Irritable Bowel Syndrome (IBS), like many other medical ailments, is defined by its symptoms rather than its causes, since its causes are unknown. This means that ‘IBS’ may actually be a catch-all term for several different diseases which happen to have similar symptoms. IBS has also been known as ‘colitis’, ‘spastic colon’ and ‘functional bowel disease’.
If ‘IBS’ is not a single disease, then an effective treatment for one person might be completely ineffective for someone else, since they really suffer from different diseases that were diagnosed with the same name. This does seem to be the case — in fact, clinical studies of IBS and its treatments often contradict each other or show null results for treatments that work quite well for some users.
For example, in a study of treatments including peppermint oil, the conclusion was that “the available evidence does not support the effectiveness of any of these treatments” (Rev Gastroenterol Disord. 2003;3 Suppl 2:S18-24); whereas in another study, peppermint oil was found effective: “There seemed to be greater improvement when therapy (famotidine, pizotifen, peppermint oil) was targeted to the specific functional gastrointestinal disorder (dyspepsia, abdominal migraine, irritable bowel syndrome).” (Pediatrics. 2003 Jan;111(1):e1-11)
Symptoms of IBS
The symptoms that currently define Irritable Bowel Syndrome were set down in 1988 at a conference in Rome and amended in 1992. They are known as the Rome Criteria:
(1) abdominal pain or discomfort characterized by the following:
(2) Two or more of the following characteristics at least 25% of the time:
Note that characteristics (1) and (2) must both be present, but that (2) itself is a logically convoluted combination of symptoms. This kind of definition is typical of medical ailments that are not understood and that are collections of separate diseases.
The criteria used for diagnosing IBS do not actually cover all the symptoms that sufferers may have. These include: diarrhea, intestinal cramping/spasm, constipation, gas/flatulence, heartburn, indigestion, pain upon eating or defecating, hemorrhoids, or anal fissures (small tears in the anus often caused by frequent bowel movements, or, excessive straining and hard stools).
Treatments for IBS
Since the causes of IBS are not understood, and may vary from person to person, the recommended treatments form a hodge-podge rather than a coherent regimen. These include:
Drugs that are often used for IBS include:
Supplements that are often used include:
This list of possible remedies is discouraging, it’s so long. The number of drugs alone runs to several dozen, if you count all the individual compounds. Many of them are very expensive, and so are many of the non-drug remedies. It could take years to try them all individually, and a lifetime to try combinations of them in the hope of finding a combination that works.
Supplements
If you’ve suffered for awhile from IBS, chances are good that you’ve already tried some of the easiest and cheapest remedies — antacids, vitamins, minerals, some form of colonic massage (e.g., rubbing the abdomen), relaxation techniques, and perhaps even mysticism and prayer — and these haven’t worked. What should you do next?
Keep it simple: try peppermint/caraway capsules and fiber supplements. These are both quite affordable and you should be able to tell right away whether or not they work for you.
Fiber supplements are thought to be helpful because they absorb liquids, forming a gel that relieves cramping and prevents both diarrhea and constipation.
The peppermint story is more interesting.
Peppermint and caraway oils
The leaves of peppermint (Mentha x piperita), a hybrid of water mint and spearmint, have been used since ancient times to make peppermint tea, a favorite cure for indigestion. Peppermint oil, extracted from the leaves, is composed mainly of menthol and menthone.
Peppermint oil was shown in the 1960s to be an inhibitor of gastric smooth muscle spasms. It was first studied as an IBS treatment in the 1970s, and was deemed beneficial. Enteric coated capsules were used to avoid absorption of the oil in the stomach. Many more studies have followed, generally confirming peppermint oil’s efficacy. However, some statisticians have studied those studies, found flaws in the methodology, and dismissed them all as worthless. Other statisticians have come to the opposite conclusion. Let’s be sensible — perfect data is impossible to obtain, and there are far too many positive studies and individual successes to dismiss all the data as worthless.
Caraway (Carum carvi) has been used for thousands of years to calm the digestive tract and expel gas. Caraway oil is obtained by steam distilling the dried and crushed seeds. The oil’s main constituents are carvone and limonene.
Although the use of caraway for gastric problems has been noted in Western medical literature since the 1600s, no effort was made to study these effects scientifically until the 1990s — between 1960 and 1989 medical researchers conducted searches for possible toxicities of caraway oil rather than for benefits. Finally, in 1996, a study was published about the use of caraway oil (in combination with peppermint oil) to treat ‘non-ulcer dyspepsia’ (an ailment with similar symptoms to IBS).
IBS researchers in Germany continued experimenting with formulas containing both peppermint and caraway oils. This led to the widespread use of this combination and to its official recognition by the Kommission E — a regulatory agency that focuses on herbal remedies.
Regimint, a superior IBS supplement
In the U.S., on the other hand, the combination of peppermint and caraway oils went unrecognized until an IBS sufferer named Barry LeVan read about it on the Internet. LeVan managed to find an apothecary who specialized in German botanical medicines, bought a couple bottles of enteric-coated capsules, and began using them. Much to his surprise his IBS symptoms diminished, then disappeared, and he felt re-energized.
After six months without pain, LeVan thought that his IBS might be gone forever. He tried stopping the treatment. Several months later the IBS symptoms returned. The capsules were obviously a treatment, not a cure.
LeVan thought that a treatment like this ought to be more widely available in the U.S., so in 1998 he formed a company to make such a product. Cutting-Edge Herbal Products now produces Regimint — enteric-coated capsules containing 0.2 ml each of peppermint oil and caraway oil.
Soluble fiber
The word ‘fiber’ refers to substances that pass through the digestive tract unabsorbed. Many of these substances consist of long molecules composed of chains of saccharide subunits. Some are soluble in water (pectins, gums, mucilage), others are not (cellulose, lignan).
Although soluble and insoluble fiber both have a reputation for treating IBS, recent work has concentrated on soluble fiber, such as the mucilage ‘psyllium’ and the gums ‘beta-glucan’ and ‘guar’. Unfortunately, beta-glucan supplements are probably too expensive to use in the amounts needed for IBS, and guar gum supplements are non-existent. Psyllium, however, is available inexpensively in products such as Metamucil, and beta-glucan is plentiful in oat bran and barley.
Conclusion
Before embarking on an expensive IBS treatment based on drugs, psychiatry, or New Age paraphernalia, one should first try the easier, cheaper alternatives. If antacids, ice cream, or prayer don’t make the symptoms go away, then a good second step would be peppermint/caraway oil or an inexpensive soluble fiber supplement … or both!
More information about Regimint capsules can be found at http://www.LifeLinkNet.com/ or at http://www.regimint.com/. Psyllium products are sold at drugstores and foodstores under many brand names, including: Correctol, Effer-syllium, Fiberall, Hydrocil, Konsyl, Metamucil, Modane, Perdiem, Serutan, Siblin. Beta-glucan soluble fiber can be bought as a supplement or obtained by eating oat bran or barley products.
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