Food Cures (64 page)

SUPPLEMENTS

If you suffer from IBS and want to consider supplements
in addition to
the food fixes, I recommend:

1. Multivitamin.
   I recommend a multivitamin to ensure that you always get the basic nutrition you might otherwise miss if you’re tip-toeing around a sensitive stomach. Unfortunately, many people with IBS find that vitamins upset the delicate balance of their digestive systems. Look for liquid or chewable multivitamins—any brand, even children’s chewables, are great for people with IBS. Read the label, and take the amount recommended for adults.
   
2. Calcium and vitamin D
   ₃
   .
   If you have IBS triggered by milk products, you may not get enough calcium in your diet to stay healthy. Women may want to consider taking a calcium supplement with added vitamin D
   ₃
   (cholecalciferol, the most potent form). The vitamin D is necessary, otherwise your body can’t absorb and use the calcium. I recommend taking 500 to 600 milligrams of calcium (plus 100 to 400 IU of vitamin D) twice a day. (If you are a man, talk with your doctor before taking a calcium supplement. There is some evidence that too much calcium may be related to an increased risk of developing prostate cancer.) I recommend brands that contain calcium citrate (instead of the more common calcium carbonate), because it is easier on the stomach. One of my favorite brands is Citracal Plus, which also contains vitamin D and magnesium (take two tablets twice a day). If you can’t swallow a pill, look for chewy supplements.
   Important note:
   Some chews contain lactose, so if milk bothers your stomach, avoid the chews. Instead, buy the pill form, crush them with a pill crusher, and mix with natural applesauce to help them go down more easily.
   
3. Probiotics.
   Our intestines are full of microorganisms, but that’s not necessarily bad. Some of the bacteria and yeast microorganisms are good for us, and can help keep us healthy. Some experts believe that people with IBS don’t have enough of the good microorganisms, which is why their intestines seem to be out of balance. Probiotics are supplements that provide more of the good stuff, which can prevent the bad stuff from causing diarrhea or constipation. There are many varieties of probiotics, but the brand I recommend most often for IBS is Florastor (which contains
   Saccharomyces boulardii
   ), a non-harmful yeast. You should take one capsule twice a day, morning and evening. Although most probiotics require refrigeration, the Florastor brand should
   not
   be stored in the fridge—always read labels. Research shows that other probiotics, including
   Lactobacillus plantarum
   (Lp299v) and
   Bifidobacterium infantis
   , also help reduce pain, bloating, and abnormal bowel movements. Another respected brand to consider is VSL#3—take ½ to 1 packet per day for IBS. When taking probiotics, keep in mind that for the first two to seven days, your symptoms may worsen. Don’t panic, the supplements are just doing their job. Your body will soon adjust and you’ll most likely feel better than baseline. Florastor and other probiotics are often sold behind the pharmacy counters at mainstream drug stores. Speak with your local pharmacist if you have trouble finding them.
   
4. Enteric-coated peppermint oil.
   Peppermint naturally reduces gastrointestinal muscle spasms. It also acts as an antimicrobial agent, capable of stopping the growth of some strains of bacteria—particularly some harmful bacteria. For both those reasons, researchers have studied peppermint oil as a way to control IBS symptoms. The results have been mixed, but there is some strong evidence that peppermint oil may work as well as some smooth muscle relaxant medications (called
   anticholinergics
   ). Treatment with peppermint oil capsules seem to help reduce abdominal pain, distention, flatulence, and diarrhea. Studies have found that participants get some relief if they take a total of 0.2 to 0.4 mL, three times a day 15 to 30 minutes before meals for one or two weeks. Choose a brand that is enteric-coated, which means that the supplements are specially designed to bypass the stomach and dissolve only in the intestines, reducing the possibility of heartburn and stomach distress.
   
5. Beano.
   When we eat beans, we get gas. It’s a fact of life. That’s because we don’t have enough of an enzyme called
   alpha-galactosidase
   , which breaks down certain components of complex carbohydrates. The bacteria naturally found in our intestines break down the undigested complex carbs, creating gas in the process. The product Beano contains alpha-galactosidase, so it helps break down more of the gas-producing foods. It works with beans, of course, but also with vegetables (including cruciferous vegetables) and whole grains. Follow the directions on the label for best results. I suggest you keep a bottle on hand at all times—you’ll thank me when you’re unexpectedly dining out at a restaurant of someone else’s choosing!
   
6. Artichoke leaf extract.
   Studies by researchers in the United Kingdom have shown that artichoke leaf extract (
   Cynara scolymus
   ) can reduce IBS symptoms of pain and flatulence by more than 25 percent with just two months of use. About half of the IBS patients who claimed to have alternating constipation and diarrhea reported having “normal” bowel habits after treatment with the extract. The recommended dosage is 320 to 640 milligrams, two to three times per day.