Many patients with irritable bowel syndrome (IBS) use herbal and homeopathic remedies to help manage their symptoms. These may be used in combination with traditional medicines (complementary medicine), or as alternatives to traditional medicine.
Herbal remedies refer to the use of plant and plant extracts. Homeopathy is the practice of treating patients with the smallest amounts of substances, which may include herbal remedies, and is a holistic practice that seeks to cure the patient on the physical, mental and emotional levels. There are many different herbal and homeopathic remedies, however only some have been studied in clinical trials. The most clinically proven herbal remedy for IBS is peppermint oil.1
Other herbal remedies that have been investigated by researchers as possible treatment options for IBS include:
- Curcuma longa – In an 8-week study, patients receiving Curcuma longa reported significant improvements in their quality of life and reduction in abdominal pain and discomfort. Approximately two thirds of all subjects reported an improvement in symptoms after treatment.
- Cynara scolymus – Cynara scolymus has demonstrated effectiveness to have both preventive and therapeutic roles in IBS. In one study, patients receiving Cynara scolymus reported a decrease in the severity of their symptoms, and 96% of patients rated this treatment as better than or at least equal to previous therapies. Another study showed a decrease in IBS symptoms by 26.4% with a significant shift in self-reported bowel pattern from “alternating constipation/diarrhea” to “normal.”
- Hypericum perforatum (St. John’s Wort) – Hypericum perforatum is a popular herbal medicine for the treatment of depression and may be beneficial in the management of IBS due to its effects on psychological stress and serotonin. There are conflicting results in trials for the efficacy of Hypericum perforatum, although it has shown some effectiveness in improving psychological symptoms and helping with stress-related IBS symptoms.
- Iberis amara – Patients treated with Iberis amara showed significant improvement in their IBS symptoms compared to placebo in a 4-week trial.
- Maranta arundinacea (Arrowroot) – Maranta arundinacea was studied in patients with diarrhea-predominant IBS (IBS-D). It reduced diarrhea and decreased in abdominal pain.
- Plantago psyllium – The effectiveness of Plantago psyllium in IBS was determined in a randomized trial. Patients receiving Plantago psyllium reported significantly improved symptoms: after three months of treatment, symptom severity in the Plantago psyllium group was reduced by 90 points, compared to 49 points in the placebo group.
- Carmint – Carmint is an Iranian herbal medicine that includes extracts of Melissa officinalis, Metha spicata, and Coriandrum sativum. Patients who received Carmint in a trial experienced significantly less abdominal pain and discomfort.
- Chinese herbal medicine – A Chinese herbal medicine composed of 20 different herbs was compared to placebo in a trial. Patients in the Chinese herbal medicine group showed a significant improvement in bowel symptoms.
- Padma Lax – Padma Lax is a complex Tibetan herbal formula. In a clinical trial, significant improvement in the symptoms of constipation, abdominal pain, incomplete evacuation, bloating and gas was demonstrated after 3 months of treatment with Padma Lax compared to the placebo.
- STW 5 (iberogast) – STW 5 is a formula composed of extracts from nine herbs. In clinical trials, it has proven effectiveness in reducing abdominal pain and the severity of IBS symptoms.2
Peppermint Oil (Mentha x piperita)
Of all the herbal remedies, the most well-studied in clinical trials is Peppermint oil, and there is substantial evidence proving its effectiveness. In one placebo-controlled trial, 79% of patients receiving Peppermint oil capsule experienced an alleviation of the severity of abdominal pain, 83% had less bloating, 83% showed a reduction in stool frequency, and 79% had less flatulence (gas). Symptom improvements were significantly better than placebo. Other trials have also demonstrated the effectiveness of Peppermint oil in abdominal pain and quality of life. No significant adverse reactions, or side effects, have been reported from Peppermint oil capsules. Mentha, the chemical component in Peppermint oil, has been shown to have antimicrobial and antispasmodic activity and cause reduction in gastric motility.2
Additional Treatment Options for IBS
Patients with IBS often try many treatment options before finding the right ones that work to best manage their symptoms. In addition to herbal and homeopathic remedies, patients with IBS may be treated with medications, probiotics, fiber supplements, stress management or dietary changes.