Dietary Changes Are More Effective at Treating IBS Symptoms Than a Pharmaceutical Approach

Irritable bowel syndrome (IBS) is a functional bowel disorder that typically responds well to an integrative approach, as illustrated by a study published earlier this year, which featured patients from the University of Kansas Medical Center Integrative Medicine Clinic.

Another recently published study confirmed that dietary treatment is more effective than medications presently used to treat IBS symptoms. That single-center, single-blind, randomized, controlled four-week trial featured patients with moderate-to-severe IBS and compared a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) to pharmaceutical interventions based on the predominant symptom(s). The low FODMAP diet was more effective at reducing symptom severity than medications.

Pharmaceutical Interventions

Presently, there are no medications available that will cure IBS. Pharmacological treatments for IBS are based on the patient’s symptom(s) and can include antispasmodics, intestinal secretagogues, 5-hydroxytryptamin type-3 receptor antagonists, opioid receptor agonists, antidepressants, and selective serotonin reuptake inhibitors.

Unfortunately, many of these medications have side effects. For example, the opioid receptor agonist, eluxadoline, used to treat IBS-D, can cause severe constipation, pain, shortness of breath, chest pain, or difficulty swallowing or breathing. Alosetron is also used to treat IBS-D, and it can cause serious gastrointestinal side effects, including severe constipation and ischemic colitis.

Lubiprostone is used to treat IBS-C, and in addition to actually causing IBS-C symptoms such as bloating, pain, and gas, side effects also include dizziness, tiredness, chest discomfort, and swelling of the hands, feet, ankles, or lower legs. Linaclotide is also used to treat IBS-C, and animal studies have shown that it can lead to life-threatening dehydration, as well as dizziness, fainting, severe stomach pain, and headaches.

Natural Interventions

In addition to recommending a low FODMAP diet, research regarding the use of herbs and other natural substances to treat IBS symptoms has been growing over the years. For example, a 2023 systematic review found that herbal remedies for IBS-C improved bowel frequency, stool consistency, abdominal pain, and quality of life.

A 2021 paper explained that psyllium supplements can benefit both IBS-C and IBS-D. A 2019 meta-analysis found that peppermint oil was effective at relieving IBS symptoms. In addition to being a carminative herb that has antispasmodic effects, peppermint oil also has antimicrobial, anti-inflammatory, antioxidant, and immunomodulating effects.

Probiotic supplements can also help with symptom relief with both IBS-C and IBS-D. A 2022 review indicates probiotics can help alleviate gas, bloating, abdominal pain, and bowel urgency. A 2023 review came to the same conclusion and also mentioned that preliminary animal research shows that probiotics can help reduce intestinal inflammation.

Research demonstrates that acupuncture and moxibustion can be effective at treating IBS symptoms. Interestingly, a new meta-analysis featuring patients with IBS-D along with anxiety and depression found that acupuncture and moxibustion therapies helped reduce anxiety and depression, which are known to be either a cause or consequence of IBS-D.

An integrative approach to treating IBS features many options and treatment strategies in addition to the ones mentioned. Through a combination of diet, acupuncture, lifestyle advice, and/or dietary supplements, integrative practitioners can help their patients reduce IBS symptoms and avoid potentially harmful medications.