What Are the Best Supplements to Take for IBS?

Irritable bowel syndrome (IBS) can significantly decrease your quality of life, so people with this condition are looking for ways to reduce their symptoms. Many people find relief through diet and lifestyle changes, but some people are looking for other solutions.

Over-the-counter supplements for IBS are becoming more popular. This article will review the science behind some of the most popular supplements for IBS so you can decide which supplements to take.

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Can Supplements Help with IBS?

Despite how common it is, we don’t yet have a cure for IBS. However, many effective treatments are available, from diet changes to prescription medications to gut-directed hypnotherapy.

There is also growing interest in over-the-counter supplements for IBS. While the American College of Gastroenterology recommends diet and lifestyle changes as a first-line approach to treating IBS, some people may benefit from adding supplements for IBS to their routine.

Since herbal supplements can interfere with prescription medications, it’s best to consult with a healthcare professional before starting a supplement regime.

A dietitian can help you manage your IBS symptoms and get to the root cause. If you’re interested in trying supplements for your IBS, consider booking a virtual appointment with a registered dietitian at Nourish. 

What Are the Best IBS Supplements?

The best supplements for IBS are the ones that have strong research to support their use. Here are seven commonly-used supplements for IBS and what the research says about them.

Psyllium

Psyllium husk is made up primarily of soluble fiber, which forms a gel when it comes into contact with water. It is considered a bulk-forming laxative. That means it absorbs water in your intestines and increases stool size. This can help with both constipation and diarrhea.

Psyllium can be used to effectively treat IBS symptoms. A study involving 275 people looked at the effects of taking 10 grams of psyllium husk daily for 12 weeks. They found that the people who took the psyllium husk had better improvements in their IBS symptoms after three months. 

The evidence for the effectiveness of psyllium in treating IBS is so convincing that the American College of Gastroenterology recommends psyllium in their clinical guidelines for the management of IBS. 

If you’re interested in using psyllium to manage your IBS, start with a small dose of three or four grams per day. This can help prevent the bloating that is often associated with increasing your fiber intake. You can mix psyllium into a glass of water or try sprinkling it into soups, sauces, yogurts, cereals, or smoothies. 

Psyllium can make it harder for your body to absorb other medications, so it’s best to take your medications either two hours before or two hours after taking psyllium.

Probiotics

Probiotics are live microorganisms that can improve human health when taken in the right amounts. Since it’s thought that changes to the gut microbiome (the community of microorganisms living in your gut) are a risk factor for developing IBS, it’s thought that taking probiotics could help reduce IBS symptoms.

Several studies have shown a benefit to taking probiotics when you have IBS. One study found that probiotics containing several different types of bacteria were effective in reducing gas and abdominal pain while increasing the quality of life for IBS patients.

Another study found that probiotics helped relieve constipation in people with constipation-predominant IBS (IBS-C). Probiotics are also effective in treating diarrhea-predominant IBS (IBS-D). One study showed that taking probiotics was associated with better symptom control, less pain and increased quality of life for people with IBS-D.

If you don’t want to take probiotic capsules, try adding more yogurt to your diet. Yogurt is naturally high in probiotics because it uses bacterial cultures during production. A study looking at the effect of two containers of Activia yogurt found that people who ate Activia yogurt daily for six weeks had better improvements in overall discomfort, bloating, and constipation. Look for the “live and active cultures” seal on the label to ensure the yogurt has live bacteria in it.

Iberogast

Iberogast is an herbal supplement that contains extracts of nine different herbs. It has been used to treat gastrointestinal disorders for over 50 years. A study looking at the effectiveness of Iberogast in treating IBS found that taking Iberogast was associated with fewer IBS symptoms and less abdominal pain after four weeks.

Iberogast comes in a bottle with a drop dispenser. For adults and children over 13 years of age, taking 20 drops in a small glass of water or juice three times a day is recommended. If you continue to have symptoms, see your doctor. 

Since Iberogast has not been fully studied for pregnant or breastfeeding people, it should only be taken in these circumstances under the direction of a healthcare professional.

L-Glutamine

L-glutamine is an amino acid, one of the building blocks of your cells. It promotes the growth of several different types of cells in your body, including immune cells and cells in the intestines. 

L-glutamine also controls the “leakiness” of your gut walls. While a small amount of leakiness is important for allowing things like nutrients through, too much leakiness can cause problems. It’s thought that increased gut leakiness is a risk factor for developing IBS. Since low levels of L-glutamine can cause increased gut leakiness, supplementing with L-glutamine may improve IBS symptoms.

A study of people following the low FODMAP diet found that when people added an L-glutamine supplement on top of the low FODMAP diet, they had better relief of their IBS symptoms compared to people who took a whey protein supplement on top of the low FODMAP diet. According to the study, 15 grams of L-glutamine per day was effective in relieving IBS symptoms. 

The low FODMAP diet is quite restrictive and should only be done under the supervision of a healthcare professional.

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Digestive Enzymes

Digestive enzymes are proteins that help break down the food you eat to aid digestion. Some people don’t make enough digestive enzymes, which means they can’t break down certain foods. 

A good example of this is lactose intolerance. People with lactose intolerance do not produce enough of the lactase enzyme, which helps digest lactose. The lactose travels to the large intestine undigested, where it can cause digestive problems like gas, bloating, and diarrhea.

Some people with IBS have lactose intolerance. If this is the case, taking digestive enzymes containing lactase can help improve their symptoms.

Many people with IBS find relief when they follow the low FODMAP diet. FODMAPs are carbohydrates that are not digested by humans. When they enter the large intestine undigested, they get fermented by gut bacteria. This can lead to bloating, abdominal pain, gas, constipation and diarrhea.

Some people think that taking digestive enzymes to break down the FODMAPs before they enter the large intestine could help manage IBS symptoms. One of the FODMAPs that can cause problems for people with IBS is galactooligosaccharides (GOS). A small study of people who were known to be sensitive to GOS found that taking an alpha-galactosidase (the enzyme needed to break down GOS) supplement reduced overall IBS symptoms and bloating. 

However, while some small studies have shown promise, we need more research before we can recommend digestive enzymes for IBS treatment. With the exception of lactase, which can help relieve symptoms for people with IBS who also have lactose intolerance, there isn’t enough evidence that digestive enzymes are helpful.

Peppermint Oil

Peppermint oil is an evidence-based supplement for IBS. Peppermint oil contains a compound called menthol, which helps the bowel wall muscles relax. This can help relieve cramps, bloating, and gas.

A meta-analysis published in 2019 combined the results of 12 randomized trials with 835 patients. They found that taking peppermint oil helped relieve IBS symptoms, especially abdominal pain.

If you’re interested in taking peppermint oil for IBS, start by taking one capsule three times a day. If this is not enough to relieve your symptoms, try taking two capsules three times a day. Keep in mind that it can take up to two weeks for the peppermint oil to take full effect. 

Some people who take peppermint oil may get heartburn or indigestion. If you have heartburn or indigestion, opt for enteric-coated peppermint oil capsules, which do not dissolve until they reach the small intestine. This can help prevent heartburn.

Do not take peppermint oil for longer than two weeks without consulting a doctor.

Slippery Elm

Slippery elm is a tree native to North America. The inner bark is used as medicine. It contains chemicals that increase the secretion of mucous, which could help stomach and intestinal problems like IBS.

A small study looking at the effects of slippery elm, lactulose, oat bran, and licorice root on people with IBS-C found that the supplement was associated with an increased bowel movement frequency, less straining, less abdominal pain, and overall improvement of IBS symptoms. However, since slippery elm was not studied by itself, it’s unclear whether it was the slippery elm or one of the other ingredients that led to the improvement of symptoms. 

Overall, there is not enough high-quality evidence to recommend slippery elm as a treatment for IBS.

Takeaway

Many supplements are advertised as helpful for IBS, but not all of them have enough research to recommend them as an effective treatment for IBS. Some of the most evidence-based supplements for IBS include psyllium, probiotics, Iberogast and peppermint oil.

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See a Dietitian for IBS Online

If you’re considering taking supplements for IBS but aren’t sure which supplements to choose, consider working with an IBS registered dietitian. Nourish offers personalized nutrition counseling and accepts the most popular insurance carriers. If you have IBS and are interested in using supplements, consider booking a virtual appointment with a registered dietitian.

Find a dietitian near you that accepts insurance using Nourish.