Updated on February 2, 2023
- Patients struggling with IBS often seek out home remedies to address symptoms after failing to find complete, durable relief using conventional therapies.
- Research suggests that exercise can significantly address IBS symptoms owing to its beneficial effects on the gut microbiome.
- There is compelling evidence that dietary interventions that support the health of the microbiome, including butyric acid supplements, can provide benefits for patients and be more easily integrated in a patient’s lifestyle.
Irritable bowel syndrome (IBS) is one of the most challenging gastrointestinal disorders to effectively manage because there is no single, clear cause that applies to every patient. Often, it is a “diagnosis of last resort,” when a physician simply cannot find another cause to explain the patient’s symptoms. These symptoms are often wide-ranging, can be opposing, and include diarrhea, constipation, abdominal pain, bloating, and flatulence.
Although there are a number of prescription IBS medications on the market, patient experiences and drug efficacy are mixed. As a result, many patients look toward home remedies to find greater relief than prescription options can provide. Although the targets of home remedies can vary considerably depending on patient needs, IBS home remedies with universal appeal focus on supporting the health of the gut microbiome, which can play a role in most IBS symptoms. Researchers who have studied the efficacy and mechanisms of home remedies have found that changes in both diet and exercise habits support the gut microbiome in IBS patients.
Exercise as a Home Remedy for IBS
The earliest evidence that exercise supports the gut microbiome came from a study by a group of researchers in Japan who reported that running exercise alters the bacterial composition of the gut microbiome in rats. More specifically, these rats had higher gut concentrations of n-butyrate than their sedentary counterparts. The relevance of these findings for IBS patients was clarified in a 2015 study, in which researchers compared the microbiota of IBS patients to those of healthy controls. Based on more than 20 million 16S rRNA samples from patient fecal samples, the researchers found that IBS patients had significantly lower levels of microbial diversity—and, most notably, they had lower levels of the bacterial genera that produce butyrate. This disruption of the microbiome might be responsible for a range of IBS symptoms and dictate symptom severity. Although no human studies have yet associated butyrate production with exercise, the studies in mice help make a strong case for the potential of exercise to normalize butyrate concentrations in IBS patients.
More recently, researchers at Rutgers University also found that exercise altered the gut microbiome of mice—regardless of whether the mice were on a standard or a high-fat diet—and that the changes in microbial composition modulated both inflammatory markers and gut integrity in exercising mice. Because inflammation and intestinal permeability both have an impact on the symptoms of IBS patients, this study suggests that using exercise to strengthen the gut microbiome can be beneficial for patients through a variety of mechanisms.
There is also preliminary evidence from clinical studies supporting the possible benefits of exercise for IBS patients, including a landmark randomized clinical trial conducted by a group of Swedish researchers. They randomly divided a group of 102 IBS patients into a sedentary control group and a group who performed 20 to 60 minutes of moderate exercise, 3 times a week for 12 weeks. Symptoms were measured using an IBS Severity Scoring System, and the results showed there was a statistically significant reduction in IBS symptoms for the individuals who exercised compared to those who did not. Although the authors did not specifically probe the molecular mechanisms through which these benefits were conferred, the results showed that even a small amount of exercise could make a real difference for IBS patients.
Gut Microbiome-Supporting Dietary Modifications for IBS Management
Although exercise appears to hold significant promise for IBS management, dietary interventions might also offer meaningful symptom management. Although such strategies have traditionally focused on elimination diets that seek to identify individual “trigger” foods, researchers are increasingly investigating ways to address the underlying, pathophysiological causes of IBS. Many of these efforts focus specifically on improving the health of the gut microbiome.
The simplest studies have demonstrated the possible efficacy of both probiotic supplements and high-probiotic foods, like yogurt. Some studies suggest that targeted therapies focused on addressing specific microbial deficiencies might make a particular difference for IBS patients. For example, one study of 274 patients with constipation-predominant IBS (IBS-C) found that participants who ate a probiotic yogurt containing Bifidobacterium animalis had lower abdominal discomfort scores and a significantly higher number of bowel movements per week than participants in the control group, who ate a placebo. There have also been multiple studies suggesting that probiotic supplements containing B. infantis might be particularly useful for IBS patients, whereas studies on other probiotics have been less promising. Based on these studies, suggesting that the gut microbiota of IBS patients are different from those of the general population, it makes sense to focus on key, evidence-based probiotic options when choosing dietary probiotic-based home remedies for IBS.
Given the associations between IBS and butyrate, butyric acid supplements are also emerging as a potential dietary therapy. As an alternative remedy for IBS, butyric acid supplements are particularly appealing to clinicians and researchers because of their biochemical support—rather than the mixed, anecdotal evidence that underpins other botanical supplements that are purported to address IBS symptoms. Additionally, multiple clinical studies indicate the efficacy of butyric acid supplements for IBS patients. As of a 2017 review, two clinical studies had been conducted, and both yielded positive results:
- In a 2012 study, researchers compared a control group of 29 patients receiving a standard therapy of trimebutine and mebeverine with a similarly-sized second group of patients who took an additional 300 mg of sodium butyrate daily. After six weeks, the researchers noted a statistically significant improvement in IBS symptoms among the second group, and these patients also reported higher scores on a subjective Quality of Life assessment.
- A similar study in the same year served to verify these results. A group of 66 patients who had a multi-year history of IBS were divided between a control group (32 patients) and another group (34 patients) who took 300 mg of sodium butyrate daily. After four weeks, the researchers noted a statistically significant drop in abdominal pain, and after twelve weeks there was a statistically significant drop in all of the symptoms studied: abdominal pain, flatulence, bowel movement, mucus in stool, and quality of life interference.
Together, these studies provide strong preliminary evidence of the efficacy of sodium butyrate for patients with IBS when used in combination with conventional therapy. Future studies should probe the effects of the different forms of sodium butyrate that are available. In addition, studies should be conducted on larger patient groups, as well as those who have not yet been diagnosed with IBS. Going forward, it is also important to note that sodium butyrate is not the only possible solution for IBS patients. There are ongoing studies on a variety of pharmacological, dietary, and lifestyle interventions that might offer relief.
Implications for Clinicians and Patients
As far as home remedies for IBS go, there are, regrettably, no simple solutions. Still, rigorous research evidence supports the idea that targeting the gut microbiome—either with exercise, dietary modifications, and nutritional supplements—could be an effective solution for many patients, regardless of which type of IBS they have. These simple home remedies have the potential to address symptoms in IBS patients—the two key long-term goals of IBS management.
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