Best Supplements for IBS

Best Supplements for IBS

It’s been suggested that between 8% and 22% of people suffer from Irritable Bowel Syndrome (IBS). As scientists have yet to agree on a foolproof treatment for such a common condition it’s natural that many sufferers turn to supplements. The question is really whether supplements can actually help, and if so which are likely to be most beneficial?

Probiotics

Once an exotic and unusual idea, in recent years the consumption of “friendly bacteria” has become quite mainstream. Found in anything from yogurts to drinks, there’s some fascinating science to suggest that they may also help soothe the symptoms of IBS.

With so many people routinely suffering from IBS, and considering the negative impact the condition can have on quality of life, it is perhaps odd that scientists aren’t yet full agreed on the root causes.

All the same, repeated studies have demonstrated differences in gut bacteria between those who suffer from IBS and those who do not. For example, IBS sufferers tend to be unusually low in two particular bacterial strains known as “Lactobacillus” and “Bifidobacterium”. It has been suggested that this may affect how food is digested, leading to the symptoms we experience as IBS.

Furthermore, the “gut microbiome” as it is often known, is at the forefront of research. Every year we learn more about the direct impacts of bacteria on the wider human body. For example, one study claimed that probiotics “enhance gut barrier function, inhibit pathogen binding and modulate gut inflammatory response”. In other words, they help to support the immune system and reduce unpleasant reactions in the gut. Quite impressive for something that can’t be seen with the naked eye.

There’s more; the effect of probiotics on IBS has been tested repeatedly. One group of researchers pooled the results from dozens of previous studies - something known as a “meta-analysis” - to assess the overall impact of probiotics on IBS. Their findings based on 1,793 patients demonstrated that “probiotics reduce pain and symptom severity scores”.

The research has gone further. We discussed earlier the specific bacterial strains that tend to be present in low doses in IBS sufferers. One study therefore aimed to supplement these specific bacteria, to see if a “top-up” was beneficial for digestion. Participants took either a placebo or a probiotic mixture of Lactobacillus and Bifidobacterium for a period of 4 weeks before their condition was assessed.

Perhaps unsurprisingly, the probiotic group found that their symptoms “significantly decreased” when compared to the placebo group. For example, abdominal pain improved by 20% in just the first two weeks, widening to over 30% after a month. They summarized that probiotics “may be considered a promising approach to the therapy for IBS”.

Other studies have found even more extreme improvements. One assessed IBS as a whole, rather than specific symptoms, and reported a 42% improvement in probiotic users versus the general populace.

This all sounds very positive - but there is a caveat. And it’s an important one.  

Scientists consider IBS sufferers to be “heterogeneous” - there are a range of potential causes. As a result, not every treatment will work for everyone. Even more importantly, in cases where probiotics can offer relief, the specific bacterial strains and the dosing required can also vary.

To quote two scientific studies, “each probiotic has unique features” and as a result “probiotics have considerable potential in the management of IBS... however the benefits are strain specific.”  

The key message here is that you may need to experiment a little. If you’ve tried probiotics before but experienced no noticeable benefit then it may be worth trying again. Test out a different variety, or modify the dosage you take, to see if there are any improvements.

And if you’re new to probiotics but are looking for a good starting point then consider looking for one that offers both Lactobacillus and Bifidobacterium as this seems like the combination with the most scientific evidence - like our own Super ProBio Complex supplement.

Fibre & Prebiotics

We all know that fibre is important in our diets. Despite this knowledge, statistics show that many of us aren’t getting the recommended dose.

Fibre can serve a number of purposes in the gut. Firstly, as is commonly known, it helps to keep us “regular” by moving food through the digestive tract. Secondly, it can serve as a source of food for our friendly gut bacteria. This type of fibre is often referred to as a “prebiotic”.

As we’ve already discussed, the right mixture of gut bacteria can improve many cases of IBS. Therefore it logically follows that fibre may also be beneficial. After all, why would you plant a seed and not water it?

But what does the science tell us?

Let’s start by looking broadly at any source of fibre. Here the results seem quite clear. For example, in a case where 72 IBS sufferers were encouraged to eat a high fibre diet “all patients... reported an improvement”. This was the result of consistently consuming at least 30g of fibre per day.

A meta-analysis of 20 previous rigorous experiments found that, in general, fibre was “effective” in the relief of IBS symptoms, though they cautioned that the results varied significantly.

So fibre and prebiotics show some positive impacts. Although detailed studies have shown that the impact is far from uniform. Some forms of fibre seem to be far more beneficial than others when it comes to IBS.

Consider bran; a cheap, widely-available and well-known source of fibre found in many common breakfast cereals. One hundred IBS sufferers were encouraged to eat more bran and to track the results. Surprisingly, only 10% of volunteers reported any benefit. Even more worryingly, 55% said their symptoms actually got worse.

Another study found that 52% of patients given 12g of bran per day reported improved symptoms. This sounds quite impressive until you realise that 54% of those taking a harmless placebo also saw improvements. In other words, quoting directly from the results “bran supplementation was no more effective than placebo”. More so, “for wind-related symptoms it [bran] was significantly less effective”.

So what does seem to have a positive effect? The answer, it seems, are so-called “soluble” fibres. A study that compared different types of fibre for their effectiveness in cases of IBS found that “soluble fibre showed significant improvement, whereas insoluble fibre, in some cases, worsened the clinical outcome”.

While there are many forms of soluble fibre, one of the best-known is psyllium husk. Fortunately, this particular variety has been studied extensively.  

Psyllium husk was pitted head-to-head against bran in one scientific study to see how the impact differed. Not only did “significantly” more of the psyllium group respond positively to the treatment, but also “early dropout was most common in the bran group [primarily because] the symptoms of irritable bowel syndrome worsened”.

Further evidence as to the efficacy of psyllium for IBS comes from a study involving childhood IBS. For six weeks the volunteers either consumed a placebo or psyllium husk supplements alongside their standard diet. While no evidence of changes to gut bacteria were observed, improvements were seen in more typical IBS symptoms. Most notably, “psyllium fiber reduced the number of abdominal pain episodes in children with IBS”.  

In conclusion it is worth quoting one final scientific study here which didn’t mix its words when claiming that “fiber supplementation, particularly psyllium, is both safe and effective in improving IBS symptoms”.

When it comes to IBS supplements, therefore, the evidence seems to suggest that sources of soluble fibre are likely to be effective. Of these, psyllium husk is probably the variety that has the most scientific backing as things stand.

You’ll find our psyllium husk capsules here.

Peppermint

Peppermint has been used for generations to soothe stomach upsets. A nice cup of peppermint tea is routinely recommended as a “settler” after a large or rich meal, and many people use it as a natural remedy for travel sickness. Understandably, researchers have therefore investigated its potential application in cases of irritable bowel syndrome.

The first study was admittedly quite small - involving just 24 volunteers. All the same, this limited sample size showed impressive improvements with 75% of IBS sufferers involved reporting reduced discomfort.

A rather more rigorous investigation involved 110 IBS patients. They were encouraged to consume a single peppermint capsule half an hour before eating. This seemingly simple regimen resulted in 79% of participants reporting reduced abdominal pain and flatulence, with an even more impressive 83% claiming reduced bloating.

These results have been mirrored in similar experiments, one of which saw 75% of patients improve simply by consuming two peppermint capsules per day, irrespective of their dietary regime.

While peppermint has perhaps received less attention than some other solutions as a natural remedy for IBS, the results are generally quite impressive.

Fortunately peppermint has a very good safety profile, having been used for centuries. It could therefore represent a worthwhile addition to your routine if you’re struggling with irritable bowel syndrome.

You can learn more about our peppermint tablets here.

What Else Can Help?

While the above supplements all show positive results in the scientific literature, they are of course far from the only treatment options available. It is advisable that you speak to your doctor if suffering from IBS, as they may be able to make additional or alternative suggestions. Here are some options that may be discussed...

Exclusion Diets

Many IBS sufferers find that certain foods - or even individual ingredients - can cause a flare-up of their condition.

The FODMAP diet is probably the best-known of these. FODMAP stands for “fermentable oligo-, di-, mono-saccharides and polyols”. This is quite a mouthful - hence the standard use of an acronym to describe it.

Broadly speaking the FODMAP diet seeks to restrict foods that are high in these elements. Examples of foods affected can include grains, dairy, artificial sweeteners and some fruits and vegetables.

An exclusion diet eliminates these “high risk” elements from the diet. They are then slowly re-introduced one-by-one until an episode occurs. With enough patience and suitable record keeping many patients are able to identify their “trigger foods”. These can then be excluded from the diet entirely going forward.

Antispasmodics

Antispasmodic drugs are medicines formulated to suppress spasms of the muscles. There is good evidence to show that an overactive gut is characteristic of IBS. By taking an antispasmodic these spasms should decline over time, leading to greater comfort and more reliable bowels.

While extensive studies have demonstrated the effectiveness of antispasmodics these will generally need to be prescribed by a medical professional.

Relaxation Techniques

Behavioural analyses have shown that IBS often comes bundled with psychological conditions. While it is too early to decipher which condition affects the other, there have been improvements in IBS symptoms from treating conditions such as anxiety or depression.

Relaxation techniques, meditation, deep breathing and even hypnotism have all shown some positive results in the past. Indeed, some professionals have even utilised antidepressants with purportedly good results.

With the exclusion of prescription drugs, all of these can be considered complementary or alternative therapies. What makes these concepts appealing is that they can generally be used safely alongside more traditional solutions without the risk of side effects.

If you’re currently experimenting with probiotics, soluble fibre and peppermint then adding some focused relaxation is only likely to help further.   


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