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Jan 11, 2024

The 5 Best Supplements for IBS

IBgard peppermint oil capsules offer research-backed benefits for IBS symptoms

IBgard peppermint oil capsules offer research-backed benefits for IBS symptoms

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Verywell Health / Reese Herrington

Irritable bowel syndrome (IBS) affects 35 million adults in the U.S.. Although the cause of IBS is unknown, researchers have found there is often an abnormality in how the gut and brain communicate to express pain, known as a disorder of the gut-brain axis. This can be associated with inappropriate contractions of muscles in the GI tract as well as visceral hypersensitivity (extra sensitive nerves that line the digestive tract).

Although IBS symptoms cannot be "seen" and are not life-threatening, they can be disruptive on a physical, social, and emotional level. Various stimulants, including stress, anxiety, hormonal changes, and dietary triggers, may result in symptoms of IBS, including severe abdominal pain, bloating, gas, cramping, diarrhea, and/or constipation.

Despite its prevalence, there is no cure for IBS. However, there are a variety of effective treatments that have made living with IBS much more comfortable. Between diet changes, prescription medications, hypnotherapy, and over-the-counter supplements, IBS sufferers have more options than ever before to manage symptoms.

If you are struggling with IBS, the American College of Gastroenterology recommends prioritizing diet and lifestyle changes as a first-line approach to feeling better. However, some individuals may improve with a multipronged approach including a supplement regimen.

When it comes to incorporating supplements, it depends on your specific symptoms, says gastroenterologist Laura Frado, MS, MD. "The best way to know which supplements would be best is to speak with your gastroenterologist or GI-train dietitian about your case."

A limited number of supplements are backed by evidence and are not suitable for everyone, so it's important to seek support for a personalized approach. In recommending the top IBS supplements on the market, our registered dietitian (who has worked with thousands of patients with gastrointestinal conditions) reviewed the latest research and clinical guidance from fellow experts in the field.

Our team of registered dietitians reviews and evaluates every single supplement we recommend according to our dietary supplement methodology. From there, a registered dietitian on our Medical Expert Board reviews each article for scientific accuracy.

There are many different types of supplements for IBS available on the market, and matching your symptoms to the appropriate product will help you get the most benefit.

Always speak with a healthcare professional before adding a supplement to your routine to ensure that the supplement is appropriate for your individual needs, and to find out what dosage to take.

Amazon

Most evidence for IBS

Suitable for all IBS subtypes

Widely available

Fast acting

Large pills

More expensive

When choosing an IBS supplement backed by research, IBgard is our clear winner. Peppermint oil is the most research-backed supplement for managing IBS, plus it's well-tolerated and safe for most people to take on a regular basis. New research has found that 97% of people with IBS who took this specific form of peppermint reported improved bowel habits and 87% reported improvements related to eating.

Just one dose (two capsules) of IBgard can prevent IBS-related abdominal pain on a daily basis, though up to 3 doses are recommended for more severe symptoms. When taken 30 to 90 minutes before meals, IBgard can also work to reduce food-associated symptoms such as cramping and urgency.

Peppermint oil has been used to treat digestive symptoms across the globe for centuries, including in ancient Egypt, Rome, and Greece. But in recent decades, scientists have specifically identified that peppermint oil, which includes the active ingredient L-menthol (derived from the herb Mentha peperta), has the ability to relax the muscles in the GI tract and affect pain sensation. A wealth of clinical studies have proven that when taken orally, L-menthol has therapeutic benefits for IBS including major reductions in abdominal pain, cramping, urgency, and bloating.

Yet, when it comes to peppermint oil supplementation for IBS, not all forms are created equal. Peppermint pills that are not enteric coated (which helps them survive stomach acid), peppermint essential oils, and peppermint tea have not been shown to be effective therapies for IBS, whereas enteric coated capsules designed to target the small bowel have been proven to significantly improve gastrointestinal symptoms across IBS subtypes.

This product may not be good if you have swallowing difficulty due to the size of the capsules. If you are pregnant or nursing, consult with a healthcare provider first.

Price at time of publication: $28 ($1.17 per serving)

Active Ingredient: Peppermint oil (L-menthol 83mg) | Form: Capsule | Standard Dosage: 2 capsules (180mg each)

Amazon

Broad spectrum for multiple common IBS trigger foods

Helps reduce dietary restriction

Suitable for all subtypes of IBS

Less widely available

More expensive

Our top digestive enzyme product to allow for increased food freedom without triggering symptoms is FODMATE by Microbiome Labs. This product offers a unique blend of specific enzymes to help the FODMAP-sensitive enjoy a complex meal with less dire consequences.

If a single FODMAP category is your known issue, this enzyme cocktail is likely more than you need to prevent symptoms. However, since FODMATE contains not just one but five enzymes to help digest the spectrum of high-FODMAP foods, it can be a great occasional remedy for those with multiple FODMAP-related reactions.

Many individuals associate their IBS symptoms with eating, and research has shown that a diet low in FODMAPs (groups of fermentable carbohydrates) can significantly improve symptoms for those with IBS. A low-FODMAP diet is not a forever diet—it's a temporary tool to identify specific dietary triggers that may then be avoided. Yet, even a small number of foods can be a burden to avoid. Luckily, alongside experimenting with portions, targeted enzymes can be a ticket to more dietary freedom for those with FODMAP intolerance.

If you are one of these individuals, FODMATE may be worth a try to control symptoms when dining out, at social events, traveling, or otherwise consuming some tasty but digestively triggering foods. Keep in mind that in order for the digestive enzymes to be effective they must be taken at the start of a meal, so remember to time FODMATE appropriately before chowing down on FODMAP-rich foods.

Price at time of publication: $62 ($1.03 per serving)

Active Ingredient: Lactase, alpha-galactosidase, endo- and exo-inulinase, glucose isomerase, pectinase | Form: Capsule | Standard Dosage: 2 capsules

Amazon

Good for IBS-C

Budget-friendly

Convenient capsule form

Third-party tested

Not recommended for those with IBS-D, kidney disease, or heart disease

May interact with certain medications

Solgar's Magnesium Citrate tops our list because it is third-party tested and clinically proven to ease constipation. Research has shown that magnesium may be more effective than other supplements, such as fiber products, in increasing stool frequency and stool consistency in those with chronic constipation.

When taken in doses greater than 350 milligrams, magnesium works to gently draw water into the bowels making stool softer and easier to pass. This is great news for people with IBS-C, whose constipation is often accompanied by excessive abdominal pain and discomfort.

Solgar had its magnesium supplement tested in a 2022 review of magnesium supplements through ConsumerLab.com's voluntary certification program. This verifies that the product contains what it says it contains without potentially harmful contamination. The convenient capsules are also certified gluten free, dairy free, non-GMO, and vegan, and, at 210 mg each, they are easy to customize to your personal effective dose. While the recommended amount is two pills per day, larger amounts may be advised by a healthcare provider.

Note magnesium supplementation is not intended for those with IBS-D and should be avoided by people with kidney disease or heart disease. Magnesium may interfere with certain medications, including specific antibiotics and diuretics.

Price at time of publication $18 ($0.30 per serving)

Active Ingredient: Magnesium citrate | Form: Capsule | Standard Dosage: 2 capsules (210mg each)

Amazon

Research-backed benefits

Good for all IBS subtypes

Budget-friendly

Thickens quickly in liquid

Not third-party tested

When choosing a fiber supplement, the array of options can be overwhelming. Luckily, psyllium husk–the main (and only) ingredient in Konsyl's Daily psyllium fiber—holds the strongest and largest amount of evidence for those with IBS. While many fiber products claim to provide constipation relief, the American College of Gastroenterology has highlighted psyllium as the only fiber supplement with adequate evidence for improving chronic constipation. Yet psyllium is not just for constipation: it's been shown to resolve loose stools, reduce urgency, and normalize stool form in patients across IBS subtypes.

Konsyl Daily Psyllium Fiber is a readily available, all organic, and reasonably priced option for IBS sufferers with unruly bowels. This mostly soluble fiber comes from the husks of Plantago ovata plant seeds, which gel with water to improve stool form, passage, and transit. Unlike some other psyllium products on the market, Konsyl's psyllium husk is free of sugar alcohols and artificial sweeteners, which can trigger additional IBS symptoms.

Konsyl is available in powder and capsule form, though it may take a larger dose (5 capsules) to equal one powder serving. The ground husks can be disguised in prepared foods such as smoothies or oatmeal, but psyllium gels in cold liquid so consume it quickly if you do not enjoy a gooey texture.

Price at time of publication $28 ($0.49 per serving)

Active Ingredient: Psyllium husk | Form: Capsule | Standard Dosage: 1 -3 teaspoons (6g each)

Amazon

Research-backed benefits

Convenient pill form

Flavorless and odorless

More affordable option

Larger pills

Not suitable for some types of constipation

Not suitable for those with swallowing difficulty

Although psyllium is the most clinically researched fiber product, FiberCon is a promising alternative for those with IBS-related bowel irregularities. The main ingredient, calcium polycarbophil, is a unique synthetic fiber that acts like soluble fiber (gels with water) in the colon. In fact, the label claims it swells to 60 times its weight in water.

This swelling can slow transit time and reduce bowel urgency—a very desirable trait for those with IBS-D who are prone to these uncomfortable symptoms. At the same time, this fiber type has also been proven to normalize stool consistency for those with constipation. And the benefits don't stop there: research on calcium polycarbophil also showed reduced abdominal pain in people with IBS.

Unlike many of the loose fiber products on the market, FiberCon's pill form is easy to remember and good for transport. A daily dose of just two pills is the recommended serving, though don't forget to take it with at least eight ounces of water for it to work. Keep in mind this supplement may not be suitable for those with pelvic floor dysfunction, slow motility, or severe constipation.

Price at time of publication $22 ($0.31 per serving)

Active Ingredient: Calcium Polycarbophil | Form: Pill | Standard Dosage: 2 pills (1250 mg)

There are many different types of digestive supplements available on the market, and matching your symptoms to the appropriate product will help you get the most benefit. Your body's response to a supplement may vary depending on multiple factors, such as diet, lifestyle, health status, dosage, and supplement type.

According to the latest research, supplements can be helpful for IBS as follows:

Those with IBS-C: Some supplement options intended to improve the frequency and/or form of bowel movements, as well as products that can alleviate bloating, gas, or abdominal pain associated with IBS-C have proven benefits. Examples include:

Those with IBS-D: Products intended to slow transit time, bulk up stool, or reduce gastrointestinal spasms offer benefits for IBS-D. Examples include:

Those with IBS-M: Those with an alternating pattern of stool habits may respond well to:

Those with IBS-related dietary triggers: Regardless of IBS-subtype, eating specific foods, such as gas-promoting high-FODMAP foods (think beans and broccoli), can trigger post-meal symptoms such as abdominal pain, bloating, and pooping issues. While avoidance of dietary triggers may be feasible for some, it can be nutritionally limiting and practically difficult to sustain. Products that can improve food tolerance include:

Before considering supplements for IBS, consult a healthcare provider to determine what's appropriate for your particular symptoms. Some digestive supplements are not appropriate if you have a health condition(s) beyond IBS. Below are some, but not all, of these considerations.

If you are pregnant, lactating, on prescription medications, or have diabetes, consult with your healthcare provider if you plan to take any other digestive supplements for IBS.

Keep in mind that ongoing symptoms such as abdominal pain, cramping, constipation, diarrhea, or bloating should be evaluated by a healthcare provider to clarify the nature of the condition before supplementing with an over-the-counter product. The majority of supplements are designed for occasional use but may be used for longer periods under the supervision of a healthcare provider.

Many products make promising claims about resolving IBS symptoms. However, in reality, only a small number of products are backed by strong clinical evidence. We have carefully chosen supplements that have a studied ability to improve IBS management or symptoms associated with IBS.

We do not recommend trying supplements based on the promises made by the company selling the product or their marketing efforts.

The following supplements lack scientific evidence for helping with IBS:

The following supplements still have limited research for IBS management, although more evidence may develop in the future :

Although IBS is often referred to as a "diagnosis of elimination" (meaning doctors resort to this diagnosis if they can't identify another problem), this can be misleading. While your doctor will likely rule out gastrointestinal infection and disease, a specific tool to diagnose IBS called the Rome criteria also exists. This criteria was developed in 1992 and is periodically updated to characterize the core IBS symptoms, which include:

If your symptoms also meet the frequency criteria (three times a month for the past three months), your doctor may diagnose you with IBS. Yet "IBS" is still an umbrella term: there are multiple subtypes of this condition that can feel very different from person to person.

IBS-C: IBS with constipation, most often experienced as:

IBS-D: IBS with diarrhea, most often experienced as:

IBS-M (aka IBS-A): IBS mixed type or IBS alternating, most often experience as:

Our team works hard to be transparent about why we recommend certain supplements; you can read more about our dietary supplement methodology here.

We support supplements that are evidence-based and rooted in science. We value certain product attributes that we find to be associated with the highest quality products.

It's important to note that the FDA does not review dietary supplements for safety and effectiveness before they go to market. Our team of experts has created a detailed, science-backed methodology to choose the supplements we recommend. We also spoke with Laura Frado, MD, MS, a gastroenterologist at New York Gastroenterology Associates, for her insight on supplements.

Supplements that are third-party tested are sent to a lab where they are tested to ensure they contain what they say they contain and are not contaminated with specific high-risk, common contaminants. However, it's important to note:

Fiber supplements, laxatives, and peppermint oil products will differ in overall quality and ingredients. The ingredients or amounts of ingredients may not match what is written on the label. Those with food allergies or intolerances should examine all product ingredients and labels, as there may be sources of cross-contamination.

Supplements with benefits for IBS come in a variety of forms, including capsules, powders, tablets/pills, and chewable/gummy products. Powdered products, including some fiber powders and laxatives, can be added to liquid with no taste or texture changes, while others may be artificially flavored or gel with water (you can add these to moist foods to avoid a gooey substance).

There is no research suggesting significantly greater efficacy of one physical form over another, so you can decide based on taste preferences and convenience. However, keep in mind that some chewable, gummy, or flavored products may contain additional ingredients that can cause extra gastrointestinal symptoms, including sugar alcohols (e.g., sorbitol, xylitol, erythritol) or inulin (chicory root fiber). We recommend reading product labels and avoiding products with these particular ingredients.

It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included relative to the recommended daily value of that ingredient. Please bring the supplement label to a healthcare provider to review the different ingredients contained in the supplement and any potential interactions between these ingredients and other supplements and medications you are taking.

Over-the-counter supplements are not the same as prescription medications which are regulated by the FDA. Check with your healthcare provider before using any store-bought digestive products, as they can interact with a variety of medications and supplements. Interactions vary between products, and it is best to verify before taking to ensure safety. For example, fiber supplements can delay or reduce the effectiveness of antidepressants, diabetes medications, and carbamazepine.

Some products may also contain added ingredients such as prebiotics, which can worsen gas and bloating in digestively sensitive people, or sugar alcohols, which can worsen diarrhea. Chewable and gummy supplements are more likely to contain one of these ingredients as a sweetener.

Prebiotics (avoid for gas and bloating) include:

Sugar alcohols (avoid for diarrhea) include:

The recommended dose for a given supplement will vary by supplement type and specific product. We recommend speaking with a healthcare provider to determine if a supplement may be appropriate for you. Depending on your symptoms and health history, a healthcare provider may recommend more or less than the standard dose suggested by the manufacturer.

Keep in mind that the majority of supplements are designed for occasional use but may be safe to take for longer periods when directed by a healthcare provider.

Because of the potential side effects and risk of overdosing laxative supplements, follow package directions carefully. Some products, such as magnesium, may require a larger amount than what is contained in standard doses to attain a laxative benefit. Alternatively, some standard doses may have too strong of an effect for sensitive individuals.

In general, there is typically no harm in starting with a smaller (e.g., half) dose and increasing it as tolerated. For fiber supplements, it is typically best to start with a lower serving and increase gradually, along with increasing fluids.

The supplements listed above have all been shown to be safe and well-tolerated for most individuals with IBS. However, some supplements can cause serious side effects when used in excess. Particular caution is advised for laxative and fiber supplements, which can cause uncomfortable symptoms and/or health complications when taken in inappropriate doses.

Risks vary by specific product as well as individual health status, so it is best to work with a healthcare provider to determine the appropriate dose for you. Some considerations include:

Osmotic laxatives:

Osmotic laxatives such as magnesium are generally considered safe and well-tolerated, though they can cause bloating and/or diarrhea with too large of a dose. Since these types of laxatives draw water into the colon, overusing these products can lead to dehydration and electrolyte imbalances

Fiber supplements:

While there is no Tolerable Upper Intake Level for fiber, concentrated doses can cause constipation, gas, or bloating if you add it too quickly or without enough fluids. Most fiber supplements recommend 8 ounces of water with a standard dose, though individual product directions may vary. Inadequate fluid intake can cause the supplement to swell and lead to choking, blockages, or stool impaction, as well as gas, bloating, abdominal pain, and constipation.

Enzymes:

There are generally no established upper limits for over-the-counter enzymes marketed for IBS. There is no standard dosing for commercially available digestive enzymes, and guidelines vary across different products. Additionally, many products contain ingredients that have not been studied in human digestion and therefore have unknown health risks.

Of the most researched enzyme products, documented side effects include gastrointestinal upset, such as gas, bloating, and nausea. High-dose lipase intake, in particular, has been shown to cause damage to the colon walls. When it comes to digestive enzymes, there is no "adjustment period," so if you find one is not working, or especially if you have an allergic reaction to any supplement, stop taking it.

There currently no oral supplement clinically proven to target anxiety in those with IBS. However, some products may improve anxiety related to IBS symptoms. For example, the latest research on enteric coated peppermint oil supplementation showed that daily dosing in adults with IBS improved bowel function along with a variety of quality of life measures including social activity engagement and emotional well-being.

According to Dr. Frado, anxiety management can play a key role in getting a grip on IBS symptoms, although the evidence for supplementation for this is lacking. Instead, she recommends yoga, which has been shown to help with both IBS and anxiety.

There are no vitamins that have been demonstrated to improve irritable bowels. However, magnesium (a mineral) has been shown to improve chronic constipation and may be worth a try if you have IBS-C. By normalizing bowel habits, symptoms associated with being backed up, such as bloating and gas, can also improve. We otherwise do not recommend vitamin blends that claim to target IBS symptoms without clinical evidence to support this.

"By discussing specific symptoms with your provider, you may be able to pinpoint specific dietary or lifestyle modifications that can treat your IBS symptoms without a prescription medication," says Frado.

Luckily, there are more options than ever for IBS sufferers, which include a FODMAP elimination diet, gut-directed hypnotherapy, physical movement, as well as a variety of supplements. There is no "one size fits all" when it comes to IBS treatment, so working with a healthcare provider is important to create an effective, tailored approach.

There are many supplements on the market that claim to improve symptoms associated with IBS, though very few are backed by clinical evidence. A knowledgeable healthcare provider such as a gastroenterologist or GI dietitian can help guide you on the options that are safe and appropriate for your personal treatment plan.

Suzie Finkel, MS, RD, CDN is a registered dietitian specializing in the nutritional management of digestive symptoms and diseases. She holds a master's degree in nutrition from Columbia University and has trained in numerous clinical gastroenterology settings. As a GI dietitian, she provides evidence-based nutrition services for a wide array of conditions including IBS-C, IBS-D, and IBS-M. Her goal is to demystify nutrition (mis)information and facilitate digestive comfort.

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