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Natural Remedies for Irritable Bowel Syndrome: A Comprehensive Review of Herbal-Based Therapies
Open accessAbstract
Irritable Bowel Syndrome (IBS) is a complex and multifactorial gastrointestinal disorder characterized by recurrent abdominal pain and altered bowel habits, impacting quality of life. Therapy is mainly based on relieving symptoms with specific drugs, whereas herbal and complementary remedies have gained attention in recent years. This review examines the current knowledge on herbal remedies in IBS management. Several herbal treatments, particularly peppermint oil and Iberogast, have demonstrated efficacy in randomized controlled trials. Preclinical studies have revealed promising anti-inflammatory and antispasmodic effects for herbs, e.g., curcumin, fennel oil, and cannabis derivatives. However, many studies suffer from some limitations, e.g., small sample sizes, short study durations, or methodological weaknesses. There is a lack of large-scale, long-term randomized controlled trials for most herbal remedies, and heterogeneity in study designs makes direct comparisons challenging. Moreover, limited evidence exists regarding herb–drug interactions and long-term safety profiles. Despite these limitations, certain herbal remedies may offer a valuable complementary approach for some IBS patients when used under medical supervision. Future research should focus on larger, well-designed clinical trials to establish efficacy, optimal dosing, and long-term safety, as well as elucidate specific mechanisms of action and identify patient subgroups that may benefit most from specific herbal treatments.
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Overview
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TL;DR
This narrative review summarizes herbal and natural-product therapies for irritable bowel syndrome (IBS), emphasizing peppermint oil and Iberogast as the best-supported options and preclinical promise for curcumin, fennel oil, and cannabis derivatives. It concludes that most evidence remains limited by small, short, heterogeneous studies and calls for larger, long-term randomized trials.
Key findings
- IBS affects about 11% of people worldwide, with prevalence ranging from 1.1% in France and Iran to 35.5% in Mexico, and 35 million patients in the United States; the female–male ratio is 1.8–2:1.
- Peppermint oil and Iberogast (STW 5) have the strongest clinical support: a phase 3 trial in 69 Japanese patients using 187 mg peppermint oil improved patient global assessment, IBS symptom severity, stool frequency, and stool form; an observational study of 418 pediatric IBS patients (age 3–14 years) reported GI symptom score falling from 19.1 ± 8.9 to 4.8 ± 4.6 with 0.7% adverse events.
- Curcumin, fennel essential oil, and Cannabis sativa derivatives show preclinical anti-inflammatory, antispasmodic, or visceral-pain effects; a randomized trial of curcumin plus fennel essential oil (CU-FEO) in 121 mild-to-moderate IBS patients reduced abdominal pain and IBS-SSS after 30 days.
- Coffee evidence is mixed: a meta-analysis of >430,000 individuals found regular intake associated with lower likelihood of developing IBS (OR 0.84), but in diagnosed IBS patients coffee was linked to acute diarrhea and, in an Iranian study, weekly coffee increased IBS likelihood by 44% and high caffeine intake by 47%, with associations significant only in women (OR 1.48) and stronger in overweight/obese individuals (OR 1.72).
Methods
- Narrative/comprehensive review of herbal-based IBS therapies, covering peppermint oil, Iberogast (STW 5), curcumin, fennel essential oil, ginger, Aloe vera, Cannabis sativa, coffee, yellow gentian, and Chinese herbal medicine.
- Literature was searched in PubMed, Scopus, and Web of Science up to July 2025 using terms including “IBS,” “herbal remedies,” and specific herbal remedy names; the review synthesizes preclinical mechanisms, clinical evidence, and safety data rather than conducting a new primary study.
Limitations
- Stated by the paper: many studies have small sample sizes, short study durations, methodological weaknesses, heterogeneous designs, dosing regimens, and outcome measures; there is a lack of large-scale, long-term randomized controlled trials for most herbal remedies, limited evidence on herb–drug interactions and long-term safety, and most studies do not examine differential effects across IBS subtypes or patient subgroups.
- Stated by the paper: Chinese herbal medicines are often insufficiently characterized, limiting reproducibility; curcumin evidence comes mostly from studies with high risk of bias; and coffee studies are scarce, mostly observational, and heterogeneous, with no randomized clinical trials directly assessing coffee’s impact on IBS symptoms.
- Evident from the text: some remedies, such as yellow gentian, have no specific IBS studies reported, and several cannabis findings rely on preclinical models or small, uncontrolled, or unstratified human studies.
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“Preclinical studies have revealed promising anti-inflammatory and antispasmodic effects for herbs, e.g., curcumin, fennel oil, and cannabis derivatives.”
§ Natural Remedies for Irritable Bowel Syndrome: A Comprehensive Review of Herbal-Based Therapies > Abstract
plainstates a cause- Asserted: passes — The authors put it forward as true.
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“There is a lack of large-scale, long-term randomized controlled trials for most herbal remedies”
§ Natural Remedies for Irritable Bowel Syndrome: A Comprehensive Review of Herbal-Based Therapies > Abstract
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, limited evidence exists regarding herb–drug interactions and long-term safety profiles.”
§ Natural Remedies for Irritable Bowel Syndrome: A Comprehensive Review of Herbal-Based Therapies > Abstract
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Several herbal treatments, particularly peppermint oil and Iberogast, have demonstrated efficacy in randomized controlled trials.”
§ Natural Remedies for Irritable Bowel Syndrome: A Comprehensive Review of Herbal-Based Therapies > Abstract
boostedstates a cause- Asserted: passes — The authors put it forward as true.
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In the paper
“However, many studies suffer from some limitations, e.g., small sample sizes, short study durations, or methodological weaknesses.”
§ Natural Remedies for Irritable Bowel Syndrome: A Comprehensive Review of Herbal-Based Therapies > Abstract
plain- Asserted: passes — The authors put it forward as true.
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Sex-specific brain microstructural reorganization in irritable bowel syndrome
Labus, J. S., Wang, C., Mayer, E. A., Gupta, A., Oughourlian, T. C., Kilpatrick, L. A., Tillisch, K., Chang, L., Naliboff, B. D., & Ellingson, B. M. (2022) · Pain · doi:10.1097/j.pain.0000000000002699 · Cited by 13
Lee, J., Yau, C., Loh, C., Lim, W., Teoh, S., Yau, C., Ong, C., Thumboo, J., Namasivayam, V., & Ng, Q. (2023) · Nutrients · doi:10.3390/nu15224745 · Cited by 13
Coffee, Alcohol, and Artificial Sweeteners Have Temporal Associations with Gastrointestinal Symptoms
Clevers, E., Launders, D., Helme, D., Nybacka, S., Störsrud, S., Corsetti, M., Van Oudenhove, L., Simrén, M., & Tack, J. (2024) · Digestive Diseases and Sciences · doi:10.1007/s10620-024-08457-y · Cited by 13
Functional Foods and Nutraceuticals in Irritable Bowel Syndrome
Marasco, G., Cremon, C., Salvi, D., Meacci, D., Dajti, E., Colecchia, L., Barbaro, M. R., Stanghellini, V., & Barbara, G. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14061830 · Cited by 13
Tu, X., Ren, H., & Bu, S. (2023) · Frontiers in Microbiology · doi:10.3389/fmicb.2023.1274559 · Cited by 12
Goodoory, V. C., Riggott, C., Khasawneh, M., Black, C. J., & Ford, A. C. (2024) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.18363 · Cited by 12
Ahluwalia, B., Magnusson, M. K., Böhn, L., Störsrud, S., Larsson, F., Öhman, L., & Simrén, M. (2021) · Therapeutic Advances in Gastroenterology · doi:10.1177/17562848211048133 · Cited by 11
A systematic review of the efficacy and safety of turmeric in the treatment of digestive disorders
Thavorn, K., Wolfe, D., Faust, L., Shorr, R., Akkawi, M., Isaranuwatchai, W., Klinger, C., Chai‐Adisaksopa, C., Tanvejsilp, P., Nochaiwong, S., et al. (2024) · Phytotherapy Research · doi:10.1002/ptr.8189 · Cited by 11
Pellegrino, R., & Gravina, A. G. (2025) · World Journal of Gastroenterology · doi:10.3748/wjg.v31.i8.101357 · Cited by 11
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The Role and Function of TRPM8 in the Digestive System
Wu, Z., Peng, S., Huang, W., Zhang, Y., Liu, Y., Yu, X., & Shen, L. (2024) · Biomolecules · doi:10.3390/biom14070877 · Cited by 10
Pop, D. M., Pop, R. S., & Farcău, D. (2023) · Nutrients · doi:10.3390/nu15204351 · Cited by 9
Aguilar, A., Benslaiman, B., & Serra, J. (2024) · Neurogastroenterology & Motility · doi:10.1111/nmo.14765 · Cited by 9
Systematic Review: Integrated Models of Care for Managing Irritable Bowel Syndrome
Warner, M. M., Soliman, O. M., Crichton, M., Marshall, S., Staudacher, H. M., & Kelly, J. T. (2025) · Neurogastroenterology & Motility · doi:10.1111/nmo.14989 · Cited by 9
Matsueda, K., Fukudo, S., Ogishima, M., Naito, Y., & Nakamura, S. (2024) · BioPsychoSocial Medicine · doi:10.1186/s13030-024-00302-y · Cited by 8
Entourage Effects of Nonpsychotropic Cannabinoids on Visceral Sensitivity in Experimental Colitis
Svendsen, K., Bradaia, A., Gandini, M. A., Defaye, M., Matisz, C., Abdullah, N. S., Gruber, A., Zamponi, G. W., Sharkey, K. A., & Altier, C. (2025) · The Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/j.jpet.2025.103389 · Cited by 8
Stress and the gut microbiota-brain axis
Hyder, N., & Raza, M. L. (2025) · Progress in brain research · doi:10.1016/bs.pbr.2025.01.002 · Cited by 8
Moniruzzaman, M., Shah, A., Morrison, M., Koloski, N., Gwee, K. A., Chen, M., Kim, Y., Ayaki, K., Efferth, T., & Holtmann, G. (2025) · Digestive and Liver Disease · doi:10.1016/j.dld.2025.07.010 · Cited by 8
Li, F., Yano, Y., Étiévant, L., Daniel, C. R., Sharma, S. V., Brown, E. L., Li, R., Loftfield, E., Lan, Q., Sinha, R. R., et al. (2024) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002675 · Cited by 7
Krynicka, P., Kaczmarczyk, M., Skonieczna‐Żydecka, K., Cembrowska-Lech, D., Podsiadło, K., Dąbkowski, K., Gaweł, K., Botke, N., Zawada, I., Ławniczak, M., et al. (2025) · BMC Gastroenterology · doi:10.1186/s12876-024-03580-6 · Cited by 7
Carter, K. A. (2024) · JAAPA · doi:10.1097/01.jaa.0000000000000035 · Cited by 6
Editorial: Rebuilding Rome—Revising Diagnostic Criteria for Irritable Bowel Syndrome
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Gastrointestinal transit abnormalities in irritable bowel syndrome and their relation to symptoms
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Drug Survival of Drugs Recommended for Irritable Bowel Syndrome: A Retrospective Observational Study
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Aggeletopoulou, I., Karaivazoglou, K., Kalafateli, M., & Triantos, C. K. (2025) · Nutrients · doi:10.3390/nu17223595 · Cited by 6
Natural Compounds for Counteracting GI and Liver Diseases
Abalo, R., & Gabbia, D. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27146475 · Cited by 1
Self-citationCurrent Treatment Strategies for Irritable Bowel Syndrome - A Literature Review
Michałek, S., Rokosz, J., Sładek, K., Koczuk, J., Mazur, K., Trzepizur, A., & Wnorowski, B. (2026) · Journal of Education Health and Sport · doi:10.12775/jehs.2026.90.70580
Pathophysiology-driven use of natural products in irritable bowel syndrome: a review
Mohamed, F. A., Hassan, M.-A. M., Aboulmagd, Y. M., Attallah, K. A., Ghaiad, H. R., El‐Shiekh, R. A., & Fahmy, M. I. (2026) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-026-05337-2
Choi, W.-G., Choi, N. R., Jung, D., Kim, S. C., Woo, J., & Kim, B. J. (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.1813619
Metadata
- Authors
- Abalo, R., Gallego-Barceló, P., & Gabbia, D.
- Affiliations
- Consejo Superior de Investigaciones Científicas (ES)
- Universidad Rey Juan Carlos (ES)
- University of Padua (IT)
- Corresponding author
- Abalo, Raquel
- Gabbia, Daniela
- Venue
- International Journal of Molecular Sciences
- Publisher
- MDPI AG
- Published
- 2025-09-24
- Volume
- 26
- Issue
- 19
- Pages
- 9345
- ISSN
- 1422-0067 (ISSN-L)
- PMC
- PMC12525128
- OpenAlex
- W4414516413
- Cited by
- 5
- References
- 110
- Citations by year
- 2026: 4 · 2025: 1
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Molecular Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion, cc-by)
- Funders
- University Rey Juan Carlos (URJC, Bridge project 2024, A671)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Health and Development
- Keywords
- irritable bowel syndrome, herbal medicine, complementary therapy, peppermint oil, Iberogast, curcumin, fennel essential oil, cannabis derivatives, anti-inflammatory activity, antispasmodic activity, herb-drug interactions, long-term safety, randomized controlled trials
- MeSH terms
- Animals, Humans, Phytotherapy, Plant Oils, Quality of Life, Randomized Controlled Trials as Topic, Mentha piperita, Irritable Bowel Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-11-14, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
