Originally appeared in the article, "Home Remedies for IBS," by Leoni Jesner, ACE-CPT on December 6, 2021.

Irritable Bowel Syndrome (IBS) is a chronic disorder that comes with a list of unpleasant symptoms including abdominal pain, bloating, cramping, and fluctuations between constipation and diarrhea. In Western countries, IBS affects 10 to 20% of the adult population and is twice as common for women.1

"Worldwide, it affects almost 1 billion people, although there are varying degrees in the severity of IBS and a variation in symptoms," explains Mark Pimentel, MD a gastroenterologist and associate professor of gastroenterology at Cedars-Sinai in Los Angeles, California.

Catherine McQueen / Getty ImagesCatherine McQueen / Getty Images

It may not come as a surprise then that IBS is one of the most common functional gastrointestinal (GI) disorders seen by physicians within the U.S. and worldwide, says Melanie Keller, ND, a naturopathic doctor and epigenetic intuitive. However, there are many who do not seek medical care for their symptoms.

"Functional disorders are conditions when there is an absence of structural or biochemical abnormalities on common diagnostic tests that could explain symptoms," says Dr. Keller. "Among the patients who do seek care, about 40% have mild IBS, 35% moderate IBS, and 25% severe IBS."

Symptoms of IBS

Not everyone experiences IBS in the same ways. Here are some common signs and symptoms of IBS.2

  • Experiencing pain in the abdomen especially with regard to bowel movements
  • Noticing changes in bowel habits including diarrhea, constipation, or sometimes both
  • Feeling that you have not completed a bowel movement
  • Having whitish mucous in your stool
  • Noticing an increase in symptoms around your menstrual cycle if you have one

To diagnose IBS, a healthcare provider will look for a pattern in your symptoms over time. Because IBS is a chronic disorder, it lasts a long time with symptoms often coming and going.

What Causes IBS?

A magnitude of factors can contribute to IBS, some of which are more prevalent than others. In many cases, pinpointing the exact cause can be a challenge. Here is a closer look at some of the things that can contribute to IBS symptoms.

Food Poisoning

One of the most common causes of IBS is food poisoning. A second-generation antibody blood test called IBSsmart can confirm this. In fact, one in nine people who experience food poisoning develop IBS, says Dr. Keller.

"Post-infectious irritable bowel syndrome (PI-IBS) is a form of IBS caused by food poisoning and almost always has a diarrheal component," she adds.

A systematic review and meta-analysis of over 21,400 patients with enteritis (caused by bacteria or virus-contaminated food or drinks) found that the risk of IBS was four times higher compared to those without infectious enteritis.3

The IBSsmart blood test measures anti-CdtB and anti-vinculin antibodies, biomarkers that can distinguish IBS from inflammatory bowel disease, such as Crohn’s Disease. Crohn's disease has been found to cause ongoing severe inflammation of the gut, according to Dr. Pimentel.4

By definition, IBS does not present with visible inflammation. However, though it may not be seen during routine diagnostic testing, it may still be involved.

Evidence of low-grade chronic inflammation on a cellular level in some individuals who suffer from IBS is beginning to build. This inflammation is thought to be associated with cases in which IBS was preceded by a bout of gastroenteritis, the condition classified as IBS-PI. 

Small Intestinal Bacterial Overgrowth

Small intestine bacterial overgrowth (SIBO) occurs when bacteria usually found in the large intestine overgrows in the small intestine. It is sometimes considered a potential cause of IBS.

"The most common symptoms of SIBO are persistent abdominal pain, cramping, gas, bloating, and diarrhea, with those experiencing constipation possibly due to intestinal methanogenic overgrowth (IMO)," says Dr. Keller.

The latter is caused by microorganisms with methane (methanogens) which can also overgrow in the small bowel or colon and lead to constipation.5 In short, more focus is being placed on the role of gut bacteria and the bacterial makeup of IBS patients who do not have the disorder to understand if bacteria in the small intestine contributes to IBS.

"Both conditions [SIBO and IMO] can be diagnosed with a simple breath test and there are options available for treatment," she says.

Food Additives

Although most studies on the effects of food additives have yet to be performed on humans, evidence suggests that artificial sweeteners can exasperate IBS. First polyols, which are found within FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), are short-chain carbohydrates and are closely linked with symptoms of IBS.

The development of IBS is linked to changes in the gut bacteria and therefore foods that are poorly digested only make things worse.

— MARK PIMENTEL, MD

Also, the consumption of processed food has only risen in recent decades, suggesting that alterations to food additive-induced microbiota may be a growing cause of IBS in Western countries.6

"The development of IBS is linked to changes in the gut bacteria and therefore foods that are poorly digested only make things worse," says Dr. Pimentel. "The most problematic food additives are non-absorbed sugars such as sorbitol and sucralose."

Also, Dr. Keller suggests stopping the intake of stevia as it can interrupt the cleaning wave of the gut, which is called the migrating motor complex. Doing so can prevent an overgrowth of bacteria in the small intestine.

Psychological Stress

A study on psychological stress and IBS points to growing evidence that the condition is a stress-sensitive disorder, and a link between brain and gut is contributing to flare-ups known as irritable bowel and irritable brain.

Psychological stresses have an impact on intestinal sensitivity among other gut functions including alterations in gastrointestinal microbiota. One study suggests that managing stress and triggers to stress is one approach to treat IBS.7

As our bodies respond to both internal and external stressors, practices such as deep breathing, meditation, and relaxation exercises can help in managing symptoms.

Home Remedies

Depending on the severity of symptoms, there are several home remedies that may ease some of your discomforts. These options may help you naturally manage your IBS. But, if your symptoms persist or worsen, you should see a healthcare provider for an accurate diagnosis and treatment options.

Peppermint Oil

Peppermint has long been used to treat digestive problems and is known for reducing intestinal gas. A randomized trial with patients suffering from IBS found that an 8-week treatment of small-intestinal-release peppermint oil reduced symptoms of abdominal pain, discomfort, and the severity of IBS.8

"Peppermint tea and/or a concentrated oil can be soothing for those with abdominal pain/discomfort," says Dr. Keller.. "[Peppermitn] may also be used to make a compress that can be applied to the abdomen."

 

Try Ginger Root

Ginger has long been hailed for its host of health benefits, including nausea relief, pain reduction, and its ability to calm an upset stomach.

"Ginger root contains powerful digestive enzymes that may help to relieve nausea, while also offering mild anti-inflammatory properties to ease abdominal pain, discomfort, and the intestinal cramping and inflammation associated with diarrhea," says Dr. Keller. "It's easy to add fresh ginger root to your meals, with crystallized ginger also a convenient remedy."

You can also make your own ginger tea by grating the root into hot water before straining and adding honey for a dash of sweetness.

Find the Right Meal Times

Allowing 4 hours between meals has been found to optimize the gut's cleaning wave function, according to Dr. Keller. Many people with IBS benefit from spaced-out meals, as well as intermittent fasting.

On the other hand, some find that smaller, frequent meals are less stressful on the digestive tract and promote better bowel regularity. Another consideration is watching how much air you take in while eating or drinking. For instance, avoid inhaling additional air when drinking with a straw or eating as it can increase the likelihood of bloating and intestinal gas.

Alter Your Diet

Many foods can trigger IBS, such as gluten, carbonated drinks, fried foods, and dairy. Through food elimination, you may be able to identify such triggers. Another popular method is adopting a low-FODMAP diet.

This eating plan is still nutritionally dense, yet reduces many short-chain carbohydrates that can increase digestive symptoms. Foods on the list include bananas, raspberries, olives, rice, oats, and some cheeses.

An observational study on 90 patients with IBS following a low FODMAP diet found that abdominal pain and discomfort, as well as constipation, bloating, and bowel urgency, improved. In fact, 75% said they found relief in their symptoms. However, not all studies on consuming low FODMAP have concluded the same results, and therefore more research on its long-term effects is required.9

Address Probiotic Intake

Although probiotics are promoted for their benefits in restoring gut flora, they can sometimes alter your unique microbiota in unfavorable ways. That is because with multiple strains available, finding the right version for you can take trial and error.

"SIBO is an overgrowth of 'good' bacteria that are getting stuck in the small intestine and haven’t moved into the large intestine where they are our friends," explains Dr. Keller. "Clinically as an epigenetic intuitive, I’ve seen probiotics contributing to the problem and I recommend pausing them at least 21 days to find out."

Daily probiotics in supplement form, as well as in food such as yogurts and even in drinks may be contributing to your issues. If you are still experiencing gastrointestinal discomfort after 4 weeks on a probiotic, research suggests switching to a different strain until benefits are evident. However, the unknown remains as to their long-term effects.>10

 

When to Contact a Healthcare Provider

If your symptoms do not get better with diet and lifestyle changes, you should see a healthcare provider for evaluation. You also should see a healthcare provider if:11

  • You notice changes in your stool like blood, pus, or tar-like appearance.
  • Your symptoms seem to have come out of nowhere over the past few weeks.
  • You experience unexplained weight loss, fever, or diarrhea.
  • Your pain wakes you up at night or interferes with your day-to-day life.
  • You are over the age of 50.

A Word From Verywell

The causes of IBS are complex and still evolving. Although there is no definitive reason as to why people are affected by IBS, there are a number of remedies that can ease symptoms including peppermint oil, spacing out meals, and watching what food additives you consume.

If your symptoms are severe, do not hesitate to contact a healthcare provider who can advise what medical treatments are available. They also can offer suitable lifestyle adjustments to help you manage the symptoms of your IBS.

Sources

1. Varjú P, Farkas N, Hegyi P, et al. Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (Fodmap) diet improves symptoms in adults suffering from irritable bowel syndrome (Ibs) compared to standard IBS diet: A meta-analysis of clinical studies. Stengel A, ed. PLoS ONE. 2017;12(8):e0182942. doi:10.1371/journal.pone.0182942

2. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms and causes of irritable bowel syndrome.

3. Klem F, Wadhwa A, Prokop LJ, et al. Prevalence, risk factors, and outcomes of irritable bowel syndrome after infectious enteritis: a systematic review and meta-analysisGastroenterology. 2017;152(5):1042-1054.e1. doi:10.1053/j.gastro.2016.12.039

4. Talley NJ, Holtmann G, Walker MM, et al. Circulating anti-cytolethal distending toxin b and anti-vinculin antibodies as biomarkers in community and healthcare populations with functional dyspepsia and irritable bowel syndromeClin Transl Gastroenterol. 2019;10(7):e00064. doi:10.14309/ctg.0000000000000064

5. Takakura W, Pimentel M. Small intestinal bacterial overgrowth and irritable bowel syndrome – an updateFront Psychiatry. 2020;11:664. doi:10.3389/fpsyt.2020.00664

6. Rinninella E, Cintoni M, Raoul P, Gasbarrini A, Mele MC. Food additives, gut microbiota, and irritable bowel syndrome: a hidden trackInternational Journal of Environmental Research and Public Health. 2020;17(23):8816. doi:10.3390/ijerph17238816

7. Qin HY, Cheng CW, Tang XD, Bian ZX. Impact of psychological stress on irritable bowel syndromeWorld J Gastroenterol. 2014;20(39):14126-14131. doi:10.3748/wjg.v20.i39.14126

8. Weerts ZZRM, Masclee AAM, Witteman BJM, et al. Efficacy and safety of peppermint oil in a randomized, double-blind trial of patients with irritable bowel syndromeGastroenterology. 2020;158(1):123-136. doi:10.1053/j.gastro.2019.08.026

9. Capili B, Anastasi JK, Chang M. Addressing the role of food in irritable bowel syndrome symptom management. The Journal for Nurse Practitioners. 2016;12(5):324-329. doi:10.1016/j.nurpra.2015.12.007

10. Cozma-Petruţ A, Loghin F, Miere D, Dumitraşcu DL. Diet in irritable bowel syndrome: What to recommend, not what to forbid to patientsWorld J Gastroenterol. 2017;23(21):3771-3783. doi:10.3748/wjg.v23.i21.3771

11. University of Michigan Health. Irritable bowel syndrome.