"I look at it this way: I don't have a lot of great things in conventional medicine to offer, so what I do have is in the realm of natural therapy," says Tieraona Low Dog, MD, a clinician and professor at the University of Arizona College of Medicine.
It is not entirely clear how stress, anxiety, and irritable bowel syndrome (IBS) are related -- or which one comes first -- but studies show they tend to co-exist.
"If you do diagnostic interviews, what you find is that about 60% of IBS patients will meet the criteria for one or more psychiatric disorders," says Edward Blanchard, PhD, professor of psychology at the State University of New York at Albany.
The most common mental ailment suffered by people with IBS is generalized anxiety disorder...
But that doesn't mean that all natural remedies touted as IBS fixes work, and in some cases, research results have been mixed. What really works? Here's what experts say.
Probiotics for IBS
Probiotics are microorganisms that supplement the gut's natural bacteria, helping to "balance" intestinal flora.
Why probiotics seem to work is still something of a mystery, but some studies suggest that probiotic supplements, especially those with a predominance of Bifidobacterium infantis, alleviate IBS symptoms like abdominal pain, bloating, and bowel movement irregularity.
Lawrence Schiller, MD, a gastroenterologist in Dallas, says he's comfortable recommending probiotic supplements to patients because probiotics don't do any harm and seem to help some of them.
But Schiller is skeptical of the products on the market; he says most studies of probiotics and IBS don't differentiate between bacterial strains and doses, a conundrum for the consumer who is faced with shelves full of probiotic-laced yogurts and milk in the market.
"The chances of going to the store and finding something viable and effective is very much a long shot," he says. "The best evidence for probiotics is with some of the combination products and some that contain bifida bacteria, not acidophilus or lactobilli."
Prebiotics for IBS
Prebiotics are nondigestible food ingredients that stimulate growth and activity of microorganisms in the gut.
Prebiotics are naturally found in many foods, such as oatmeal and other whole grains, and many fruits and vegetables, including artichokes, asparagus, onions, and bananas.
Clinical studies have been small and few, and the results are mixed. One study showed that IBS patients given a combination of probiotics and prebiotics experienced a significant improvement in abdominal pain, bloating, and constipation; another study showed prebiotics had no effect.
Fiber Supplements for IBS
Research into the role of fiber supplements in treating IBS symptoms is conflicting, with some finding no benefit, a few finding that added fiber to the diet causes bloating and gas, and a handful reporting that soluble fiber helps IBS patients with constipation and diarrhea.
A recent study found that psyllium, a soluble fiber, provided significant pain relief for IBS patients with constipation and/or diarrhea. Another found that psyllium has limited effect on constipation and abdominal pain.