Irritable bowel syndrome (IBS) is a functional disorder of the lower intestines and is associated with the symptoms of abdominal pain and diarrhea or constipation or a combination of both.
Abdominal colonic fermentation due to altered bacteria flora in the colon has been proposed as a cause of IBS symptoms.Adding probiotics, which are beneficial bacteria found normally in the intestines and in certain foods, may relieve the symptoms of IBS (1)
M.Simren, M.D., of Sahlgrenska University Hospital in Gothenburg, Sweden, led a clinical trial which looked at the effect of probiotic bacteria on the symptoms of IBS. The participants were 74 patients with IBS, who were divided into two groups. For an 8 week period, the control group added 400 ml of acidified milk with no added bacteria to their daily diet. The test group added 400 ml of milk fermented with probiotic and yogurt bacteria to their daily diet for eight weeks. The yogurt bacteria included Lactobacillus paracasei, Lactobacillus acidophilus, and Biffidobacterium. The severity of IBS symptoms was gradually reduced during the 8 week treatment period for both groups. The test group noted a positive effect during the first week. The researchers could not detect significant differences between the two groups but support further assessment of the effects of probiotics in individuals with IBS. (2)
Soluble fiber in the dietary form of psyllium has more effective benefits for people with IBS in comparison to insoluble fiber, such as bran. C.J. Bijkerk, M.D., and his colleagues from the University Medical Center Utrecht in Utrecht, Netherlands, studied the effect of soluble and insoluble fiber on the symptoms of IBS. The group included 275 patients in a general practice setting who were diagnosed with IBS. The patients were divided into three groups. One group received 10 grams of psyllium daily, the second group received 10 grams of bran daily, and the third or control group received 10 grams of rice flour daily. At the end of the 12 weeks of the trial, symptom severity decreased by 90 points in the group receiving psyllium, the soluble fiber. IBS symptom severity decreased by 58 points in the group receiving bran, the insoluble fiber. The participants in the control group who received the rice flour, the placebo, scored 49 points for symptom severity reduction. (2)
Some people with IBS tolerate fiber supplements better than dietary fiber. Fiber supplements such as psyllium (Metamucil) or methylcellulose (Citrucel) taken with fluids may help control constipation and cause less gas and bloating. If using fiber supplements, it is important to gradually introduce the supplement into the diet and drink plenty of water daily to minimize constipation, bloating, and gas. (1)
Peppermint, which is a natural antispasmodic, may provide short term relief of IBS symptoms by relaxing the smooth muscles of the intestines. Research results are inconsistent and it is best to check with your physician before taking peppermint or any herbal supplements. Herbal supplements can interact or interfere with prescription medications. Peppermint may aggravate heartburn and enteric coated capsules are recommended. (1)
(1) www.mayoclinic.com
(2) www.medscape.com
Maryann Gromisch is a registered nurse with clinical experience in medical, surgical, and critical care units. She has experience assisting a gastroenterologist in a private practice setting.