What’s the Bottom Line?

What do we know about the usefulness of complementary health approaches for irritable bowel syndrome?

Nutritional Approaches

• There is some evidence that peppermint oil may help reduce irritable bowel syndrome (IBS) symptoms.
• Although some evidence suggests that certain probiotics may improve IBS symptoms, there is not enough evidence to know for sure.
• Research on prebiotics has not found clear benefits for people with IBS.
• Except for peppermint oil, the evidence on herbal products is too limited for any conclusions to be reached.

Psychological and Physical Approaches

• There is some evidence that gut-directed hypnotherapy can help with IBS symptoms and improve health-related quality of life.
• The research on acupuncture for IBS is not conclusive.
• There is very little research on meditation and mindfulness,yoga, or relaxation techniques for IBS.

What do we know about the safety of complementary health approaches for irritable bowel syndrome?

• Probiotics and peppermint oil have a history of apparently safe use, but both can have side effects. Also, few studies have looked at the safety of probiotics in detail, so there’s a lack of solid information on the frequency and severity of side effects.
• Prebiotics have a long history of safe use. However, taken in large doses (more than 20 grams per day for an adult), they can have side effects including gassiness, bloating, abdominal pain, cramps, and diarrhea.
• Psychological and/or physical approaches generally have good safety records when used correctly. However, that doesn’t mean that they’re risk-free for everyone. Your health and special circumstances (such as pregnancy) may affect the safety of these approaches.

About Irritable Bowel Syndrome

IBS is the most commonly diagnosed gastrointestinal (GI) condition. Symptoms include repeated abdominal pain with changes in bowel movements (diarrhea, constipation, or both). IBS is a disorder of how the brain and gut work together.

In the United States, IBS is more common in women than men, and people younger than age 50 are more likely to develop IBS than people older than age 50. About 12 percent of people in the United States have IBS.

IBS was once called by different names, such as colitis or spastic colon, but doctors now refer to three types: IBS with constipation, IBS with diarrhea, or IBS with mixed bowel habits. Many people with IBS have normal bowel movements on some days and abnormal bowel movements on other days.

What the Science Says About the Effectiveness of Complementary Health Approaches for IBS

Nutritional Approaches

Peppermint Oil

There is some evidence that enteric-coated peppermint oil capsules can help reduce IBS symptoms over the short term. There is not yet enough evidence to know if peppermint oil helps long term.

• A 2020 review and analysis of 11 studies in 684 people reported that peppermint oil is a safe and effective treatment for global IBS symptoms over the short term.
• A 2021 study that gave 133 people with IBS either enteric-coated peppermint oil pills or placebo (fake) pills for 6 weeks reported that IBS symptoms improved the same amount in both groups. More people in the peppermint oil group reported side effects, but none were serious.
• Clinical practice guidelines published in 2021 by the American College of Gastroenterology, the professional organization for doctors who treat digestive disorders, include peppermint oil as one of several approaches that may be helpful for relieving IBS symptoms. However, this recommendation is based on low-quality evidence.

• Side effects from peppermint oil are usually mild and may include reflux, heartburn (especially if the pills are not enteric coated), belching, and perianal burning.
• Peppermint oil shouldn’t be taken by people with a hernia or gastroesophageal reflux disease (GERD), especially at high doses.

Herbal Products

In addition to peppermint oil, other herbal products have been studied for IBS, but there has only been a small amount of research on them, and much of it is of limited quality.

• A 2018 analysis of 3 studies in 326 people suggested that curcumin, a substance found in the herb turmeric, may have a potential benefit for treating symptoms in some people with IBS. The quality of the evidence was very low, however, and there wasn’t enough evidence to know for sure if it is helpful. Although in the past turmeric had been considered safe, recent research has raised concerns about a potential association between turmeric and liver injury in a small number of people with certain genes.

Probiotics

Probiotics are live microorganisms (such as bacteria and yeast) that can be taken as dietary supplements or included in yogurt and other fermented foods and some beauty products.

Some evidence suggests that some probiotics may improve IBS symptoms; but the evidence is not conclusive. Some probiotics seem to be more effective than others, depending on whether they’re used alone or in different combinations.

• According to practice guidelines from the American College of Gastroenterology (2021), there’s not enough strong evidence on the effectiveness of probiotics for IBS to recommend their use. The guidelines say that the current evidence for this recommendation is very weak, however, because many different types of probiotics have been studied, and most of the studies have been small, with mixed results.
• A 2022 review and analysis of 10 studies in 757 people with constipation-predominant IBS found that probiotics improved stool consistency but did not help reduce pain or bloating or improve quality of life. The quality of the evidence in the reviewed studies was low.
• A 2021 review and analysis of 9 studies in 651 children with IBS found that children who took probiotics had less severe and less frequent abdominal pain than those who took a placebo (fake treatment). Different studies used different doses and types of probiotics, however, and it is not clear how the size of the probiotic dose relates to pain in children with IBS.
• A 2020 review and analysis of 35 studies involving 3,452 people with IBS found that taking probiotics for 4 weeks may help relieve IBS symptoms such as abdominal pain, bloating, and gas. Better results were obtained with combination probiotics than single probiotics. However, because of small study sizes and differences in the types of probiotics and methods used in the studies, it is not clear which types of probiotics are the most effective.
• A 2019 review and analysis of 14 studies in 1,695 people with IBS reported that daily doses of probiotics containing Lactobacillus and Bifidobacterium microorganisms relieved overall IBS symptoms more than daily doses of a single probiotic.
• Probiotics have an extensive history of apparently safe use, particularly in healthy people. However, few studies have looked at the safety of probiotics in detail, so there’s a lack of solid information on the frequency and severity of side effects. The risk of harmful effects from probiotics is greater in people who are seriously ill or have compromised immune systems.
• In people with IBS, probiotics usually have only minor side effects, if any. Side effects that have been reported include cramping and nausea. Rarely, more serious side effects have been reported, including infections and acidosis, a potentially life-threatening condition where there is too much acid in the body.
• Most research about the safety of probiotics comes from studies of Lactobacillus and Bifidobacterium; less is known about other probiotics.

Prebiotics

• Prebiotics are nondigestible ingredients in food or dietary supplements that support the growth or activity of beneficial gut bacteria.
• A 2019 review and analysis of 11 studies in 729 people with IBS or other functional bowel disorders found that taking prebiotic supplements did not improve GI symptoms or quality of life. Moderate amounts of some prebiotics, specifically less than 6 grams/day of non-inulin-type fructans, improved gassiness. However, other prebiotics (inulin-type fructans) had the opposite effect; they increased gassiness in people with IBS.
• Prebiotics have a long history of safe use. However, when taken in large doses (more than 20 grams per day for an adult), they can have side effects including gassiness, bloating, abdominal pain, cramps, and diarrhea.

Psychological and Physical Approaches

Gut-Directed Hypnotherapy (Hypnosis)

In hypnosis, practitioners help lead people into a state where they are open to suggestion. In gut-directed hypnotherapy, practitioners make suggestions aimed at allowing people to control their GI functions.

There is some evidence that gut-directed hypnotherapy can help people who have IBS with GI symptoms, anxiety, depression, disability, and health-related quality of life. Research has also reported that gut-directed hypnotherapy can help relieve GI pain in children with IBS.

• Practice guidelines issued in 2021 by the American College of Gastroenterology recommend gut-directed psychotherapies including gut-directed hypnotherapy for treating IBS symptoms. This recommendation is conditional, however, based on very low-quality evidence.
• A 2020 review and analysis of 41 studies in 4,072 people found that gut-directed hypnotherapy helped improve IBS symptoms or pain more than education in adults with IBS. However, it did not help more than other psychological therapies, such as cognitive behavioral therapy or stress management, which worked about as well. In people with refractory IBS symptoms (symptoms that are ongoing and do not respond to conventional treatments), cognitive behavioral therapy and gut-directed hypnotherapy helped the most over the long term.
• A 2017 review of 4 studies in 146 children and adolescents with recurrent abdominal pain and functional abdominal pain disorders including IBS reported that hypnotherapy and guided imagery may reduce pain frequency and intensity in this age group in the short term, based on low-quality evidence.
• The use of hypnosis in the treatment of medical conditions has a good safety record. However, it’s possible that hypnosis could worsen symptoms in people with some mental health conditions.

Yoga

• A small amount of evidence suggests that yoga and other types of exercise may be helpful for IBS. A 2022 review of 5 studies in 218 people with IBS reported improvement in IBS symptoms but not pain or quality of life from doing yoga. The authors of the study cautioned, however, that the quality of the evidence was very low.
• Yoga is generally considered a safe form of physical activity for healthy people when performed properly, under the guidance of a qualified instructor. However, as with other forms of physical activity, injuries can occur. The most common injuries are sprains and strains. Serious injuries are rare. The risk of injury associated with yoga is lower than that for higher impact sports activities.

Meditation and Mindfulness

There is little research on the benefits of meditation and mindfulness for improving health in people with IBS, and the results are not conclusive.

• A 2018 review of 5 studies in 695 people concluded that in addition to receiving conventional care, participating in online mindfulness along with education or cognitive behavioral therapy can benefit general health in people with health conditions including IBS.
• A 2019 review and analysis of 2 studies in 165 people reported that mindfulness meditation training did not improve IBS symptoms, based on low-quality evidence.
• Meditation and mindfulness practices usually are considered to have few risks. However, few studies have examined these practices for potentially harmful effects, so it isn’t possible to make definite statements about safety.

Acupuncture

The research on acupuncture for IBS is mixed. When compared with sham (fake) acupuncture, real acupuncture does not improve IBS symptoms. However, research that compared acupuncture to various medications found that acupuncture was more effective in relieving IBS symptoms.

• A 2021 review and analysis of 24 studies in 3,220 people with IBS found that in studies comparing acupuncture to various medications, acupuncture was more effective in relieving IBS symptoms. When used in combination with other treatments including medicines or herbs, acupuncture helped to improve their effectiveness in treating IBS symptoms. However, acupuncture did not work better than sham acupuncture for improving IBS symptoms. The authors noted that the quality of the evidence was low to moderate in the reviewed studies.
• Relatively few complications from using acupuncture have been reported. However, complications have resulted from use of nonsterile needles and improper delivery of treatments.
• When not delivered properly, acupuncture can cause serious adverse effects, including infections, punctured organs, and injury to the central nervous system.
• The U.S. Food and Drug Administration (FDA) regulates acupuncture needles as medical devices and requires that they be sterile and labeled for single use only.

Relaxation Techniques

There has been a small amount of research on the use of relaxation therapy for IBS.

• A 2021 review and analysis of 6 studies in 278 people with IBS reported that relaxation therapy was not helpful for abdominal pain or overall symptoms from IBS.
• Relaxation techniques are generally considered safe for healthy people. In most research studies, there have been no reported negative side effects. However, occasionally, people report negative experiences such as increased anxiety, intrusive thoughts, or fear of losing control.
• There have been rare reports that certain relaxation techniques might cause or worsen symptoms in people with epilepsy or certain psychiatric conditions, or with a history of abuse or trauma.

More About Complementary Psychological and Physical Approaches

A 2020 analysis of 53 studies looked at using a variety of complementary psychological and physical approaches in adults and children with IBS. Among the included approaches were various relaxation techniques, yoga, meditation, hypnosis, and biofeedback (i.e., using breathing or information from external devices to learn how to control heart rate or other body functions). The authors concluded that, when used together with medicinal treatment, these complementary psychological and physical approaches along with conventional psychological therapies, such as psychoeducation and cognitive behavioral therapy, can help reduce IBS symptom severity. They also found that different complementary psychological and physical approaches appear to be equally effective; none appears to be more effective than the others.

More To Consider

• If you have IBS, you may have to try a few treatments—lifestyle changes, medicines, probiotics, mental health therapies—to see what works best for you. See what your health care provider recommends.
• If you’re considering a practitioner-provided complementary health practice such as hypnotherapy or acupuncture, ask a trusted source (such as the health care provider who treats your IBS or a nearby hospital) to recommend a practitioner. Find out about the training and experience of any practitioner you’re considering.
• Keep in mind that some dietary supplements can interact with medications or other dietary supplements. They also may contain ingredients not listed on the label. Your health care provider can advise you about potential interactions. If you’re pregnant or nursing a child, or if you’re considering using a dietary supplement for a child, it’s especially important to consult your (or the child’s) health care provider.
• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.

There is some evidence that suggests some probiotics may improve symptoms of IBS; however, benefits have not been conclusively demonstrated, and not all probiotics have the same effects. Clinical guidelines issued in 2021 by the American College of Gastroenterology recommend against the use of probiotics for the treatment of global IBS symptoms. (The recommendation is conditional, with “very low level of evidence.”)

Prebiotics are specialized plant fibers that beneficially nourish the good bacteria already in the large bowel or colon. They are a nondigestible food ingredient, are not affected by heat, cold, acid, or time, and provide a wide range of health benefits. There has been increasing interest in prebiotics because they may reduce the risk for certain conditions and help improve health. However, the quality of evidence examining the effect of prebiotics in IBS is poor and more well-designed, long-term clinical trials are needed to support health claims.

What Does the Research Show?

• Clinical guidelines issued in 2021 by the American College of Gastroenterology recommend against the use of probiotics for the treatment of global IBS symptoms. (The recommendation is conditional, with “very low level of evidence.”) Authors of the guidelines noted that there are challenges in interpreting the existing literature because of small studies, the multiple types and strains of probiotics, the inconsistent benefits on individual symptoms, and the lack of rigorous trials based on U.S. Food and Drug Administration (FDA) endpoints.
• A 2022 systematic review and meta-analysis of 10 randomized controlled trials involving 757 patients with constipation-predominant IBS (IBS-C) found that compared to placebo, probiotics significantly improved stool consistency and increased the number of fecal Bifidobacteria and Lactobacillus; however, no significant differences were found in abdominal pain scores, bloating scores, or quality-of-life scores. It is important to note that only three studies included in the review were rated as having low risk of bias.
• A 2021 systematic review and meta-analysis of 9 randomized controlled trials involving 651 pediatric patients found that probiotics significantly reduced the abdominal pain score, increased the rate of abdominal pain treatment success and abdominal pain relief, and reduced the frequency of abdominal pain. But, increasing the daily intake of probiotics was not found to decrease abdominal pain further and, thus, no significant correlation between abdominal pain and the amount of probiotics ingested was found. The authors suggest that determining the most suitable probiotics may be relatively more important.
• A 2020 systematic review and meta-analysis of 35 randomized controlled trials involving 3,452 participants found that compared to placebo, probiotics improved persistent symptoms and showed beneficial effects on global IBS symptoms, including abdominal pain, bloating, and flatulence. The authors noted that there was a trend toward a beneficial effect of Bifidobacterium on global IBS symptoms and pain scores, although the strain or species responsible was uncertain.
• A 2019 review and meta-analysis of 14 studies involving a total of 1,695 participants with IBS found that daily low doses of probiotics containing Lactobacillus and Bifidobacterium microorganisms were superior to daily doses of a single probiotic or higher doses of the two probiotics.
• A 2019 systematic review of 11 studies evaluating the effects of probiotics on IBS symptoms found mixed results. Seven of the studies included in the review reported that probiotics significantly improved IBS symptoms compared with placebo, whereas the other four studies did not report any significant improvement in IBS symptoms after taking probiotics. It is important to note that three studies included in the review involved a monostrain supplement, while the remaining eight studies used a multistrain probiotic. Overall, the reviewers noted that the multistrain probiotic supplements given over 8 weeks or more appeared to produce more distinct beneficial effects.
• A 2019 randomized, double-blind, placebo-controlled, multicenter trial involving 109 patients with celiac disease on a strict gluten-free diet found that a 6-week probiotic treatment used in the study was beneficial in improving the severity of IBS-type symptoms and is associated with a modification of gut microbiota, characterized by an increase of Bifidobacterium.
• A 2019 review and analysis of 11 randomized controlled trials in 729 people with IBS or other functional bowel disorders found that taking prebiotic supplements did not improve gastrointestinal symptoms or quality of life compared to placebo. Moderate amounts of some prebiotics, specifically less than 6 grams/day of non-inulin-type fructans, improved flatulence. However, other prebiotics (inulin-type fructans) had the opposite effect; they increased flatulence in people with IBS.

Safety

• In healthy people, probiotics usually have only minor side effects, if any. However, in people with underlying health problems (for example, weakened immune systems), serious complications, such as infections, have occasionally been reported.
• Most research about safety of probiotics comes from studies of Lactobacillus and Bifidobacterium; less is known about other probiotic strains.

• While adverse events were rare, they were significantly more frequent in participants who received probiotics compared to placebo.

• Prebiotics are generally considered safe for most people. However, when taken in large doses (more than 20 grams per day for an adult), they can have side effects including flatulence, bloating, abdominal pain, cramps, and diarrhea.

Some studies have suggested benefit of gut-directed hypnotherapy for IBS symptoms, including gastrointestinal symptoms, anxiety, depression, disability, and health-related quality of life. Significant relief from pain-related functional gastrointestinal pain disorders in children has been reported after hypnotherapy compared with standard care or waitlist approaches. Clinical guidelines issued in 2021 by the American College of Gastroenterology recommend that gut-directed psychotherapies, such as gut-directed hypnotherapy, be used to treat global IBS symptoms. (The recommendation is conditional, with “very low quality of evidence.”)

What Does the Research Show?

• Clinical guidelines issued in 2021 by the American College of Gastroenterology recommend that gut-directed psychotherapies, such as gut-directed hypnotherapy, be used to treat global IBS symptoms. (The recommendation is conditional, with “very low quality of evidence.”)
• A 2020 systematic review and network meta-analysis of 41 randomized controlled trials involving a total of 4,072 participants found that gut-directed hypnotherapy was more efficacious than either education and/or support or routine care in adults with IBS. However, other psychological therapies were analyzed as well, and none was superior to another; cognitive behavioral therapy and gut-directed hypnotherapy had the largest evidence base and were the most efficacious over the long term.
• A 2022 systematic review and meta-analysis of 33 randomized controlled trials involving a total of 2,657 children with functional abdominal pain disorders found that hypnotherapy may be considered as a treatment for these disorders in childhood.
• A 2015 review of seven randomized trials of gut-directed hypnotherapy for IBS found that six of those trials reported a significant reduction in overall gastrointestinal symptoms compared to supportive therapy only. The reviewers concluded that gut-directed hypnotherapy has durable efficacy in patients with IBS, but there is not enough evidence to determine whether hypnotherapy belongs as a primary or adjunctive therapy option for patients with IBS.

Safety

• Gut-directed hypnosis is generally considered safe and tolerable among children and adults when led by licensed hypnotherapists with special training in this technique.

There is some evidence that enteric-coated peppermint oil capsules may be modestly efficacious, in the short term, in reducing several common symptoms of IBS, in particular abdominal pain, bloating, and gas. Long-term efficacy has not been established. Clinical guidelines issued in 2021 by the American College of Gastroenterology recommend the use of peppermint to provide relief of global IBS symptoms. (The recommendation is conditional, with “low quality of evidence.”)

What Does the Research Show?

• Clinical guidelines issued in 2021 by the American College of Gastroenterology recommend the use of peppermint to provide relief of global IBS symptoms. (The recommendation is conditional, with “low quality of evidence.”)
• A 2020 randomized, double-blind trial of 190 patients in the Netherlands found that neither small-intestinal-release nor ileocolonic-release peppermint oil, administered over 8 weeks, produced statistically significant reductions in abdominal pain response or overall symptom relief, when using U.S. FDA/European Medicines Agency recommended endpoints. However, the small-intestinal-release peppermint oil did produce significant reductions in abdominal pain, discomfort, and IBS severity.
• A 2020 systematic review and network meta-analysis of 51 randomized controlled trials involving 4,644 patients evaluated soluble fiber, antispasmodic drugs, peppermint oil, and gut-brain neuromodulators for IBS. The reviewers found peppermint oil was ranked first for efficacy with regard to improvement in global IBS symptoms, on the basis of data from six trials. However, the reviewers also noted that only 13 trials were at low risk of bias, and therefore, there is likely to be considerable uncertainty around these findings.
• A 2021 randomized double-blind, placebo-controlled trial involving 133 participants compared the effects of peppermint oil to placebo for relieving IBS symptoms. The results showed clinically significant improvements after 6 weeks in both groups. However, there were no statistically significant differences between peppermint oil and placebo on any of the outcome measures (improvement in IBS-Severity Scoring System scores, global improvement of IBS symptoms, and adequate relief of symptoms). Although there were no serious adverse events, there was a higher rate of adverse events, as well as adverse event-related dropouts in peppermint oil compared to placebo.
• A 2014 systematic review and meta-analysis of 9 studies involving a total of 726 participants found peppermint oil to be superior to placebo for global improvement of IBS symptoms and improvement in abdominal pain.

Safety

• Non-enteric coated forms of peppermint oil may cause or worsen heartburn symptoms, but otherwise appears to be generally safe over the short term.

There is evidence to suggest some herbal remedies improve IBS symptoms. However, much of the data available is based on studies with inadequate methodology and small sample populations.

What Does the Research Show?

• A 2021 network meta-analysis of 28 studies in 3,323 people found low-quality evidence that Chinese herbal products could be beneficial for patients with IBS in relieving their various clinical symptoms and improving their quality of life.
• A 2017 double-blind, randomized, placebo-controlled trial involving 99 participants found that those who received an herbal remedy (IQP-CL-101) containing a mixture of curcuminoids and essential oils from different Curcuma species, fish oil, peppermint oil, caraway oil, and vitamins B1, B9, and D3, had a significant reduction in IBS symptoms compared to placebo.
• A 2019 randomized trial of 240 women with diarrhea-predominant irritable bowel syndrome (IBS-D) found that crofelemer, an active compound from the latex of the plant Croton lechleri, had no significant effect compared with placebo on the number of days without pain and discomfort. However, in an analysis conducted after the trial ended, crofelemer did improve abdominal pain compared with placebo based on the FDA abdominal pain monthly responder endpoint, which suggests that crofelemer may have a role in the management of pain in IBS-D.
• A 2006 Cochrane review of 75 randomized controlled trials involving a total of 7,957 participants with IBS concluded that while some herbal remedies may improve IBS symptoms, positive findings from less rigorous trials should be interpreted with caution due to inadequate methodology, small sample sizes, and lack of confirming data.

Safety

• Herbal supplements may contain dozens of compounds and all of its ingredients may not be known.
• Some herbs can interact with medications. For example, St. John’s wort is a potent inducer of both cytochrome P-450 enzymes and intestinal P-glycoprotein. Clinically significant interactions have been documented with St. John’s wort and cyclosporine, the antiretroviral agent indinavir, oral contraceptives, coumadin, digoxin, and benzodiazepines, among others.
• Some herbs can cause serious side effects. For example, comfrey and kava can cause liver toxicity.

In sham-controlled, randomized trials, acupuncture was found to be no better than placebo for IBS symptom severity or health-related quality of life. In other studies, acupuncture appeared to provide greater benefits than two antispasmodic drugs, although the studies could not rule out that these benefits may have been due to patient preferences or expectations of improvement.

What Does the Research Show?

• A 2021 systematic review and meta-analysis of 24 studies involving 3,220 participants with IBS found that in studies that compared acupuncture to pharmacotherapy, acupuncture was superior in relieving IBS symptoms. When used as an adjuvant intervention to other treatments, including pharmacotherapy and herbal medicine, acupuncture helped to improve clinical efficacy in treating IBS symptoms. However, acupuncture was not superior to sham acupuncture for improving IBS symptoms. The authors noted that the quality of the evidence was low to moderate in the reviewed studies.
• A 2019 meta-analysis of 41 studies involving a total of 3,440 participants showed that acupuncture was no more effective than sham acupuncture for symptoms of IBS, but there was some evidence that acupuncture could be helpful when used in addition to other forms of treatment.
• A 2014 meta-analysis of six randomized, placebo-controlled trials found some benefit of acupuncture for IBS symptoms; however, only one of the six studies showed a positive effect. The authors concluded that data are insufficient to establish long-term results or to recommend acupuncture as first-line treatment.
• A 2012 Cochrane review of 17 randomized controlled trials involving a total of 1,806 participants found no evidence of an improvement with acupuncture compared to a sham acupuncture control for symptom severity or quality of life. The review also included four Chinese comparative effectiveness trials and found acupuncture to provide greater benefits than two antispasmodic drugs (pinaverium bromide and trimebutine maleate), which have been known to provide modest benefits for IBS symptoms. However, it is unclear if the benefits of acupuncture in these studies were due to patient preferences or expectation of improvement.

Safety

• Relatively few complications from using acupuncture have been reported. Still, complications have resulted from use of non-sterile needles and improper delivery of treatments.
• When not delivered properly, acupuncture can cause serious adverse effects, including infections, bleeding, pneumothorax, and injury to the central nervous system.

Irritable bowel syndrome (IBS) is a chronic disorder that interferes with the normal functions of the colon. Symptoms may include abdominal pain, cramping, bloating, constipation, and diarrhea. Many people with IBS turn to complementary health approaches to help relieve their symptoms, and there is emerging evidence that some of these approaches may have modest benefits.

Here are 7 things to know about complementary health approaches for IBS.

1. Probiotics. There is evidence that some probiotics may improve IBS symptoms, but benefits have not been conclusively demonstrated, and different probiotics may have different effects.

2. Gut-directed hypnotherapy (hypnosis). Some research suggests that gut-directed hypnotherapy may be helpful for gastrointestinal symptoms, anxiety, depression, disability, and health-related quality of life in people with IBS. Hypnosis may also help relieve pain in children with functional abdominal pain disorders, but the amount of evidence is small.

3. Peppermint oil. Enteric-coated peppermint oil capsules may have modest short-term benefits for several common IBS symptoms, including abdominal pain, bloating, and gas.

4. Herbal products. Besides peppermint oil, several other herbal products have been suggested as possible treatments for IBS. Very little high-quality research has been done on these products.

5. Acupuncture. In studies in which real acupuncture was compared to sham (fake) acupuncture, real acupuncture wasn’t more helpful than sham.

6. Yoga. A small amount of research suggests that yoga and other types of exercise may be helpful for symptoms of IBS.

7. Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.