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 to relieve your symptoms.
Prescription medication may come with potential side effects and aren’t always as effective as advertised. 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, medical director at Lower Elwha Klallam Tribe Health Department in Port Angeles, Washington.
Keep in mind, you should always talk to your doctor about any treatment to make sure it is safe for you. And if you’re ready, ask your provider, about these eight natural ways to find relief from IBS pain:
New guidelines from the American College of Gastroenterology (ACG) suggest trying a low-FODMAP diet, which cuts out foods that are difficult for the body to absorb. While the diet may seem daunting because it eliminates so many foods you may be used to, it revolves around basic healthy eating habits.
If your IBS symptoms persist even after you change your dietary patterns, consider taking psyllium powder, which is soluble fiber and the active ingredient in the fiber supplement Metamucil. The ACG strongly recommends soluble fiber to treat IBS in their latest guidelines.
“There is a moderate quality of evidence for psyllium for overall symptoms relief,” says Kara Gross Margolis, MD, a pediatric gastroenterologist at Columbia University Medical Center and NewYork-Presbyterian Morgan Stanley Children's Hospital in New York City.
According to a review published in March 2021 in Current Opinion in Gastroenterology, psyllium supplementation is recommended to help treat IBS-C and IBS-D. Stir a teaspoon of psyllium powder into your morning oatmeal or into a glass of water, and down the hatch.
“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.
IBS is often associated with chronic gastritis, which may cause the lining of your small intestine to break down, creating tiny openings that allow digestive by-products, called lipopolysaccharides, to slip through and enter your body. These uninvited guests can ignite the immune system, causing a generalized inflammatory reaction and symptoms such as achiness and fatigue. If your IBS makes you feel tired or achy, L-glutamine may be another over-the-counter supplement to try. It’s an amino acid, sold as a powder and found in foods like chicken, fish, lentils, and spinach. In an eight-week study published online in May 2019 in the journal Gut, of 106 adults with IBS-D, those who took oral glutamine supplements safely reduced all major IBS-related symptoms.
“L-glutamine can help the lining of your gut heal to correct the permeability issue,” Powell says. “I recommend taking 2 teaspoons once a day, when experiencing diarrhea.”
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”). It’s based on the principle that qi flows through various pathways in the body called meridians.
“Inserting needles into acupuncture points along meridians is thought to bring energy flow back into proper balance,” says Anne Mok, an acupuncturist and the coowner of Cornerstone Healing in Brooklyn, New York. With IBS-C, acupuncture can help calm down the autonomic nervous system, which helps regulate your GI tract.
Acupuncture may even be helpful if you have IBS-D. A study published in December 2020 in Frontiers in Neuroscience found that acupuncture improved functional connections in the brain that eased symptoms of IBS-D and improved quality of life for patients.
Reducing stress with breathing exercises and mindfulness may also help calm down the gut nerves that are misfiring. The ACG’s guidelines recommend various mindfulness techniques that have the potential to improve IBS symptoms. A study published in September 2020 in the journal 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 reduction in severity also continued for three months after the eight weeks of the study.
“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,” she adds. Best of all, it’s portable. “You can do it anywhere, such as when you’re waiting in your car at a stoplight.”
While mindfulness may reduce symptoms, physical activity is an integral part of the mind-body connection. One of the most effective ways to pair mindfulness and exercise is through the ancient practice of yoga. And, studies suggest it can be helpful in managing IBS, but the quality of the data is limited.
A review published in December 2019 in the journal 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, their digestion, and their physical health, as well as improvements in mood, anxiety, and their outlook on life. The results suggest that practicing yoga can lead to improvements in physical health and a more positive outlook on life, which helps decrease IBS symptoms.
Peppermint oil has been used as an herbal remedy for a number of ailments for centuries. Now the ACG acknowledges that this herb soothes the gut and recommends it to provide relief for all IBS symptoms. A recent meta-analysis published in January 2019 in BMC Complementary Medicine and Therapies looked at 12 different trials from three different continents, and found that regularly taking a peppermint oil capsule with meals helped reduce IBS symptoms, including abdominal pain, diarrhea, bloating, and constipation.
It’s worth noting that peppermint oil could make heartburn worse so be careful how much you take. Talk to your doctor if you are thinking about trying peppermint oil, since IBS is a complicated condition and she’ll need a complete picture of the remedies you’re using to determine an overall treatment plan.
Additional reporting by Jordan M. Davidson.
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