I get it — when you have IBS, you’re often willing to do whatever it takes to get relief from your frustrating symptoms. While there seem to be a LOT of so-called “IBS cures” out there, not all of them are rooted in scientific evidence.
Today, I’m sharing 11 of my favourite evidence-based IBS interventions that actually work. From revolutionary diets and fibre supplements to cognitive behavioural therapy, gut-directed hypnotherapy, and exercise, there are numerous effective strategies that shrink bloated bellies, relieve foul gas and normalize bowel movements.
The keys to any IBS management plan are finding what works for you and recognizing that you may need to employ a few strategies to enjoy the best results.
Diet and Healthy Gut Habits
A balanced, varied diet is the foundation of IBS management. Here are some of my top 5 strategies for eating in a way that supports gut health and optimal functioning:
1. Focus on Fibre
Fibre requirements can vary from person to person. An adequate fibre intake is 25 grams per day for women and 38 grams per day for men. However, depending on your symptoms, you may need more or less than this.
Getting enough fibre involves eating at least 5 servings/day of fruits and veggies, enjoying nuts and/or seeds daily, making at least half your grains (eg. oats, rice) and grain products (eg. pasta, bread) whole grain, and including plant-based proteins like beans, and legumes, and tempeh in your diet a few times a week.
Increase dietary fibre slowly over several weeks to avoid any unpleasant side effects, and make sure you’re drinking at least 8 cups (2000ml) of fluid per day.
Looking for ways to boost your fibre intake? Here are 20 low FODMAP, high-fibre foods to add to your diet!
2. Prioritize Dietary Variety
Eating a varied diet promotes a robust gut microbiome that houses more of the good gut bugs and less of the potentially bad ones. It also helps to ensure your diet meets your nutritional needs and supplies plenty of inflammation-fighting antioxidants.
A varied diet is one that includes a wide range of different plant-based foods like legumes, fruits, veggies, whole grains, nuts, seeds, herbs, and spices throughout the week. Don’t just stick to buying the same fruits and veggies week after week – mix it up!
3. Follow a Mediterranean-Style Eating Pattern
A 2024 clinical trial found that a Mediterranean-style diet improves both gastrointestinal and psychological symptoms in people with IBS. Focus on colourful fruits and veggies, whole grains, legumes, nuts, seeds, olive oil, and fatty fish like salmon.
4. Minimize Common Food Triggers
Some foods are common food triggers in IBS. Many of my clients find sugary foods and high fat meals provoke various gut symptoms. Alcohol, coffee, and spicy foods are also commonly cited as aggravating.
5. Eat Consistently and Avoid Grazing
Some research shows that people with a regular meal pattern that involves 3 meals per day have less severe IBS symptoms.
Grazing throughout the day leads to stacking food up in your gut, thereby providing your gut microbiota with ongoing fuel that leads to gas production, bloating and discomfort. Many of my clients feel a lot better when they stick to 3 meals per day with 1-3 snacks between meals, rather than constantly eating little bits throughout the day.
The Low FODMAP Diet
The low FODMAP diet is an elimination diet that temporarily reduces symptom-inducing fermentable carbohydrates and slowly reintroduces them to identify which ones cause symptoms. When followed properly, the low FODMAP diet can bring about major relief from bloating, gas, abdominal pain and diarrhea.
Working with a Monash FODMAP-trained registered dietitian (like me!) is key to success on this tricky but effective diet. They’ll help you meet your nutrient needs and avoid overly restrictive eating, which can affect your microbiome and overall gut health.
If you’re not keen on doing a complete low FODMAP diet, consider a FODMAP Gentle Diet or focus on ways to relieve IBS symptoms without the low FODMAP diet.
Learn everything you need to know about the low FODMAP diet to see if it’s right for you. Get the details on how it helps and how to do it right.
Exercise and IBS
Regular, low- or moderate-intensity exercise can improve gut motility (which can relieve constipation) and help with gas clearance — both of which can ease common IBS symptoms. Exercise can also help reduce stress levels, which can benefit people whose IBS is especially sensitive to stress.
The best types of exercise for IBS are low- to moderate-intensity activities like walking, swimming, cycling, and yoga. Yoga may be particularly useful in alleviating digestive symptoms when gut-massaging, gas-relieving poses (asanas) are performed in tandem with breathwork and mindfulness meditation.
With any exercise, it’s best to listen to your body and build a routine that feels both sustainable and supportive.
Whether going for a hike, hopping on your bike or simply taking a post-dinner stroll, exercise can ease constipation, relieve gas and reduce abdominal pain. Learn which exercises are best for IBS symptom relief.
Fibre Therapy and Fibre Supplements
Fibre plays a crucial role in digestive health, intestinal motility, and supporting a flourishing gut microbiome. But not all fibre types are created equal.
Insoluble fibre (found in the skins and seeds of fruits, vegetables, whole grains and bran), stimulates intestinal motility and adds bulk to stool. As a result, it can improve constipation but worsen diarrhea.
Soluble fibre (found in oats, chia, psyllium, beans, the fleshy parts of fruit and vegetables) attracts water to both soften stool and make stool more cohesive, thereby improving both constipation and diarrhea.
If modifying food choices to tweak the balance of insoluble and soluble fibre in your diet doesn’t noticeably improve symptoms, fibre supplements can help bridge the gap.
Psyllium husk and partially hydrolyzed guar gum (PHGG) are both well-tolerated options that have been shown to improve bowel regularity and overall IBS symptoms. Psyllium in particular is a very useful tool in the battle to control bowels, and it’s the only fibre supplement recommended by the Canadian Association of Gastroenterology.
Gut-Directed Hypnotherapy
Gut-directed hypnotherapy may sound a little out there, but it’s actually a very evidence-based treatment for IBS. This technique uses relaxation and visualization techniques to help regulate the connection between the gut and the brain. It’s been shown in research to reduce IBS symptoms about as well as the low FODMAP diet. It’s also been shown to improve psychological symptoms in people with IBS.
The Nerva app offers a convenient gut-directed hypnotherapy program that’s been shown to improve IBS symptoms. A 2023 study supports the effectiveness of app-based gut-directed hypnotherapy programs. However, the same study found that many people didn’t stick to the app-based program. For it to be effective, you have to keep up with the program consistently!
Cognitive Behavioural Therapy
Cognitive behavioural therapy (CBT) is a therapy technique that can help you identify and reframe the unhelpful thought patterns that can worsen stress and physical IBS symptoms. CBT can reduce how strongly the brain reacts to GI discomfort by targeting the gut-brain connection, improving overall symptom management.
Several studies have shown that CBT significantly reduces the severity of many symptoms, especially abdominal pain and bloating. It’s particularly beneficial for people whose IBS symptoms are worsened by stress.
Sleep and IBS
Some research shows that poor sleep can worsen IBS symptoms by increasing visceral hypersensitivity (an extra-sensitive gut) and disrupting normal digestive rhythms. Sleep disturbances are more common in people with IBS, and people with IBS often report more severe symptoms after a night of poor sleep. This highlights the importance of developing a sleep routine that promotes both enough sleep and high-quality sleep.
Here are some of my favourite tips for better sleep:
- Stick to a consistent bedtime and wake time (even on weekends).
- Limit screen time for at least an hour before bed to reduce your exposure to blue light, which can disrupt circadian rhythms.
- Avoid large meals or snacks right before bedtime.
- Keep your bedroom cool, quiet, and dark to promote more restful sleep.
Peppermint Oil
Peppermint oil has antispasmodic properties, which means it helps relax the gut muscles. This can reduce the abdominal pain and discomfort that are common with IBS.
While there are lots of different peppermint oil supplements available, it’s best to choose an enteric-coated product. This coating prevents the peppermint oil capsule from breaking down too early in digestion and allows it to reach the intestines (where it’s most effective).
Some people may experience acid reflux or heartburn when they take peppermint oil capsules, but this is less common when taking enteric-coated products that don’t break down until they reach the intestines.
Probiotics
Probiotics are live microorganisms — usually bacteria, but sometimes yeasts — that can provide specific health benefits when taken in the right amounts. Probiotics are incredibly trendy at the moment, but contrary to popular belief, not everyone needs to take a probiotic for gut health.
Probiotics have strain-specific and condition-specific benefits. In other words, not every strain of probiotic works for every condition. Only certain strains have been shown to benefit IBS symptoms like gas and bloating. The Clinical Guide to Probiotic Products is a fantastic resource for choosing a probiotic with evidence-backed strains for symptom control.
Many studies looking at the effectiveness of probiotics on IBS last for a minimum of four weeks, which is why I suggest taking a probiotic for about four weeks once you’ve chosen an evidence-based product. If you don’t notice any improvement in your IBS symptoms after four weeks, stop taking the probiotic and consider other IBS management options.
Digestive Enzymes
While a lot of digestive enzyme products are available, not all of them are evidence-based. Here are some digestive enzymes that can help break down FODMAPs and may help reduce IBS symptoms:
- Alpha-galactosidase: This enzyme helps break down the galacto-oligosaccharides (GOS) found in legumes and cruciferous vegetables. Products like Beano contain this enzyme. Alpha-galactosidase has been shown to significantly reduce IBS symptoms when taken alongside foods high in GOS.
- Lactase: The lactase enzyme helps break down the lactose found in dairy products. It’s found in branded products like Lactaid and Lacteeze, but there are also many generic versions available. You can also buy lactose-free dairy products, which have the lactase enzyme added to them to break down the lactose.
- Fructan hydrolase: The fructan hydrolase enzyme breaks down the fructans found in foods like wheat, onions, and garlic.
FODZYME is a digestive enzyme supplement that contains all three of the enzymes listed above. You sprinkle it on your food before eating, and it breaks down the GOS, lactose, and fructans in real-time.
Pharmacotherapy: Prescription and Over-The-Counter Options
Last in our IBS management toolkit are over-the-counter (OTC) and prescription medications. Medications can play a key role in IBS management, especially when symptoms are severe and don’t respond to other treatments.
Here are some OTC medications that some people find helpful:
- Osmotic laxatives that draw water into the bowel to soften stool and promote bowel movements (like Restoralax, lactulose, or higher-dose magnesium supplements).
- Stimulant laxatives that stimulate the colon muscles to promote a bowel movement (like Senokot and Dulcolax).
- Anti-diarrheal medications (like Imodium and Pepto-Bismol). These should be used under the supervision of a doctor, especially if being used long-term.
- Hyoscine Butylbromide (eg. Buscopan), which can help calm cramping and spasms in your gut. It may help ease pain and discomfort.
- Simethicone (eg. Gas-X), which breaks up gas bubbles in the intestines and makes it easier to pass gas.
OTCs can be incredibly helpful when travelling, eating out, and managing short-term flare-ups.
There are also IBS subtype-specific prescription medications which target the underlying mechanisms behind symptoms.
Because IBS symptoms and triggers vary so widely from person to person, consulting with your family doctor or gastroenterologist to find the safest and most effective medication for your specific needs is important.
Bottom Line
Managing IBS often requires a combination of different strategies, from diet and lifestyle tweaks to supplements, therapy, and in some cases, medication. There’s no one-size-fits-all approach, which highlights why it’s so important to work with a healthcare provider who can create a plan that’s personalized to your unique needs.
While IBS is frustrating, with the right support, lasting relief is possible!
Thanks for reading!
xoAndrea, RD
