Herbal Solutions For Irritable Bowel Syndrome

irritable bowel syndrome herbal medicine for IBS IBS solutions natural solutions for IBS natural treatments for irritable bowel syndrome

Irritable bowel syndrome, or IBS, has been researched from many different angles. Some researchers think that most IBS is simply small intestinal bacterial overgrowth (or SIBO) that hasn’t been diagnosed yet, others insist it is a diagnosis of exclusion meaning if you have SIBO you don’t have IBS. 

Today I wanted to explore a simple remedy for IBS that I have been using with great success in my clinical practice. This two herb combination can help to lessen the painful cramping often seen in IBS, is antimicrobial, can stimulate bile flow and reduces inflammation. But before we dive into these two herbs and how they work together to improve IBS symptoms let’s briefly cover what IBS is exactly. 

IBS 101 

Irritable bowel syndrome is a common functional gastrointestinal disorder. The amount of people with IBS ranges depending on the country. The number range with one meta-analysis finding that the lowest prevalence of IBS is in Southeast Asia at 7% of the population. They found that the highest incidence of IBS was in South America at a whopping 21% (1).

Image taken from: Global Prevalence of and Risk Factors for Irritable Bowel Syndrome: A Meta-analysis

Chronic abdominal pain and discomfort and changes in bowel habits are used to diagnose IBS with an absence of an organic disease (ie inflammatory bowel disease or cancer). 

This definition is constantly being updated by the Rome foundation. Currently we are up to the fourth iteration of IBS diagnostic criteria. More on the Rome foundation here.

Rome IV defined irritable bowel syndrome (IBS) as a functional bowel disorder in which recurrent abdominal pain is associated with defecation or a change in bowel habits. Disordered bowel habits are typically present (i.e., constipation, diarrhea or a mix of constipation and diarrhea), as are symptoms of abdominal bloating/distension. Symptom onset should occur at least 6 months prior to diagnosis and symptoms should be present during the last 3 months

Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome
Image taken from: Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome

Two Herbs That Help Irritable Bowel Symptoms 

The two herbal medicines that I turn to in my IBS patients are peppermint and caraway. Each herb has different actions on the digestive and nervous system and can help, sometimes immediately, with the symptoms of IBS. 

Some of the studies that we will be exploring today focus on the oils found in these herbs. I prefer to start with the whole herb, often in tincture form, and work back to the oils if necessary. Making my own herbal medicine really taught me how much essential oils are in these herbs!

Peppermint for Irritable Bowel Syndrome 

Peppermint, or Mentha piperita, is a perennial herb that most people know well. When I think of peppermint I think of a cool tea on a hot day. The essential oils found in peppermint are quite nice and cooling. 

peppermint for IBS, irritable bwoel syndrome herbal medicines, herbs for IBS, natural treatments for irritabel bowel syndrome.

Peppermint contains a range of essential oils including menthol, menthone, isomenthone, 1,8-cineole (eucalyptol), menthyl acetate and menthofuran. Menthol is the major constituent and ranges from 33-60% of the essential oil extracted from peppermint. Peppermint also contains a range of vitamins and minerals as well as numerous polyphenols, mainly flavonoids (3).

Peppermint has a range of actions often overlooked. It has been shown to be:

  • Antioxidant
  • Antitumour
  • Antiallergenic
  • Antiviral 
  • Antibacterial 
  • Antifungal

When we are thinking of how it benefits people suffering from IBS symptoms we are mainly looking at the digestive actions and peppermint has many. 

Peppermint has been shown to be antispasmodic, carminative and even antiemetic. One interesting piece is that peppermint has been shown to improve peristalsis in the gastrointestinal tract which has big implications for small intestinal bacterial overgrowth, or SIBO, patients. 

Be sure to check out the Complete Guide To SIBO Ebook below for a deep dive into small intestinal bacterial overgrowth and how it overlaps IBS.

Animal studies have shown peppermint to have a relaxing effect on the small intestine (the duodenum) – think of the cramping symptoms and how helpful this could be. Peppermint has also been shown to stimulate bile flow (4) – this can help with fat digestion and is even antimicrobial so may also benefit SIBO patients too.  

This spasmolytic action which has a relaxant effect on smooth muscle can also trigger the relaxation of the lower oesophageal sphincter (or LES) and in certain people can trigger a worsening of their reflux (5). In these sensitive people it is important that the peppermint oil is enteric coated to prevent this issue. 

Peppermint even decreased the production of hydrogen sulphide in the large intestines of pigs (6). For a deeper dive on hydrogen sulphide producing bugs check out this article and stay tuned. I have been screening for and finding overgrowths of hydrogen sulphide producing bacteria (also known as sulphur reducing bacteria) many times. I am now seeing it as a major driver of IBS symptoms in many patients that present with abdominal pain and delayed bloating after meals too. 

Let’s dig into the studies showing peppermints benefits on IBS. 

IBS Studies With Peppermint 

Most of the studies looked into the effects of peppermint oil. In my practice I like to start with peppermint leaf tincture (if alcohol is tolerated) and work backwards towards the refined oil. It isn’t that I am concerned that peppermint oil is ‘too strong’ or that it may do damage to the gut microbiome, more that peppermint leaf contains many additional constituents that would be lost in the essential oil products alone. 

Making my own herbal tinctures from the best quality raw herbs I can find has taught me how strong peppermint leaf tincture can be! When the first few drops come through the percolator it is clear that the tincture is full of essential oils! 

One large meta analysis from 2019 looked at 12 randomised control trials making up 835 patients. They found that peppermint oil was safe and effective for treating the pain and global symptoms of IBS. The number needed to treat to improve the global symptoms of IBS was 3, improvement of abdominal pain was 4, and for adverse effects it was 125 patients (7). 

Straight talk – Peppermint oil is effective in the majority of people and is quite safe. 

Image taken from: The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data

Another meta-analysis with systemic review from 2013 looked at 9 randomised control studies with 726 patients in total. Again they found that peppermint oil was significantly better than placebo for IBS symptoms (global symptoms and abdominal pain). They did find that patients taking peppermint oil were more likely to experience ‘adverse events’ which were mild and transient. Heartburn was the number one side effect as we discussed previously in this article (8).

Just so I am not accused of cherry picking the data, there have been some studies where the effects of peppermint have not been promising in IBS. One recent randomised control trial found that peppermint oil did not significantly improve IBS symptoms compared to placebo (9). 

When we compare the quality of evidence it is clear that peppermint can be beneficial in certain IBS patients (two meta-analyses vs one RCT). 

Now let’s move onto the second uncommon herb for IBS that shows some promise. 

Caraway For Digestive health support

Carum carvi, or caraway, is another herbal medicine with a long history of use in traditional medicine and is grown in Europe, Western Asia and North Africa (10).

As one of the oldest spices grown in Europe caraway has been used as a carminative helpful in spasmodic cramps, indigestion and lack of appetite. The seeds have been used as a laxative and to treat colic (11). 

Based on traditional uses and experience the British Herbal Compendium recommends caraway to help treat flatulence, bloating and spasmodic pains in the gut. They note that the essential oil is antibacterial and antifungal (12).

Constituents of Caraway

The main constituents of caraway are terpenes and terpenoids found in the essential oil. These include (13).

  • Carvone
  • D-limonene
  • A-pinene
  • Cis-carveol
  • B-myrcene
Image taken from A Review on the Pharmacological Aspects of Carum carvi showing the different phytochemicals of caraway. 

Carvone is the most abundant active constituent in caraway essential oil followed by limonene (14). 

Carvone structure. Image taken from – https://en.wikipedia.org/wiki/Carvone

Caraway for Irritable Bowel Syndrome

Much of the science that backs caraway’s use for irritable bowel patients have studied it alongside peppermint. This may seem a bit odd at first. We have discussed how peppermint is helpful for IBS patients but how does the addition of caraway increase its benefits.

The best way to answer this question is to combine the traditional uses and actions of caraway’s carminative actions being helpful in spasmodic cramps with the human studies on the peppermint-caraway combination. 

One review of 3 randomised control trials found menthacarin, a proprietary, enteric coated peppermint-caraway combination, to be effective at reducing abdominal pain and IBS symptoms such as pressure, heaviness, fullness, flatulence, or diarrhea (15).

Image taken from – Effectiveness of Menthacarin on symptoms of irritable bowel syndrome 

The authors concluded that ‘In functional gastrointestinal disorders, peppermint oil and caraway oil can therefore be expected to show a synergistic effect’ 

Natural Solutions For Your IBS

As irritable bowel syndrome is complicated there is more to treating this functional digestive disorder than simply adding peppermint and caraway to your herbal regime. Other steps I frequently recommend to my IBS patients include dietary eliminations and inclusions, for example swapping fat for fibre as tolerated, and eliminating gluten and dairy if necessary. Adequate exercise is key as is good sleep. 

We also need to properly evaluate IBS patients for infections and microbiome imbalances such as parasites and small intestinal bacterial overgrowth. 

With all this accomplished herbs such as peppermint and caraway that have good evidence behind them to help with IBS symptoms are likely candidates for many irritable bowel syndrome sufferers. 

byron herbalist todd mansfield gut health specialist

Need help with your digestion?

Hi, my name is Todd Mansfield. I am a clinical herbalist with a special interest in all things gut health.

If you are looking for digestive health support consider working with me. I see people online as well as in person from my clinic in Byron Bay.

More booking information here.

References and Resources

  1. Global Prevalence of and Risk Factors for Irritable Bowel Syndrome: A Meta-analysis
  2. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome
  3. A Review of the Bioactivity and Potential Health Benefits of Peppermint Tea (Mentha piperita L.)
  4. A Review of the Bioactivity and Potential Health Benefits of Peppermint Tea (Mentha piperita L.)
  5. Peppermint Oil: Clinical Uses in the Treatment of Gastrointestinal Diseases
  6. Influence of Dietary Supplementation of Herb Extracts on Volatile Sulfur Production in Pig Large Intestine
  7. The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data
  8. Peppermint Oil for the Treatment of Irritable Bowel Syndrome A Systematic Review and Meta-analysis
  9. Efficacy and Safety of Peppermint Oil in a Randomized,Double-Blind Trial of Patients With Irritable Bowel Syndrome
  10. A Review on the Pharmacological Aspects of Carum carvi.
  11. Antioxidant and antibacterial properties of phenolic extract from Carum carvi
  12. The content and composition of the essential oil Found in Carum carvi L. commercial fruits obtained from different countries
  13. A Review on the Pharmacological Aspects of Carum carvi.
  14. The content and composition of the essential oil Found in Carum carvi L. commercial fruits obtained from different countries
  15. Effectiveness of Menthacarin on symptoms of irritable bowel syndrome

You may also like

Leave a Reply

Your email address will not be published. Required fields are marked *

Hello. Add your message here.