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Herbal treatment for IBS

  • Dr. Amparo Aracil
    Dr. Amparo Aracil

    Amparo is a medical herbalist and doctor interested in community herbalism and acute medicine. Amparo combines¬†their work as a herbalist with working as a doctor, previously¬†for the NHS¬†and now in both primary care and A&E in Spain.¬†Amparo¬†has¬†also¬†worked with Herbalists Without Borders Calais providing first aid and herbal medicine to migrants and refugees. Having a special interest in psychoneuroimmunology and auto-immune conditions, they have extensive clinical experience helping people with ulcerative colitis, Crohn’s disease, rheumatoid arthritis and¬†thyroid disorders.

    Amparo has been involved with writing lectures and teaching clinical skills for Heartwood students, and runs student clinics on a monthly basis.

    Amparo is a registered member of the National Institute of Medical Herbalists and the General Medical Council. You can find more about them at their website.

  • 8:43 reading time (ish)
  • Digestion & Nutrition Western Herbal Medicine

IBS is a common debilitating condition that can be treated effectively with herbs.

Irritable Bowel Syndrome (IBS) is one of the most common digestive health diagnoses nowadays (1). Many people suffering with digestive complaints end up being diagnosed with IBS. IBS is characterised by recurrent abdominal pain that is associated with change in bowel movement frequency, whether that is diarrhoea, constipation or alternating between the two (2).

Herbal treatment for IBS

Remember though, that a sudden onset of change in bowel movements that persists in time, as well as blood or mucus in your stools should always be checked by a qualified healthcare professional that can direct you to appropriate testing. 

IBS is a diagnosis of exclusion, which means that people get given that diagnosis when tests for other conditions come back negative. 

There are three IBS subtypes depending on what symptoms people suffer with (2). These are: 

  • IBS-C: mostly constipation 
  • IBS-D: mostly diarrhoea 
  • IBS-M: a combination of both of the above 

Other symptoms of IBS include bloating, flatulence, passing mucus with stools, feeling nauseous and bowel incontinence (1,2). 

IBS is now considered to be a brain-gut interaction disorder, hence why many people find that their psychological and emotional state affect their IBS symptoms considerably (3,4). 

Some factors triggering IBS are the following: psychosocial stress, altered gut-brain interactions, increased intestinal permeability, gut mucosal immune activation, dysbiosis, bile acids, specific food triggers, some medications or supplements, and sometimes gut infections (1,4).

The right herbal strategy can be chosen depending on what symptoms someone has, and what are the individual triggers for that person. Anti-inflammatory and anti-spasmodic herbs are important, for example chamomile, cramp bark, valerian, peppermint, lemon balm or fennel. Demulcent herbs to heal the gut mucosa are very relevant too, these include slippery elm, marshmallow root or plantain though one must be careful with sourcing slippery elm as it has major sustainability issues (for advice on this topic see this article). Because of the gut-brain connection, nervine tonics and relaxants can be very helpful, for example chamomile, lemon balm, valerian, vervain and skullcap. When flatulence is a problem carminative and aromatic herbs like cinnamon, aniseed, angelica, fennel or chamomile are added (3,5). 

People suffering with IBS-D, where diarrhoea is one of main symptoms of IBS, astringent herbs can be very helpful, for example agrimony, yarrow or thyme. For people suffering with IBS-C, where constipation is one of the main symptoms of IBS, mild laxatives like aloe vera juice, licorice or dandelion root are recommended. A meta-analysis showed that soluble fibre such as psyllium seeds was beneficial in IBS especially to alleviate constipation (6).  Our research seed on psyllium husk for ulcerative colitis shares some more on how it can support inflammatory conditions of the gut. When there is marked IBS-C and constipation is a big problem, you can try with bitter herbs like gentian, milk thistle or feverfew. These should however be avoided in IBS-D. A really good option for people dealing with IBS-M, where there is a combination of diarrhoea and constipation, is slippery elm (3, 5), with a more sustainable replacement herb being marshmallow root which has the same soothing mucilaginous properties.

When IBS is paired with abdominal pain or dyspepsia, there is some research supporting the use of globe artichoke in these cases. Globe artichoke contains cynarin and cynaropicrin, phytochemicals which have been shown to stimulate bile production and enhance liver function (7). This can aid in digestion and alleviate symptoms of dyspepsia, such as bloating and indigestion. Additionally, globe artichoke can help regulate bowel movements, making it beneficial for individuals with IBS. Studies have suggested that globe artichoke extract can reduce symptoms of both IBS and dyspepsia, including abdominal pain and discomfort (8). 

There is also some evidence suggesting that dysbiosis and gut barrier dysfunction play a role in IBS, so addressing dysbiosis is considered an important therapeutic strategy (2). Examples of good herbs to improve dysbiosis and gut barrier function are barberry and berberine containing plants, chamomile, cinnamon and turmeric. If you are interested on this topic, you can read more about correcting dysbiosis and keeping a healthy microbiome on our Best herbs for the microbiome article.

For some people IBS symptoms flare up with their menstrual cycle, so when this is the case the medicinal plant chaste tree would be a good addition (5). 

But remember that that diet is important too! Temporarily avoiding hard to digest proteins like gluten and dairy, as well as avoiding gut stimulants such as coffee is recommended (2). Trying the FODMAP diet can also be of benefit. The main objective of the FODMAP diet is to avoid short chain carbohydrates and reduce fructose content in the diet. Examples of high fodmap foods include garlic, onions, asparagus, artichokes, beans, lentils, dairy products, and wheat products. As this can get quite complex and many of the FODMAP foods are overall healthy foods, it is best when done under the guidance of a herbalist or a qualified healthcare practitioner who is familiar with IBS, herbs and dietary advice. 

Common drugs used to treat symptoms of IBS include mebeverine or trimebutine for abdominal pain, loperamide or rifaximin for diarrhoea, and tegaserod or prucalopride for constipation. 

Dr. Amparo Aracil

Amparo is a medical herbalist and doctor interested in community herbalism and acute medicine. Amparo combines their work as a herbalist with working as a doctor, previously for the NHS and now in... Read more

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