Contents
Irritable bowel syndrome – no new conditionThe many faces of irritable bowel syndromeCauses of a leaky gutMyths and factsWhat makes a good irritable bowel supplement?Our test resultsOver the years, the diagnosis of "irritable bowel syndrome" has developed from a once mysterious intestinal condition with an unknown cause into a real common ailment.
Around 6.7 million Brits are plagued by recurring diarrhoea, often paired with abdominal pain and bloating, sometimes even constipation.1
While sufferers are looking for help, pharmaceutical companies are aggressively advertising their products that are supposed to provide relief from irritable bowel syndrome. But can they actually keep their promises? The SYNformulas expert team put them to the test for you.
Summary
- Irritable bowel syndrome is a widespread condition that can manifest itself in symptoms such as diarrhoea, abdominal pain, bloating and constipation.
- A common cause are tiny damages to the intestinal barrier, known as microlesions, through which the intestinal nervous system is irritated.
- However, a major product test shows: 4 out of 5 preparations disappoint.
Straight to the test
Why irritable bowel syndrome is not a new disease
On the internet and in health magazines, we are reading more and more about irritable bowel syndrome. In fact, many people have been suffering from intestinal complaints such as diarrhoea, abdominal pain and flatulence for centuries - for a long time without any recognisable cause.
Irritable bowel syndrome - a condition with many faces
Even Hippocrates himself, often referred to as the "father of modern medicine", could not make sense of it.
After all, he described a patient over 2,000 years ago who suffered from abdominal complaints (medical term for discomfort in the abdominal region), altered bowel movements (diarrhoea and constipation), flatulence and the urge to defecate.
Since the year 2000, it has been known that many patients with recurring bowel complaints have one thing in common: an unusually permeable intestinal barrier.
This phenomenon is known as "leaky gut". The so-called intestinal epithelial cell layer plays a central role here. This consists of a single layer of cells that are held tightly together via connections (so-called tight junctions).
However, studies have shown that these same tight junctions are not as close together as they should be in some places in people with recurring bowel complaints due to minute damage.
These lesions, known as microlesions, allow pathogens to penetrate the intestinal wall and irritate the underlying enteric intestinal nervous system. This can lead to all too familiar symptoms for those affected, such as diarrhoea, abdominal pain, flatulence or constipation.
The intestine is essentially composed of three layers:
- Microbiome
- mucus layer
- intestinal barrier
A leaky gut affects the lowest layer, the intestinal barrier. Research has shown that a damaged intestinal barrier can even affect the quality of the other layers.
The possible causes of a leaky gut
The factors that favour a leaky gut can be just as varied as the symptoms. Researchers assume that, for example, a dietary style typical of Western countries, medication, infections and, last but not least, stress are responsible.
What does this mean for those affected?
Solutions that are obvious and supposedly easy to implement, such as a change in diet, are rarely promising. And the stress that is so firmly anchored in our everyday lives is particularly difficult to simply switch off. It is particularly frustrating for patients that there is no test that can clearly diagnose irritable bowel syndrome.
And so it can sometimes take years of visits to various doctors to rule out similar illnesses before they are finally diagnosed with irritable bowel syndrome.
Myths and facts about irritable bowel syndrome
The complexity of irritable bowel syndrome and its long-standing mysterious causes have led to all kinds of myths about the subject, which fuel even more uncertainty and frustration among sufferers.
Our team therefore subjects the most common myths to a fact check.
Myth 1: Irritable bowel syndrome manifests itself in the same way in all people
Fact 1: Mostly false.
Although the symptoms of diarrhoea, abdominal pain, bloating and constipation are always mentioned in connection with irritable bowel syndrome, this does not mean that every person affected suffers from the same symptoms. The severity, frequency, combination and intensity of the individual irritable bowel symptoms (diarrhoea, abdominal pain, bloating and constipation) can vary enormously from patient to patient.
It is true, however, that experts now believe that all these types have a common cause - but more on that later.
Myth 2: Irritable bowel syndrome is no big deal
Fact 2: Rather wrong.
As already explained, the type, frequency and intensity of irritable bowel syndrome vary greatly from person to person. However, it is undisputed that recurring bowel complaints can worsen the quality of life of those affected. This is because people who repeatedly have to deal with diarrhoea, abdominal pain, flatulence and/or constipation, especially if they occur unexpectedly, are often severely restricted in their everyday life.
Many sufferers withdraw because they are uncomfortable with their problems and don't want others to know about them. They only feel safe if there is a toilet in the immediate vicinity.
Myth 3: Irritable bowel syndrome is purely psychosomatic
Fact 3 : Wrong.
This myth primarily stems from the fact that the cause of irritable bowel syndrome was unknown for a long time - and doctors were simply unable to find a reason for the recurring symptoms. The image of the "imaginary patient" was formed. Today we know that irritable bowel syndrome sufferers are also more likely than average to struggle with stress and emotional strain, which in turn can have an impact on the bowel.
Nevertheless, by no means all irritable bowel syndrome sufferers report psychological problems. On the other hand, it should not be forgotten that irritable bowel syndrome, with all its accompanying symptoms, often causes social isolation, stress and the like. Accordingly, the latter should be seen as a consequence of irritable bowel syndrome rather than its cause.
Myth 4: Irritable bowel syndrome has to do with diet
Fact 4 : Partly true.
Over the years, scientists have discovered that the traditional Western diet favours the development of "leaky gut". This would also explain why more and more people, particularly in Western countries, are struggling with recurring intestinal complaints such as diarrhoea, abdominal pain and flatulence.
The so-called FODMAP diet also follows this approach, in which foods with FODMAP substances (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) are completely removed from the diet for a certain period of time and are then slowly reintroduced in small quantities. Nevertheless, it cannot be concluded that a healthy diet alone is sufficient to prevent or cure leaky gut.
Another common assumption is that irritable bowel syndrome is caused by a food intolerance or allergy, but this is completely false:
Although the symptoms of various food allergies or intolerances can be similar to the symptoms of irritable bowel syndrome, the cause is different. While allergies are an overreaction of the immune system, irritable bowel syndrome is caused by a functional disorder of the intestine.
What characterises a good irritable bowel product and which ones meet our requirements?
Quality feature 1: Help with the four main irritable bowel symptoms
Irritable bowel syndrome is a multi-faceted condition with various symptoms, including diarrhoea, abdominal pain, bloating and constipation.
In addition, the symptoms occur with varying intensity and in different combinations. Therefore, no two cases are the same. What works for one patient may not work for another. An irritable bowel product that provides help against a wide range of symptoms offers much more flexibility for this reason.
On the other hand, preparations that only focus on individual symptoms are useless for the majority of those affected, or simply do not address the problem holistically and therefore cannot have a lasting positive effect on the general quality of life.
Last but not least, a causal approach is important. This is the only way to treat irritable bowel syndrome at its root and help sufferers in the long term. Many preparations merely suppress the symptoms, which is why they return after a while. However, the actual problem is ignored.
In this case, we base our assessment on the manufacturer's statements. We analyse the extent to which this assessment can be trusted in the second criterion.
Quality feature 2: Recommendation by expert committees
The scientific evidence that is so fundamental for an irritable bowel syndrome product is often the basis for medical guidelines and recommendations issued by professional associations and health authorities.
The members of these expert groups have extensive experience, which they use to evaluate the current state of knowledge on basic principles, diagnostics and therapy, and translate it into practical recommendations to help doctors in the treatment of irritable bowel syndrome.
The development of such guidelines is often carried out in collaboration with various medical and healthcare experts, in addition to professional associations, in order to achieve a broad consensus in the medical community. This in turn helps to ensure that the recommendations are considered trustworthy.
Products that are supported by such recommendations generally enjoy greater acceptance and credibility among healthcare professionals and ultimately also among consumers.
To assess whether a product meets this critera (and, if so, to what extent) we will use the so called S3 guideline for IBS, which provides treatment guidance for medical professionals.2,3 A product whose main ingredient is recommended by this guideline to alleviate symptoms of IBS will receive full marks (100 points), whereas products containing no recommended active ingredient will receive zero points.
Quality feature 3: Ease of use
The lives of people with irritable bowel syndrome are often dominated by their intestinal complaints. At the very least, using a preparation to combat the symptoms should therefore not be perceived as an additional burden. Simplicity of intake is therefore also important for quite banal reasons: a simple intake regimen increases the likelihood that those affected will take the product correctly.
Easy intake makes it easier for patients to take the product over a longer period of time, which is usually necessary to achieve lasting results. Easier swallowing thanks to small capsules, simple integration into everyday life and independence from aids can all play a role.
Quality feature 4: The product type
Many consumers are not even aware of the difference between product types, as it does not play a role for them in everyday life. However, on closer inspection, the type of product can be a sign of quality.
Food supplements, for example, are intended, as the name suggests, to supplement the diet. They are subject to less stringent regulatory requirements and generally do not require extensive clinical studies on efficacy and safety.
The situation is completely different for medical devices. They are intended to fulfil specific medical purposes and are subject to strict regulatory requirements by health authorities. These products must demonstrably fulfil an intended medical purpose based on scientific evidence.
To summarise, a medical device, in contrast to a dietary supplement, is therefore supported by a higher level of scientific evidence. For that reason, a medical device will receive 100 points, a food supplement only 50.
Irritable bowel preparations put to the test
We analysed four products according to these criteria and came to the following conclusion:
Kijimea IBS PRO
Advantages
The manufacturer is known in medical circles for its research and innovations.
Covers all symptoms of irritable bowel syndrome.
Vegan, gluten and lactose free.
Disadvantages
The effect usually only sets in after a few days of ingestion. The manufacturer recommends taking the product for at least 8, preferably 12 weeks.
Kijimea IBS PRO by SYNformulas is a medical device (100 points) that has been specially developed for the treatment of irritable bowel syndrome. The approach behind the preparation is interesting: The capsules contain the patented heat-inactivated bacterial strain B. Bifidum HI-MIMBb75, which symbolically attaches itself to the damaged intestinal barrier like a plaster. Under this "plaster", the intestinal barrier can heal on its own and the symptoms can subside.
The manufacturer therefore promises help with the four main symptoms of irritable bowel syndrome, diarrhoea, abdominal pain, flatulence and constipation. This statement is supported by the medical treatment guidelines: The only bacterial strain recommended there for all four main symptoms mentioned is only contained in this preparation (in heat-inactivated form). The product therefore receives full marks on both these criteria.
In fact, the strain has impressive scientific evidence. Extensive clinical studies have shown that this bacterial strain, both in live and heat-inactivated form, can relieve diarrhoea, abdominal pain, flatulence and constipation associated with irritable bowel syndrome. According to our research, the latest study on heat-inactivated HI-MIMBb75 is actually the largest OTC irritable bowel syndrome study.4,5
With two small capsules taken once a day, independently of meals, the product can ultimately be easily integrated into everyday life. We would have awarded full marks if just one capsule had been enough, but two capsules still amount to 75 points.
What particularly caught our eye during our research on this product are the numerous extremely positive customer reviews that underline our own impression of the product. Here are some examples:
Helen W.
'Since taking the product, my quality of life has improved.'
Andrew C.
'Kijimea IBS Pro is very well tolerated. My irritable bowel symptoms have improved significantly. Abdominal cramps, nausea, sometimes diarrhoea, sometimes constipation. All these symptoms are at a tolerable level thanks to Kijimea IBS Pro. I've been taking it for three months now and will continue for a while longer. I would advise anyone with irritable bowel problems to try Kijimea.'
Rachel S.
'After just three days of consistently taking Kijimea, I noticed a significant improvement in my bowel problems. The symptoms continued to improve over the following days and now (after ten days) I am almost free of the very troublesome bowel problems. I am thrilled with the positive effect!'
Kijimea IBS PRO was convincing across the board and therefore deservedly took first place with 94 points.
The product contains the bacterial strain HI-MIMBb75, which has been shown to have a significant effect in the largest OTC study known to us on irritable bowel syndrome6,7, among other things.
Nutrics Peppermint
Advantages
Uncomplicated consumption.
Good availability.
Disadvantages
Addresses only two of the four main symptoms.
Not vegan, as the soft capsules contain gelatine.
The manufacturer Nutrics relies entirely on peppermint oil. From Nutric’s own product description people may expect positive effects on, among other things, digestive health, namely bloating and discomfort. For two out of the four main IBS symptoms the product is awarded 50 points in this category. The expert committee behind the S3 guideline agree and recommend peppermint oil to treat pain and flatulence (100 points). There is, however, no such recommendation for diarrhoea and constipation.
Important studies, including a meta-study, have confirmed the effective support of peppermint oil for the irritable bowel symptom pain. However, this preparation is a food supplement (50 points), which means that it is subject to less stringent regulatory requirements than a medical product. The product, however, receives full marks on the recommended intake: one capsule per day should be consumed (ideally with a meal).
The peppermint oil capsules from Nutrics achieved a good second place with 75 points. Something positive we want to emphasise is that peppermint oil is recommended by the experts for two of the four main irritable bowel symptoms.
Buy Nutrics Peppermint Oil online
PANACEO MED DARM-REPAIR
Advantages
Natural product.
Medical device, therefore higher regulatory requirements.
Disadvantages
No recommendation by guidelines, mixed scientific evidence.
May cause constipation.
The medical product (100 points) PANACEO MED DARM-REPAIR contains the active ingredient zeolit. This is a mineral with an extremely porous surface that absorbs and removes harmful substances from the intestine - a similar principle to activated charcoal.
According to the manufacturer, the preparation alleviates the four main irritable bowel symptoms, which amounts to 100 points, and is also said to have a positive effect on intestinal inflammation, support the microbiome and strengthen the intestinal mucosa and liver. However, according to research by our team of experts, the data situation is mixed, which is why the active ingredient zeolit has not yet been included in the expert guidelines, which is why the product doesn’t receive any points in this category.
One study found that certain blood markers associated with inflammation decreased in a group of patients taking zeolit compared to a placebo group and that the bacterial composition also changed. However, when assessing their irritable bowel symptoms, both groups made similar statements. An actual improvement in irritable bowel symptoms could therefore not be proven. Another shortcoming is the manufacturer's recommended intake: 3 capsules should be swallowed 2 to 3 times a day - i.e. up to 9 capsules a day! This makes it difficult to integrate the product into everyday life (25 points).
The capsules from PANACEO rely entirely on zeolit and thus achieve 56 points or 3rd place in our test.
One positive aspect of this product is its classification as a medical device, but our experts are not entirely convinced by the scientific basis. For this reason, there is no recommendation from the expert panel.
Buy PANACEO MED DARM-REPAIR online
Cambridge Natural Supplements IBS Advanced Formula +
Advantages
Purely natural ingredients.
British made.
Disadvantages
No mention in S3 guideline.
As a food supplement the product is subject to less stringent regulatory requirements than a medical device.
Cambridge Natural Supplements IBS Advanced Formula + is a food supplement (50 points) promising to alleviate all major IBS symptoms by reducing inflammation. It’s core ingredient for that is quercetin.
The manufacturer bases this on an alternative explanation for the causes of IBS, namely an overreaction or overproduction of mast cells in the intestinal tissue. Mast cells are immune cells that occur in various parts of the body, including the digestive tract. The theory in relation to IBS is that if the mast cells in the intestinal tract overreact and therefore trigger allergic reactions, including inflammation, even in the absence of an actual allergy. This in turn causes the symptoms typical of IBS. Quercetin is said to calm the mast cells, so to speak, and thus help to reduce the symptoms. Turmeric is also said to inhibit inflammation, while theanine (known from traditional Chinese medicine) is supposed to support mental health, which many IBS sufferers struggle with.
Although initial studies show potential for quercetin in the treatment of IBS, the results of studies to date are unfortunately not yet sufficient to convince the expert committee behind the S3 guideline, which is why no recommendation has been made yet. Theanine is also not mentioned, while turmeric is mentioned but with the note that there are no convincing studies showing that turmeric supplements are more effective than a placebo in bettering IBS symptoms.
The manufacturer recommends taking two capsules daily, 30 minutes before each breakfast and dinner. This makes the dosage rather inflexible, which is why this criterion was rated with 50 points.
The capsules from Cambridge Natural Supplements reach 25 points in total and thus rank 4th in our test. Even though recent studies show potential, unfortunately there’s not yet sufficient evidence for experts to give a recommendation. Its classification as a mere supplement also may weaken consumer confidence in its effectiveness.
Buy Cambridge Natural Supplements IBS Advanced Formula + online
Conclusion
Irritable bowel syndrome sufferers know only too well how much their quality of life can suffer from an unstable bowel. The manufacturers of irritable bowel syndrome products are well aware of how desperate patients are in their search for help due to their limited quality of life.
Our test has shown that despite great advertising promises, there are significant differences in quality between the products. The different approaches used to combat irritable bowel syndrome are particularly striking. Buyers are spoilt for choice here. Those affected should therefore think carefully about whether it is worth investing in products with a poor scientific background.
1 Black CJ, Ford AC. Global burden of irritable bowel syndrome: trends, predictions and risk factors. Nat Rev Gastroenterol Hepatol. 2020;17(8):473-486. doi:10.1038/s41575-020-0286-8
2 The S3 guidelines are evidence-based, practice-oriented recommendations for medical care in Germany, based on the best scientific evidence. They are regularly updated and provide a standardized approach to the diagnosis and treatment of specific diseases or conditions. The current version of the S3 guideline regarding IBS dates from 2021.
3 Layer P et al. (2021). Update S3-Leitlinie Reizdarmsyndrom: Definition, Pathophysiologie, Diagnostik und Therapie. Gemeinsame Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Neurogastroenterologie und Motilität (DGNM). Z Gastroenterol 2021; 59: 1323–1415.
4 Comparison only takes into account studies with probiotic strains.5 Andresen V et al. Heat-inactivated Bifi dobacterium bifi dum MIMBb75 (SYN-HI-001) in the treatment of irritable bowel syndrome: a multicentre, randomised, double-blind, placebo-controlled clinical trial. Lancet Gastroenterol Hepatol. 2020 Jul;5(7):658-666.
Alammar N, Wang L, Saberi B, Nanavati J, Holtmann G, Shinohara RT, Mullin GE. The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC Complement Altern Med. 2019 Jan 17;19(1):21. doi: 10.1186/s12906-018-2409-0. PMID: 30654773; PMCID: PMC6337770
Petkov V, Schütz B, Eisenwagen S, Muss C, Mosgoeller W. PMA-zeolit can modulate inflammation associated markers in irritable bowel disease - an explorative randomized, double blinded, controlled pilot trial. Neuro Endocrinol Lett. 2021 Mar;42(1):1-12. PMID:
The information on this page does not constitute medical advice and should not be considered as such. Consult your doctor before changing your regular medical care. This product is not intended to diagnose, treat, cure or prevent any disease. The effect depends on individual factors. The images of those affected are based on real people whose names have been changed.
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