Irritable Bowel Syndrome: In Depth

IBS is a chronic disorder that affects the large intestine and causes symptoms such as abdominal pain, cramping, constipation, and diarrhea. (Shutterstock)

What Is IBS?

IBS is a chronic disorder that affects the large intestine and causes symptoms such as abdominal pain, cramping, constipation, and diarrhea.

As many as one in five Americans have symptoms of IBS. The cause of IBS isn’t well understood but stress, large meals, certain foods, and alcohol may trigger symptoms in people with this disorder.

What the Science Says About the Effectiveness of Complementary Health Approaches for IBS

Some evidence is emerging that a few complementary health approaches may be helpful for IBS. However, the research is limited so we don’t know for sure.

Psychological and Physical Approaches for IBS

• Acupuncture
  • For easing the severity of IBS, actual acupuncture wasn’t better than simulated acupuncture, a 2012 systematic review reported.
  • A 2009 clinical trial included in the review found that of the 230 participants with IBS, those who received either actual or simulated acupuncture did better than those who received no acupuncture.
• Hypnotherapy (hypnosis). Researchers are studying gut-directed hypnotherapy (GDH), which focuses on improving bowel symptoms. Several IBS studies have found an association between hypnotherapy and long-term improvement in gastrointestinal symptoms, anxiety, depression, disability, and quality of life. The American College of Gastroenterology stated in a 2014 paper that there is some evidence that hypnosis helps with IBS symptoms, but the research is very uncertain.
• Mindfulness meditation training. Some studies suggest that mindfulness training helps people with IBS, but there’s not enough evidence to draw firm conclusions.
  • The American College of Gastroenterology stated in a 2014 paper that the few studies that have looked at mindfulness meditation training for IBS found no significant effects. But the authors noted that given the limited number of studies, they can’t be sure it doesn’t help. A 2013 review that included these and other studies concluded that mindfulness training improved IBS-associated pain and quality of life but not depression or anxiety. The amount of improvement was small.
• Yoga. In a small 2014 NCCIH-supported study, young adults (18 to 26 years old) reported generally feeling better and having less pain, constipation, and nausea after completing a series of yoga classes, compared with a waitlist control group. They were still feeling better at the study’s 2-month followup.

Dietary Supplements for IBS

A variety of dietary supplements, many of which are Chinese herbs and herb combinations, have been investigated for IBS, but we can’t draw any conclusions about them because of the poor quality of many of the studies.

• Chinese herbs. In a 2008 systematic review, a combination of Chinese herbs was associated with improved IBS symptoms, but extracts of three single herbs had no beneficial effects.
• Peppermint oil. Peppermint oil capsules may be modestly helpful in reducing several common symptoms of IBS, including abdominal pain and bloating. It’s superior to placebo in improving IBS symptoms, the American College of Gastroenterology stated in a 2014 paper.
• Probiotics. Generally, probiotics improve IBS symptoms, bloating, and flatulence, the American College of Gastroenterology stated in a 2014 paper. However, it noted that the quality of existing studies is limited. It’s not possible to draw firm conclusions about specific probiotics for IBS in part because studies have used different species, strains, preparations, and doses.

• If you’re considering a practitioner-provided complementary practice such as hypnotherapy or acupuncture, ask a trusted source (such as the health care provider who treats your IBS or a nearby hospital) to recommend a practitioner. Find out about the training and experience of any practitioner you’re considering. For information about selecting a complementary health practitioner go to nccih.nih.gov/health/tips/selecting and nccih.nih.gov/health/howtofind.htm.
• Keep in mind that dietary supplements may interact with medications or other supplements and may contain ingredients not listed on the label. Your health care provider can advise you. If you’re pregnant or nursing a child, or if you’re considering giving a child a dietary supplement, it’s especially important to consult your (or your child’s) health care provider.
• Tell all of your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.