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).
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.
5 herbs to treat IBS
Even if some people can find these drugs helpful sometimes, these are 5 herbs that can be used instead of drugs to alleviate IBS symptoms:
Chamomile, a gentle and soothing herb, offers several benefits for people suffering from IBS. One of its primary advantages lies in its anti-inflammatory properties, which can help alleviate the inflammation and discomfort associated with IBS symptoms (5). Chamomile also has muscle-relaxant properties, aiding in the relaxation of the gastrointestinal muscles and reducing painful spasms and cramps commonly experienced in IBS (3). Furthermore, its calming and anxiety-reducing effects make it a good herb to reduce stress and anxiety, therefore downregulating the brain-gut interaction, potentially leading to fewer flare-ups (3, 4). Chamomile can be drunk as a tea or can be used in tincture form.
Cramp bark is an anti-spasmodic herb, and it can be very beneficial easing abdominal cramping associated with IBS (3). By helping to calm the smooth muscles of the gastrointestinal tract, cramp bark can alleviate some of the discomfort and pain experienced by those with IBS. Additionally, it can have a soothing effect on the digestive system, potentially reducing the severity and frequency of IBS symptoms (3).
Lemon balm is an aromatic and calming herb that is renowned for its ability to alleviate gastrointestinal discomfort with a nervous origin, making it a promising choice for people with IBS (5). Lemon balm also has anti-spasmodic properties that can help soothe and relax the muscles of the digestive tract, reducing painful cramps and spasms (3). Moreover, its mild sedative qualities can help manage stress and anxiety, which often exacerbate IBS symptoms. Where in a tea or a tincture, lemon balm can provide a gentle and soothing approach to ease abdominal discomfort in individuals with IBS.
Peppermint is a well-known and now widely researched digestive herb. Research has consistently demonstrated its effectiveness in alleviating IBS symptoms (9). Peppermint, and in particular peppermint oil contains the active compound menthol, which has muscle-relaxant properties (4, 9). This makes it yet again another good herb for people suffering with abdominal cramping. Clinical trials have focused on researching peppermint oil, then they have shown that peppermint oil can effectively alleviate abdominal pain, bloating, and discomfort in IBS patients (9).
Peppermint can also help regulate digestive motility, promoting more regular bowel movements (5). The cooling and soothing effect of peppermint can also alleviate symptoms of indigestion and flatulence. Some people find peppermint helpful to alleviate oesophageal reflux, but others find it makes their reflux worse, so this should be taken into consideration in people suffering with heartburn or aid reflux (9).
Slippery elm, widely used as a powder derived from the inner bark of the slippery elm tree, also can be very helpful in IBS. Slippery elm powder forms a soothing and protective layer along the digestive tract, which helps to alleviate the irritation and inflammation often associated with IBS (3). Slippery elm’s mucilage content also aids in reducing the severity of abdominal pain and discomfort by calming the smooth muscles of the gastrointestinal tract (5). Additionally, it can provide relief from both diarrhoea and constipation, making it a versatile option for different IBS subtypes. While scientific research on slippery elm for IBS is somewhat limited, it has a long history of traditional use (5).
- Camilleri, M. (2021). Diagnosis and treatment of irritable bowel syndrome: a review. Jama, 325(9), 865-877.
- Altomare, A., Di Rosa, C., Imperia, E., Emerenziani, S., Cicala, M., & Guarino, M. P. L. (2021). Diarrhea predominant-irritable bowel syndrome (IBS-D): effects of different nutritional patterns on intestinal dysbiosis and symptoms. Nutrients, 13(5), 1506.
- Bone, K., & Mills, S. (2012). Principles and practice of phytotherapy: modern herbal medicine. Elsevier Health Sciences.
- Bone, K., & Mills, S. (2021). Functional Herbal Therapy: A Modern Paradigm for Clinicians. Aeon Books.
- Fisher, C. (2018). Materia medica of Western herbs. Aeon Books.
- Moayyedi, P., Quigley, E. M., Lacy, B. E., Lembo, A. J., Saito, Y. A., Schiller, L. R., … & Ford, A. C. (2014). The effect of fiber supplementation on irritable bowel syndrome: a systematic review and meta-analysis. Official journal of the American College of Gastroenterology| ACG, 109(9), 1367-1374.
- Rahimi, R., & Abdollahi, M. (2012). Herbal medicines for the management of irritable bowel syndrome: a comprehensive review. World journal of gastroenterology: WJG, 18(7), 589.
- Bundy, R., Walker, A. F., Middleton, R. W., Marakis, G., & Booth, J. C. (2004). Artichoke leaf extract reduces symptoms of irritable bowel syndrome and improves quality of life in otherwise healthy volunteers suffering from concomitant dyspepsia: a subset analysis. Journal of Alternative & Complementary Medicine, 10(4), 667-669.
- Khanna, R., MacDonald, J. K., & Levesque, B. G. (2014). Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Journal of clinical gastroenterology, 48(6), 505-512.