Irritable Bowel Syndrome (IBS) can be an overwhelming chronic disease that can severely impact a person’s quality of life. Luckily, great strides have been made in the past 10-15 years in terms of therapies that can help manage the symptoms of IBS. There are a host of medications that can target your IBS symptoms, helping with everything from diarrhea and constipation to stomach pain. Various supplements on the market claim to help mitigate irritable bowel syndrome symptoms “naturally,” but do they actually work? Let’s find out which belly soothers you should consider adding to your IBS arsenal, from herbs to peppermint oil to digestive enzymes.
Peppermint is a natural antispasmodic, making it an ideal choice for those who suffer from abdominal pain and diarrhea. Studies have predominantly looked at peppermint oil capsules with enteric coating, which ensures that they will make their way through the stomach acid to the intestines. Improvement in stomach pain has been shown with the continuous use of peppermint capsules, although some practitioners will recommend taking peppermint only during flare-ups. While there aren’t any great studies using other forms of peppermint (i.e. peppermint tea, peppermint essential oil), anecdotally they still provide a therapeutic effect. Popular IBS-friendly brands of peppermint oil include IBGard and Heather’s Tummy Tamers.
- Who can benefit from peppermint oil: Irritable bowel syndrome (IBS) sufferers with abdominal pain can benefit from peppermint oil.
- Who should avoid peppermint oil: Be wary if you also have heartburn. Peppermint oil is often a trigger for acid reflux. Be sure to look for an enteric-coated peppermint capsule and discontinue use if you start experiencing heartburn symptoms.
STW-5, also known as the brand name Iberogast, is an herbal combination containing 9 different herbs. These herbs include bitter candytuft, angelica, chamomile, caraway, St. Mary’s thistle, lemon balm, peppermint, greater celandine, and licorice. STW-5 has been in use for over 50 years to help with abdominal pain and is primarily found in Europe. This preparation of herbs has been marketed and studied for use in Functional Dyspepsia (FD) and Irritable Bowel Syndrome (IBS). Most studies show that it is beneficial for FD with a few showing benefits in IBS sufferers. Bottom line: it’s not harmful if taken as directed. Avoid this combination of herbs if you are pregnant.
- Who can benefit from STW-5: Those with FD and possibly IBS who experience abdominal pain could be benefitted from the combination of herbs in STW-5.
- Who should avoid STW-5: Pregnant women due to the risk of preterm labor from the licorice root should not take STW-5.
Digestive aids are digestive enzymes that help to break down components of our food. One of the most well-known enzymes for digestion is lactase, which helps to break down the carbohydrate lactose. There are other various enzymes for digestion on the market that claim to help with bloating, gas, etc. Let’s look at which digestive enzymes are actually beneficial.
Lactose is the sugar in milk that often causes GI distress and diarrhea in those with irritable bowel syndrome (IBS) and/or lactose intolerance. It is found in dairy products like milk, yogurt, ice cream, and cheese. Lactase enzymes help to break down lactose, making it easier for digestion. Lactase is measured in acid lactase units (ALU). Most products on the market contain 3,000-9,000 ALUs. Studies have shown that about 3,000 ALUs cover 20g of lactose, which is more than you would find in a glass of milk. If you’re not sure how much lactose is in your meal or you’re extremely sensitive to lactose, then take a higher dose to cover your meal and ensure proper digestion.
- Who should take it: Anyone with lactose intolerance who still wants to enjoy dairy products should take lactase digestive enzymes.
- Who should avoid it: Anyone who is not lactose intolerant and does not have an issue with the digestion of dairy does not need to take lactase enzymes. If you have a known sensitivity to mannitol, look for other digestive enzymes made without it.
All humans have digestive issues when it comes to galactooligosaccharide (GOS) foods. Despite their nutrient value, people that suffer from irritable bowel syndrome (IBS) may be particularly sensitive to these foods, which include beans, legumes, and some vegetables, and benefit from digestive aids. Alpha-galactosidase is an enzyme that is made from a mold, and when taken with GOS containing foods, it helps to mitigate gas and bloating. Studies have shown that doses of at least 250 GalUs (or galactosidase units) help with symptoms. It should be taken with the first bite of food to properly aid digestion. There are a few products on the market, with the most well-known being Beano. However, be on the lookout for the added ingredient mannitol, especially if you’re completing the Low FODMAP diet or know that you have a sensitivity to that particular carbohydrate.
- Who should take it: Anyone that experiences excessive gas or bloating from GOS containing foods should take it.
- Who should avoid it: Anyone with a sensitivity to mannitol should avoid it. In that case, look for other products made without it.
While lactase and alpha-galactosidase have been found to be beneficial in reducing gas and bloating from specific carbohydrates, other digestive enzyme blends on the market may or may not have benefits. It depends on what enzymes are included, the dose, and what your specific needs are. There is a chance that enzyme blends could make your symptoms worse or just not do anything at all. You should also be careful with any other added ingredients in the blend, like mannitol, prebiotics, or probiotics (beneficial bacteria), always making sure you are working with your healthcare provider when choosing an enzyme supplement for better digestion.
Other supplements that are often an area of interest to IBS sufferers are probiotics and ginger. The jury is still out on whether specific probiotic supplements are beneficial to everyone with IBS, with the odds being that probiotics should really be tailored to an individual’s symptoms and microbiome. As for ginger, studies have shown that it can be very beneficial in improving symptoms of nausea, but when it comes to the IBS symptoms of bloating and abdominal pain, unlike peppermint oil, no benefit has been shown.
The bottom line is, you should always be intentional with your supplements, whether herbs, peppermint oil capsules, probiotics, or supplements for digestion. Be sure to look at dosage and ingredients as well as their intended purposes. Your best bet is always to work with your healthcare provider to discuss which digestive aids and belly soothers would work best for you and your unique situation, along with targeted dietary management.