or resolves IBS symptoms for some people.
An analysis in the August 2021 issue of Neurogastroenterology looked at 13 different studies involving 944 people with IBS and found that participants who adopted a low-FODMAP diet improved their symptoms more than those in any other intervention group. An analysis of 12 studies published in the February 2021 European Journal of Nutrition found that a low-FODMAP diet reduced IBS severity by an average of about 34 percent, while a slightly older analysis based on 7 studies found that the diet resulted in overall IBS symptom reduction of 31 percent.
If your IBS symptoms persist even after you change your dietary patterns, consider taking psyllium powder, which provides soluble fiber and is the active ingredient in the fiber supplement Metamucil. In their latest guidelines, the ACG strongly recommends soluble fiber to treat IBS if constipation is the predominant symptom.
“There is a moderate quality of evidence for psyllium for overall symptom relief,” says Kara Gross Margolis, MD, a pediatric gastroenterologist at NYU Langone Health in New York City.
According to a research review published in Current Opinion in Gastroenterology in March 2021, psyllium supplementation is recommended to help treat IBS-C and IBS-D.
“If you’re constipated, psyllium powder helps move your bowels. If you have diarrhea, psyllium powder gives you something to form a bowel movement around,” Dr. Powell says.
You can stir a teaspoon of psyllium powder into your morning oatmeal or into a glass of water, and gradually increase your daily dose as needed according to guidelines and your doctor’s advice.
If constipation is your main IBS symptom, you may want to try the ancient Chinese medicine technique known as acupuncture to find some relief.
“Acupuncture is really good for constipation and getting the bowels moving again,” Powell says.
Acupuncture involves inserting thin needles into the skin at specific points to balance the body’s energy or life force, also called qi (pronounced “chee”). In a more scientific sense, for people with IBS-C, acupuncture may help calm down the autonomic nervous system, which regulates your GI tract.
Acupuncture may also be helpful if you have IBS-D. A study published in Frontiers in Neuroscience in December 2020 found that acupuncture improved functional connections in the brain, which may ease symptoms of IBS-D.
Reducing stress with breathing exercises and mindfulness may calm down the gut nerves that are misfiring in people with IBS. The ACG’s guidelines recommend various mindfulness techniques that have the potential to improve IBS symptoms.
A study published in the April 2020 issue of Neurogastroenterology and Motility found that after an eight-week mindfulness-based stress reduction practice, more than 70 percent of the participants in the study reported improved IBS symptoms. The aspect of mindfulness that was most strongly tied to improvement in symptoms and quality of life was “acting with awareness” or focusing on the present moment.
As a breathing exercise, “I recommend 5-5-5 to my patients,” Powell says. That is, “smell the roses” by inhaling through your nose for a count of five. Hold that breath for five counts, then exhale through your mouth for a count of five or longer, as if you are blowing out candles on your birthday cake. “This breathing technique is very calming to the autonomic nervous system, which can help with IBS,” Powell adds. Best of all, she notes, it’s portable. “You can do it anywhere, such as when you’re waiting in your car at a stoplight.”
While mindfulness may reduce IBS symptoms, physical activity is also an integral part of the mind-body connection. One of the most effective ways to pair mindfulness with activity is through the ancient practice of yoga. While some studies suggest it may be helpful in managing IBS, the quality of the data is limited.
A review published in the December 2019 Digestive Diseases and Sciences analyzed several studies that looked at the benefits of various yoga practices focused on the mind-body-breath connection. It found that a majority of participants saw improvements in their IBS symptoms, overall physical functioning, and aspects of mental health such as depression, anxiety, and self-rated quality of life. The researchers concluded that “preliminary data supports yoga as beneficial” for people with IBS, but that more specific recommendations regarding the amount or type of yoga you should practice were not possible because of limited evidence.
Peppermint oil has been used as an herbal remedy for a number of ailments for centuries. Now the ACG says this supplement — especially in a delayed-release formulation that targets the small intestine — “may offer benefit for overall symptoms and abdominal pain.”
An analysis published in the journal BMC Complementary Medicine and Therapies in January 2019 looked at 12 studies involving 835 participants, and found that those who regularly took a peppermint oil capsule with meals reduced their IBS symptoms overall, and abdominal pain specifically.
It’s worth noting that peppermint oil can make acid reflux or heartburn worse, and that most peppermint oil supplements on the market haven’t undergone rigorous studies for safety or effectiveness. Talk to your doctor if you’re thinking about trying peppermint oil, since IBS is a complicated condition and multiple considerations are involved in creating a treatment plan.
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6 Natural Remedies for IBS – Everyday Health
