The 5 Best Supplements for IBS, According to a GI Dietitian

The Benefits of Supplements for IBS

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 supplements can improve the frequency and/or form of bowel movements, as well as alleviate bloating, gas, or abdominal pain associated with IBS-C.  Examples include:

• Psyllium husk fiber
• Osmotic laxative products
• Enteric-coated peppermint oil capsules

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

• Bulking fibers such as methylcellulose and calcium-polycarbophil
• Enteric-coated peppermint oil capsules. 

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

• Soluble fiber-predominant products which can both aid with hard/dry stool or loose/watery stool
• Laxative supplements during constipation periods

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 avoiding dietary triggers may be feasible for some, it can be nutritionally limiting and practically difficult to sustain. Products that can improve food tolerance include: 

• Targeted digestive enzymes
• Specially formulated (coated) peppermint oil

Supplements We Do Not Recommend for IBS

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. 

The following supplements lack scientific evidence for helping with IBS:

• Activated charcoal capsules
• Apple cider vinegar products
• Collagen powder products
• Powdered greens
• Berberine
• Turmeric or curcumin products
• Oregano oil 
• Aloe vera products  

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

• Prebiotics
• Probiotics
• Lipase
• L-glutamine 

How We Select Supplements For IBS

We support evidence-based and rooted-in-science supplements. To get our top picks for IBS supplements, our dietitians combed the latest research and reviewed top products on the market. We only pick products in line with research-backed guidelines; you can read more about our dietary supplement methodology here.

We thoroughly vet all supplement companies to ensure they have in-house or third-party testing to ensure the accuracy and trustworthiness of the ingredients in their supplements. Supplements that are third-party tested are sent to a lab for purity and potency to ensure they contain what they say they contain and do not contain any potential contaminants.

Ingredients To Pay Attention To

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:

• Fructo-oligsosaccharides (FOS) 
• Inulin (chicory root fiber)

Sugar alcohols (avoid for diarrhea) include: 

• Sorbitol
• Mannitol
• Xylitol  
• Erythritol

Additional Considerations for IBS Supplements

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 laxatives 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:

Laxatives:

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

Laxative supplements may not be suitable if you have the following conditions:

• Have kidney or cardiac dysfunction: High-dose magnesium supplements (used as osmotic laxatives), in particular, should be avoided or used only under the guidance of a healthcare provider. 
• Take certain medications: Laxative supplements can interfere with some medications, including diuretics and antibiotics, so speak with a healthcare provider about your regimen. 
• Have a bowel obstruction (blockage in the intestine) or fecal impaction (stool that is hardened and stuck): These circumstances require immediate medical attention. 
• Have a history of laxative abuse: Speak with a healthcare provider about constipation treatment if you’ve used laxatives excessively in the past. 
• Are on a fluid-restricted diet: Many products need to be taken with extra fluid.

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.

Fiber supplements may not be suitable if you have the following conditions:

• Have difficulty swallowing
• Have pelvic floor dysfunction: Adding more bulk when you are unable to efficiently evacuate may add to constipation and discomfort. 
• Have a slow motility disorder: Such disorders include gastroparesis (delayed stomach emptying) and slow colonic transit 
• Have esophageal stricturing (narrowing of the esophagus) 
• Are severely backed up
• Have active intestinal inflammation: This includes diverticulitis or active inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. 

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.

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.

How Do I Know If I Have IBS?

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:

• Recurrent abdominal pain
• Changes in stool frequency
• Changes in stool form

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:

• Difficulty evacuating
• Infrequent bowel movements
• Feeling an urge to go but not being able to

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

• Loose stool
• Urgency
• Lower abdominal cramps or belly pain

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

• Alternating constipation and diarrhea 
• A combination of IBS-C/IBS-D symptoms

Our Experts

We consulted the following experts during the research and writing of this article on the best supplements for IBS:

• Laura Frado, MD, MS, a gastroenterologist at New York Gastroenterology Associates, for her insight on supplements.
• Anne Cook Carroll, MS, RD, CDN, is a registered dietitian and update editor for Verywell Health. She double-checks claims and information against the latest guidelines.
  

Why Trust Verywell Health

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.