Irritable Bowel Syndrome (IBS)
What is Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS) is a functional (ie, not linked to tissue damage or other biological markers) gastrointestinal disorder characterized by chronic abdominal pain, bloating, and varying bouts of diarrhea and constipation. Importantly, IBS should not be confused with inflammatory bowel disease, a broad term describing conditions characterized by chronic inflammation of the gastrointestinal tract.
IBS symptoms may be improved with dietary and lifestyle changes; however, more serious cases could require pharmacologic interventions. Associated psychological conditions like depression must be treated as well, or common drug therapies may not be effective. IBS is very common and generally associated with reduced quality of life.
Natural interventions such as probiotics and artichoke may help alleviate IBS symptoms and improve gut health.
What are Risk Factors for Irritable Bowel Syndrome?
- Genetic predisposition
- Stress, anxiety, and/or depression
- Food sensitivities
- Overgrowth of small intestinal bacteria
- Hormonal fluctuations
- Certain medications, including proton pump inhibitors and broad-spectrum antibiotics
- Gastrointestinal infections
What are the Signs and Symptoms of Irritable Bowel Syndrome?
- Abdominal pain that is relieved with defecation and associated with change in stool frequency or appearance
- Changes in stool could include constipation (IBS-C) or diarrhea (IBS-D)
- Other symptoms not directly associated with the gastrointestinal tract may include headaches, backaches, and lethargy
What are Conventional Medical Treatments for Irritable Bowel Syndrome?
- Bulking agents like dietary fiber
- Laxatives and stool softeners (eg, lubiprostone [Amitiza] and polyethylene glycol [MiraLAX])
- Antispasmodic medications (eg, propantheline [Probanthine])
- Serotonergic antidepressants, either centrally acting (eg, duloxetine [Cymbalta]) or locally acting (eg, alosetron [Lotronex])
- Antibiotics to treat small intestinal bacterial overgrowth; however, probiotics may become a more popular option
What are Emerging Therapies for Irritable Bowel Syndrome?
- Hormone restoration therapy
- Linaclotide (Linzess), a stool softener that can also relieve abdominal pain
- Mesalazine, a drug used to treat inflammatory bowel disease, may also benefit patients with irritable bowel syndrome.
What Dietary and Lifestyle Changes Can Be Beneficial for Irritable Bowel Syndrome?
- Consider certain elimination diets (ie, low FODMAP or gluten-free diet); foods to avoid may include legumes, wheat, barley, rye, milk, certain fruits, and others.
- Get tested for and avoid foods that trigger IgG (ie, foods that cause sensitivities)
- Stress reduction techniques (eg, meditation, cognitive therapy, etc.)
- Engage in a regular form of exercise
- Consider acupuncture
What Natural Interventions May Be Beneficial for Irritable Bowel Syndrome?
- Buffered vitamin C powder. Powders containing vitamin C (ascorbic acid) and minerals like potassium and magnesium, when taken on an empty stomach, can induce colon peristalsis to support complete bowel evacuation.
- Peppermint oil/caraway oil. Peppermint oil, alone or in combination with caraway oil, can significantly improve IBS symptoms.
- Probiotics. As alterations in the gut microbiome can cause or exacerbate IBS symptoms, supplementation with probiotic bacteria or yeast may help rebalance it. Many patients taking probiotics experience improvements in their symptoms.
- Artichoke. Artichoke supports healthy digestive function by promoting bile production. In one study, artichoke leaf extract almost eliminated abdominal pain, cramps, bloating, flatulence, and constipation in patients with IBS.
- Melatonin. Melatonin, a multifunctional hormone, can be useful for more than just improving sleep. IBS patients taking melatonin had reduced abdominal pain and bloating.
- Perilla leaf extract. Perilla leaf extract, a plant from the mint family, is rich in polyphenols and has been demonstrated benefits for digestive ailments. Studies indicate it can offer relief for abdominal discomfort and may help reduce stress.
- Other natural interventions that may provide benefits for people with IBS include curcumin and adaptogenic herbs such as Rhodiola rosea and bacopa.