Supplements for IBS: What Works?
Do fiber, probiotics, prebiotics, and other products ease irritable bowel syndrome?
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.
Schiller says some of his IBS patients get relief from diarrhea and constipation with products containing psyllium, whether in the form of powder, tablets, breakfast bars, or cookies. There's no difference in their safety or effectiveness, he says.
Low Dog often prescribes psyllium for constipation, and if it aggravates constipation, which it can do until the body has enough of it and water, she'll add magnesium citrate to the mix to counteract the initial constipating effect of psyllium. She recommends powdered psyllium seed husks that can be mixed with liquid. "I also like psyllium because of its cardiovascular benefits. Any good fiber you can get, I like," Low Dog says.
Guar gum, also a soluble fiber that thickens food, shows some promise for IBS symptoms. David Rakel, MD, of the University of Wisconsin School of Public Health and Medicine, says he recommends supplements for patients to aid digestion.
Calcium polycarbophil, which is another soluble fiber, may help with diarrhea, constipation, abdominal pain, and bloating from IBS, according to a few studies. Schiller says that calcium polycarbophil supplements harden and soften stools, making it an effective supplement for mild diarrhea and constipation related to IBS.
Herbal Supplements for IBS
Peppermint oil may lessen diarrhea symptoms by slowing fecal transit time.
Research is fairly solid on the subject, with one group of researchers concluding that peppermint oil is more effective and benign than drugs for GI spasm and could be a drug of first choice for IBS patients with mild constipation or diarrhea.
"Peppermint oil has better research than many pharmaceuticals for IBS," Rakel says.
For IBS patients who don't tolerate peppermint, a chamomile-pectin combination works well, Low Dog says. Chamomile helps to relax colon muscles, Rakel says.