looking at supplements in store

5 Supplements for IBS: A Dietitian’s Review

Beth Nanson, RD

Written by: Beth Nanson, RD

Updated: April 2nd, 2024

Supplements for Irritable Bowel Syndrome (IBS) – a common area of confusion for many IBS sufferers.

Although supplements can be an effective strategy to manage IBS symptoms, it’s important to select ones with sufficient evidence to support them, as this can avoid wasting your time, energy, and money.

Keep reading if you want to learn more about five common supplements for IBS.

Please note: it’s recommended that you discuss any supplements with your doctor or a registered dietitian to ensure they are safe for you.

More of a visual learner? Skip to the 5 supplements for IBS Infographic

Probiotic Supplements for IBS

Probiotics are live microorganisms which, when given in adequate amounts, provide a benefit to the host – i.e. you! These benefits include, but are not limited to, improved digestive health, mood, and immune health.

Specifically, when taking probiotics there may be positive changes to the quantity & quality of microbes in the gut, gut motility, visceral hypersensitivity (lower pain threshold for your internal organs), and the gut-brain axis. These changes can provide improvement in IBS symptoms such as altered bowel habits, abdominal pain, bloating, distension, and excess gas production.

Probiotics can be found in certain foods, such as probiotic yogurt, but here we will focus on probiotic supplements for IBS. Probiotic supplements can come in the form of capsules, tablets, gummies, powders, or liquids.

If you do struggle with gastrointestinal upset, it’s important you understand how to choose a probiotic that is right for you, as selecting a probiotic can be tough! There are many available, so it can be difficult to know which to choose. Ideally, we want to match strains to symptoms, and ensure we are taking the effective dose noted in the evidence.

Further, there are many strains of bacteria, and certain strains have been researched to help resolve certain symptoms of IBS and improve overall quality of life. If we match the symptoms we experience with specific strains we have a better chance at attaining benefit from the probiotic.

Regarding dose, there is no known optimal dose and more is not necessarily better! Each strain and combination of strains will have a unique clinical dose, so best practice would be to follow the suggested dose on the product label. 

Once you find a probiotic that is suited to your needs, you can start taking it daily and monitor symptom response. The time of the day is less important than the consistency of taking it every day. The Alliance for Education on Probiotics (AEProbio) created a free app (for iPhone or Android) called Probiotic Guide Canada, to help you select the right probiotic for each use. In the app, you can view which probiotics have scientific evidence behind the strains specifically for IBS, for example Bio-K+® IBS Pro.  The guide can also help you find probiotics with scientific evidence such as Culturelle® Digestive Health Daily Probiotic.

It’s important to give a probiotic enough time to know if it’s working for you. Give a probiotic at least four weeks to show its effectiveness. If it works, continue another eight weeks. If it doesn’t seem to improve your symptoms, work with a registered dietitian to consider alternates interventions for symptom resolution.

Fibre Supplements for IBS

Fibre is the part of plant foods that we do not digest or absorb. This results in fibre traveling through our small intestine into our large intestine, where it is fermented by our gut bacteria.

Further, the fermentation process creates by-products that are beneficial for our health! For example, the short chain fatty acids produced can help keep our gut lining healthy which helps keep our immune system strong.

When determining what fibre is best for someone with IBS, we need to consider the fibres’ solubility, viscosity, and fermentability:

When it comes to IBS, there have been associations between a low fibre diet and the presence of IBS. For example, most individuals get an average of 15-16g of fibre daily. However, our requirements are 25-38g/day respectively for women and men. Thus, if you aren’t getting your daily requirements of fibre through food, fibre supplements for IBS may be a convenient way to boost fibre intake and manage IBS symptoms.

If you want to trial a fibre supplement for your IBS symptoms, some options with good evidence behind include:

Specifically, if you want to try a gentle, soluble, minimally fermented fibre, such as psyllium, start at a low dose (i.e. ½ tsp.) and work your way up slowly to 1-2 tbsp., as tolerated. Take this at least 2 hours outside of your other mediations and supplements and be sure to stay well hydrated.

Of course, you can find fibre in lots of foods including whole grain products, lentils, nuts and seeds and fruits and vegetables. Schär has a low fodmap line of bread products that are also high in fibre – specifically psyllium!

Prebiotic Supplements for IBS

Prebiotics are a substrate that is utilized by the host (again, us!), which then provides a clear benefit. You can think of prebiotics as the food that the beneficial bacteria in your gut (probiotics) need to grow and thrive, which helps us thrive!

Thus, when we consume prebiotics, we selectively feed the good bacteria in our guts. This helps them reproduce and increase in population, while simultaneously working to starve out the bad bugs.

All prebiotics are fibre, but not all fibre is a prebiotic! This is because not all fibre fits the criteria of selectively feeding the good bugs, starving out the bad bags, and providing a benefit to the host.

However, there are a lot more fibres now that are starting to be considered as having prebiotic potential.

Although prebiotics can clearly be beneficial for gut health, we need to be careful suggesting prebiotic supplements for IBS. Not only is there insufficient evidence to support recommending these supplements, but some types may make symptoms worse, especially if they contain the rapidly fermented prebiotic fibre, inulin.

supplements for IBS

Peppermint Oil for IBS

Peppermint oil can help reduce abdominal pain, bloating and discomfort associated with indigestion. This is thanks to its active main ingredient, menthol.

Specifically, menthol is thought to exert many of the physiological effects seen in the gut; working to inhibit smooth muscle contractility and instead relax the smooth muscles. In this sense, peppermint oil can act similarly to antispasmodics (medications that are used to relieve involuntary muscle spasms).

Further, peppermint oil is thought to exert beneficial effects on the visceral hypersensitivity of the gut. Reducing the sensitivity of the nerves in our gut can further help reduce our perception of pain.

There are different forms of peppermint oil supplements for IBS you can take, such as liquid drops or capsules. Ideally look for enteric coated or slow-release capsules to increase the chance of the supplement making its way down the gastrointestinal tract. An example would be Nature’s Bounty IBgard.

Moreover, the timing and the dose of peppermint oil is important to consider. We want to strategically place the supplement around our meals, at the right dose, to effectively target and reduce our symptoms. A common recommendation would be to take 1 serving (an example could be 1 capsule or 1 tbsp. of a liquid formulation) 30-60 minutes before a meal, or 2 hours after your meal. Start with 1 dose daily, and work up to 3 doses daily, to manage symptoms.

Lastly, peppermint may worsen acid reflux/heartburn so you may have to avoid peppermint oil if you notice a worsening of symptoms. However, you can reduce this risk by selecting an enteric coated or slow-release formulation.

Digestive Enzymes for IBS

Digestive enzymes are exactly as they sound – enzymes that aid in the digestion of our nutrients. The better we digest our food, the less residue that’s leftover to be fermented by the gut bacteria, which leads to fewer potential gut symptoms.

Let’s review the most common digestive enzymes:

As humans, we are very skilled in our ability to make all our digestive enzymes naturally. These enzymes can be found in our mouth, stomach, small intestine, and pancreas.

Typically, we are able to produce all the enzymes required to digest the carbohydrates, proteins, and fats that we consume. Therefore, if you are requiring enzymes for every meal, this may be an indication we need to dig deeper and find out why you’re not producing enough effective enzymes for adequate digestion.

Further, digestive enzymes are meant to be used occasionally for known harder-to-digest meals, not routinely for every meal of the day.

If you want to try digestive enzymes to manage IBS symptoms, it’s important to find one that is evidenced based and targeted to your individual needs. If you aren’t sure which macronutrient you maldigest, you may go for a combination product that contains enzymes for carbohydrates, proteins and fats. However, there is little research to suggest these combination products are effective.

Instead, if you know which macronutrient triggers your symptoms, it’s generally more effective to find a digestive enzyme that contains high enough amounts of that specific enzyme to cover your needs and reduce symptoms.

In terms of timing and dose, digestive enzymes should be taken just before or with the first few bites of your meal, at the dose recommended on the product label. If you find they help for certain meals, you can go ahead and add them to your IBS toolkit and use when needed.

Finally, if you don’t find relief, a registered dietitian can help determine if you took the right supplement & dose, as well as consider other strategies to help manage your IBS.

The Bottom Line

At the end of the day, the supplement world for IBS can be confusing and difficult to navigate on your own. It’s recommended to work with a registered dietitian to help find the most evidence-based supplements for IBS management.

Reference List

  1. CDHF ‘IBS & Diet’: https://cdhf.ca/en/ibs-and-diet/
  2. CDHF ‘Phases of the fodmap diet’: https://cdhf.ca/en/phases-of-the-fodmap-diet-explained
  3. ISAPP ‘Probiotics’: https://isappscience.org/for-clinicians/resources/probiotics/#toggle-id-3-closed
  4. ISAAP Probiotic Fact Sheet: https://isappscience.org/wpcontent/uploads/2019/04/Probiotics_0119.pdf
  5. ISAAP ‘Probiotic Checklist’: https://isappscience.org/wp-content/uploads/2019/04/Probiotic-Checklist-Infographic.pdf
  6. NIH ‘Probiotics’: https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/
  7. Pubmed Probiotics: https://pubmed.ncbi.nlm.nih.gov/30935559/
  8. Monash: ‘Probiotics’: https://www.monashfodmap.com/blog/probiotics-ibs-update/
  9. ODMAP Everyday: ‘IBS & Probiotics: Should I Take Them?’ https://www.fodmapeveryday.com/ibs-probiotics-should-i-take-them/#_ftn9
  10. Monash ‘Fiber Supplements & IBS’ https://www.monashfodmap.com/blog/fibre-supplements-ibs/
  11. Unlock Food ‘What are Prebiotics and What Foods Contain Them?’https://www.unlockfood.ca/en/Articles/Digestion/What-are-Prebiotics-and-What-Foods-Contain-Them.aspx
  12. THE IBS DIETITIAN: ‘Do Prebiotics Help IBS Symptoms?’https://thefoodtreatmentclinic.com/do-prebiotic-supplements-help-ibs
  13. FODSHOP ‘Prebiotics, Probiotics, and Irritable Bowel Syndrome’https://fodshopper.com.au/blogs/low-fodmap-learning/a-dietitian-s-guide-prebiotics-probiotics-and-irritable-bowel-syndrome
  14. BadGut: ‘Peppermint and Irritable Bowel Syndrome Pain Relief’:https://badgut.org/information-centre/a-z-digestive-topics/peppermint-and-ibs-pain-relief/
  15. THE IBS DIETITIAN ‘IBS Digestive Enzyme Guide – Six Options that Work’
  16. CDHF: ‘FODMAP Intolerances: How to choose the right digestive enzyme’ https://cdhf.ca/en/fodmap-intolerances-how-to-choose-the-right-digestive-enzyme/
  17. CDHF: ‘Medications and Supplements for IBS’ https://cdhf.ca/en/medications-and-supplements-for-ibs/
  18. THE IBS DIETITIAN: ‘Dietary Supplements Which Help IBS’:
  19. Desiree Neilsen: ‘The 5 Best Supplements for IBS’ https://desireerd.com/the-5-best-supplements-for-ibs/ (didn’t take anything from here yet)
  20. Monash: ‘IBS Diet’ https://www.monashfodmap.com/ibs-central/diets/
  21. HealthLink BC ‘Healthy Eating Guidelines for Irritable Bowel Syndrome’ https://www.healthlinkbc.ca/healthy-eating-physical-activity/conditions/digestive/healthy-eating-guidelines-irritable-bowel

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