A new review looks at the evidence behind the effectiveness of complementary or alternative therapies - including probiotics, prebiotics, synbiotics, fiber, and herbal medicinal products - for the treatment of bowel disorders such as irritable bowel syndrome (IBS), functional constipation, and ulcerative colitis.

The review's authors note that most available studies are biased by several drawbacks; however, probiotics, synbiotics, psyllium, and some herbal medicinal products (primarily peppermint oil) seem to be effective in ameliorating IBS symptoms. Synbiotics and fiber seem to be beneficial in patients with functional constipation, and the non-pathogenic strain Nissle 1917 of Escherichia coli may be effective in maintaining remission in patients with ulcerative colitis.

"Patients with common functional bowel disorders such as chronic idiopathic constipation and irritable bowel syndrome who cannot find benefit or have adverse effects with the use of traditional drug therapies, or do not want to use them, should be told that alternative medicines are available that may be effective," said Dr. Diego Curro, lead author of the British Journal of Pharmacology study. "Also, patients with mild clinical forms of ulcerative colitis should be informed that they might use, with caution, an alternative probiotic treatment to prevent relapse."

Article: Probiotics, fiber and herbal medicinal products for functional and inflammatory bowel disorders, Diego Currò, Gianluca Ianiro, Silvia Pecere, Stefano Bibbò and Giovanni Cammarota, British Journal of Pharmacology, doi: 10.1111/bph.13632, published online 3 October 2016.