Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that affects approximately 15 percent of American adults.1
IBS is more common among patients under the age of 45 than among older ones, and is twice as common among women as among men. Although the exact cause has not yet been pinpointed, symptoms often include abdominal cramping or pain, bloating, gassiness, and unstable bowel habits that vary between diarrhea and constipation.1
Because there is no precise cause, there is no treatment, per se. Instead, patients are advised to manage their symptoms through changes in diet to include more fiber and cut out potential trigger foods, such as those high in fat or carbohydrates. Probiotics may also help regulate the digestive system.1 IBS flare-ups may occur in response to stress, so mindful meditation or yoga may also be helpful.
However, you should not be surprised if some of your patients still have trouble with IBS from time to time, despite their best efforts to manage symptoms. What more can you do to help them manage their IBS, beyond just diet and stress management? Some interesting new research points toward a particular chemical plant compound called berberine, found in many popular herbal supplements, as having a possible key role in helping treat IBS symptoms of diarrhea.
What is berberine?
Berberine is a chemical compound found in several medicinal herbs, including goldthread (particularly within Chinese herbal medicine) and Oregon grape, which is more common in the US.2,4 It is thought to be effective against diabetes, as well as have anti-inflammatory properties.
Some studies have shown that 1500 mg of berberine, in three 500-mg doses can be as effective of 1500 mg of metformin, a standard pharmaceutical for treating Type II diabetes. It is thought to do this by reducing the production of glucose in the liver.3 Berberine may also be able to reduce high levels of low-density lipoproteins (LDLs), or “bad” cholesterol.2
Berberine uses for IBS
A 2015 article published in the journal Phytotherapy Research examined the effect of berberine on treating diarrhea symptoms of IBS by comparing its effectiveness to placebo treatment.4 A total of 132 patients with IBS-D (predominantly diarrhea symptoms) were randomized to receive either 200 mg berberine (70 patients) or 200 mg vitamin C as placebo (62 patients). All study subjects were given either the supplement or the placebo twice a day for eight weeks.4 Patients were then followed for an additional four weeks to determine the effect of the intervention on their IBS symptoms.
At the end of the initial eight weeks, both the berberine and placebo groups reported a reduction in symptoms, although the berberine group reported greater benefit. The berberine group also reported less diarrhea symptom frequency and urgency, starting at the fourth week.4
Although both groups reported a reduction in abdominal pain, the berberine group showed greater pain reduction starting at the third week and had reduced pain levels by 64 % by the eighth week, compared to only 29 percent for the placebo group.4 The researchers concluded: “Berberine hydrochloride, conveniently delivered, is well tolerated and reduces diarrhea frequency, abdominal pain frequency, and overall IBS-D symptoms score, as well as anxiety and depression scores.”
Your patients who are frustrated with their ongoing IBS flare-ups may be looking for other ways to manage their symptoms. Berberine may offer a way for them to manage some of these.
Irritable bowel syndrome FAQs. Accessed 2/23/2017.
Berberine: Uses, side effects, interactions and warnings. Accessed 2/23/2017.
Examine.com. Accessed 2/23/2017.
Chen C, Tao C, Liu Z, et al. A randomized clinical trial of berberine hydrochloride in patients with diarrhea-predominant irritable bowel syndrome. Phytother Res. 2015;29(11):1822–1827.