{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:33:53Z","timestamp":1777710833638,"version":"3.51.4"},"reference-count":97,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Irritable Bowel Syndrome (IBS) affects 4\u201315% of the global population, and the limited efficacy of existing pharmacologic therapies has driven growing interest in plant-based therapeutic options among both patients and clinicians. A comprehensive assessment of all plant extracts investigated in IBS is therefore essential, given the limited effectiveness of conventional treatments and the increasing interest in complementary approaches. Evidence from recent systematic reviews and meta-analyses consistently indicates that peppermint oil is the most effective botanical agent, particularly for reducing abdominal pain and overall IBS symptom severity. Iberogast (STW-5 and STW-5 II) has also demonstrated clinical improvements across multiple trials, while curcumin shows mechanistic and preliminary clinical potential by modulating several IBS-related pathways. In contrast, extracts such as Curcuma xanthorrhiza, Fumaria officinalis, and various Ayurvedic formulations have not shown significant clinical benefit. Other agents, including Aloe vera, flavonoids, St John\u2019s wort, and ginger, exhibit mixed or inconsistent results, reflecting heterogeneity in study designs and underlying mechanisms. A review of international guidelines reveals that peppermint oil is the only plant-based therapy consistently acknowledged across adult and pediatric recommendations. The aim of this review is to summarize, compare, and critically evaluate all plant extracts studied for the prevention and treatment of IBS, integrating mechanistic pathways, clinical evidence, and current international guideline recommendations to clarify their therapeutic relevance for clinical practice.<\/jats:p>","DOI":"10.3390\/nu18020183","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T09:40:29Z","timestamp":1767692429000},"page":"183","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Plant-Derived Treatments for IBS: Clinical Outcomes, Mechanistic Insights, and Their Position in International Guidelines"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7790-7845","authenticated-orcid":false,"given":"Ploutarchos","family":"Pastras","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4489-1485","authenticated-orcid":false,"given":"Ioanna","family":"Aggeletopoulou","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Bali","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3094-8209","authenticated-orcid":false,"given":"Christos","family":"Triantos","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1016\/S0140-6736(20)31548-8","article-title":"Irritable bowel syndrome","volume":"396","author":"Ford","year":"2020","journal-title":"Lancet"},{"key":"ref_2","first-page":"S1542-3565(25)00623-8","article-title":"The Prevalence and Burden of Disorders of Gut-Brain Interaction (DGBI) Before vs After the COVID-19 Pandemic","volume":"74","author":"Palsson","year":"2025","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1097\/MEG.0000000000002994","article-title":"Global prevalence and risk factors of irritable bowel syndrome from 2006 to 2024 using the Rome III and IV criteria: A meta-analysis","volume":"37","author":"Arif","year":"2025","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Aggeletopoulou, I., Papantoniou, K., Pastras, P., and Triantos, C. (2025). Unraveling the Pathophysiology of Irritable Bowel Syndrome: Mechanisms and Insights. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms262110598"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Pastras, P., Aggeletopoulou, I., and Triantos, C. (2024). Impact Enteric Nervous Cells on Irritable Bowel Syndrome: Potential Treatment Options. Microorganisms, 12.","DOI":"10.3390\/microorganisms12102036"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"151","DOI":"10.5056\/jnm16214","article-title":"What Is New in Rome IV","volume":"23","author":"Schmulson","year":"2017","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Lacy, B.E., and Patel, N.K. (2017). Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome. J. Clin. Med., 6.","DOI":"10.3390\/jcm6110099"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"110809","DOI":"10.1016\/j.jpsychores.2022.110809","article-title":"Quality of life in irritable bowel syndrome: Exploring mediating factors through structural equation modelling","volume":"159","author":"Trindade","year":"2022","journal-title":"J. Psychosom. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1001\/jama.2020.22532","article-title":"Diagnosis and Treatment of Irritable Bowel Syndrome: A Review","volume":"325","author":"Camilleri","year":"2021","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"17","DOI":"10.14309\/ajg.0000000000001036","article-title":"ACG Clinical Guideline: Management of Irritable Bowel Syndrome","volume":"116","author":"Lacy","year":"2021","journal-title":"Am. J. Gastroenterol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1038\/ncpgasthep1257","article-title":"Complementary and alternative medicine for IBS in adults: Mind-body interventions","volume":"5","author":"Kearney","year":"2008","journal-title":"Nat. Clin. Pract. Gastroenterol. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"102233","DOI":"10.1016\/j.ctim.2019.102233","article-title":"Western herbal medicines in the treatment of irritable bowel syndrome: A systematic review and meta-analysis","volume":"48","author":"Hawrelak","year":"2020","journal-title":"Complement. Ther. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/00001610-200001000-00005","article-title":"A study of alternative health care use for gastrointestinal disorders","volume":"23","author":"Giese","year":"2000","journal-title":"Gastroenterol. Nurs."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Yuan, H., Ma, Q., Cui, H., Liu, G., Zhao, X., Li, W., and Piao, G. (2017). How Can Synergism of Traditional Medicines Benefit from Network Pharmacology?. Molecules, 22.","DOI":"10.3390\/molecules22071135"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Li, D.Y., Dai, Y.K., Zhang, Y.Z., Huang, M.X., Li, R.L., Ou-Yang, J., Chen, W.J., and Hu, L. (2017). Systematic review and meta-analysis of traditional Chinese medicine in the treatment of constipation-predominant irritable bowel syndrome. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0189491"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4071260","DOI":"10.1155\/2016\/4071260","article-title":"Efficacy of Chinese Herbal Medicine for Diarrhea-Predominant Irritable Bowel Syndrome: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials","volume":"2016","author":"Zhu","year":"2016","journal-title":"Evid. Based Complement. Altern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"576","DOI":"10.2174\/1381612829666230328163449","article-title":"The Use of Peppermint Oil in Gastroenterology","volume":"29","author":"Scarpellini","year":"2023","journal-title":"Curr. Pharm. Des."},{"key":"ref_18","first-page":"1027","article-title":"Peppermint oil","volume":"75","author":"Kligler","year":"2007","journal-title":"Am. Fam. Physician"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1007\/BF02936952","article-title":"Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: A prospective, randomized trial","volume":"32","author":"Liu","year":"1997","journal-title":"J. Gastroenterol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/j.1365-2036.1988.tb00677.x","article-title":"The actions of peppermint oil and menthol on calcium channel dependent processes in intestinal, neuronal and cardiac preparations","volume":"2","author":"Hawthorn","year":"1988","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1159\/000445549","article-title":"Menthol Modulates Pacemaker Potentials through TRPA1 Channels in Cultured Interstitial Cells of Cajal from Murine Small Intestine","volume":"38","author":"Kim","year":"2016","journal-title":"Cell. Physiol. Biochem."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.ejphar.2014.07.018","article-title":"Effects of menthol on circular smooth muscle of human colon: Analysis of the mechanism of action","volume":"740","author":"Amato","year":"2014","journal-title":"Eur. J. Pharmacol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"118682","DOI":"10.1016\/j.lfs.2020.118682","article-title":"Menthacarin induces calcium ion influx in sensory neurons, macrophages and colonic organoids of mice","volume":"264","author":"Zhang","year":"2021","journal-title":"Life Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.phytochem.2013.08.005","article-title":"Menthol: A simple monoterpene with remarkable biological properties","volume":"96","author":"Kamatou","year":"2013","journal-title":"Phytochemistry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1111\/cts.13224","article-title":"Peppermint oil effects on the gut microbiome in children with functional abdominal pain","volume":"15","author":"Thapa","year":"2022","journal-title":"Clin. Transl. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Oz, M., El Nebrisi, E.G., Yang, K.H.S., Howarth, F.C., and Al Kury, L.T. (2017). Cellular and Molecular Targets of Menthol Actions. Front. Pharmacol., 8.","DOI":"10.3389\/fphar.2017.00472"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1097\/00003643-200208000-00005","article-title":"Voltage-dependent block of neuronal and skeletal muscle sodium channels by thymol and menthol","volume":"19","author":"Haeseler","year":"2002","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1111\/apt.14519","article-title":"Review article: The physiological effects and safety of peppermint oil and its efficacy in irritable bowel syndrome and other functional disorders","volume":"47","author":"Chumpitazi","year":"2018","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.dld.2007.02.006","article-title":"Peppermint oil (Mintoil) in the treatment of irritable bowel syndrome: A prospective double blind placebo-controlled randomized trial","volume":"39","author":"Cappello","year":"2007","journal-title":"Dig. Liver Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1007\/s10620-009-0854-9","article-title":"The effect of enteric-coated, delayed-release peppermint oil on irritable bowel syndrome","volume":"55","author":"Merat","year":"2010","journal-title":"Dig. Dis. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1053\/j.gastro.2019.08.026","article-title":"Efficacy and Safety of Peppermint Oil in a Randomized, Double-Blind Trial of Patients With Irritable Bowel Syndrome","volume":"158","author":"Weerts","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13030-024-00302-y","article-title":"Efficacy and safety of peppermint oil for the treatment in Japanese patients with irritable bowel syndrome: A prospective, open-label, and single-arm study","volume":"18","author":"Matsueda","year":"2024","journal-title":"Biopsychosoc. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1111\/apt.17179","article-title":"Systematic review and meta-analysis: Efficacy of peppermint oil in irritable bowel syndrome","volume":"56","author":"Ingrosso","year":"2022","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Alammar, N., Wang, L., Saberi, B., Nanavati, J., Holtmann, G., Shinohara, R.T., and Mullin, G.E. (2019). The impact of peppermint oil on the irritable bowel syndrome: A meta-analysis of the pooled clinical data. BMC Complement. Altern. Med., 19.","DOI":"10.1186\/s12906-018-2409-0"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Annah\u00e1zi, A., Bauer, R., Efferth, T., Khayyal, M.T., Schemann, M., Ulrich-Merzenich, G., and Feinle-Bisset, C. (2025). A Review of the Mechanisms of Action of the Herbal Medicine, STW 5-II, Underlying Its Efficacy in Disorders of Gut\u2013Brain Interaction. Neurogastroenterol. Motil., e70047.","DOI":"10.1111\/nmo.70047"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e13984","DOI":"10.1111\/nmo.13984","article-title":"Effects of the herbal preparation STW 5-II on in vitro muscle activity in the guinea pig stomach","volume":"33","author":"Schemann","year":"2021","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"49","DOI":"10.4149\/gpb_2019045","article-title":"Luteolin suppresses colonic smooth muscle motility via inhibiting L-type calcium channel currents in mice","volume":"39","author":"Yang","year":"2020","journal-title":"Gen. Physiol. Biophys."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"118112","DOI":"10.1016\/j.lfs.2020.118112","article-title":"Dual opposing actions of STW 5 on TRP receptors mediate neuronal desensitisation in vitro","volume":"257","author":"Khalil","year":"2020","journal-title":"Life Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"156167","DOI":"10.1016\/j.phymed.2024.156167","article-title":"Anti-nociceptive effect of STW 5-II in rodent models of stress and post-inflammatory visceral hypersensitivity","volume":"135","author":"Yuan","year":"2024","journal-title":"Phytomedicine"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"227","DOI":"10.15403\/jgld-814","article-title":"Multi-target Treatment for Irritable Bowel Syndrome with STW 5: Pharmacological Modes of Action","volume":"29","author":"Allescher","year":"2020","journal-title":"J. Gastrointest. Liver Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"153589","DOI":"10.1016\/j.phymed.2021.153589","article-title":"Anti-inflammatory and tight junction protective activity of the herbal preparation STW 5-II on mouse intestinal organoids","volume":"88","author":"Elbadawi","year":"2021","journal-title":"Phytomedicine"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"154996","DOI":"10.1016\/j.phymed.2023.154996","article-title":"Possible role of the gut microbiome in mediating the beneficial effects of the six-herbal formulation STW 5-II on digestive health","volume":"119","author":"Ammar","year":"2023","journal-title":"Phytomedicine"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e14765","DOI":"10.1111\/nmo.14765","article-title":"Effect of Iberogast (STW5) on tolerance to colonic gas in patients with irritable bowel syndrome: A randomized, double-blind, placebo control clinical trial","volume":"36","author":"Aguilar","year":"2024","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"102873","DOI":"10.1016\/j.ctim.2022.102873","article-title":"Functional gastrointestinal disorders in children: Effectivity, safety, and tolerability of the herbal preparation STW-5 (Iberogast\u00ae) in general practice","volume":"71","author":"Michael","year":"2022","journal-title":"Complement. Ther. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1111\/j.1365-2036.2004.01859.x","article-title":"Treatment of irritable bowel syndrome with herbal preparations: Results of a double-blind, randomized, placebo-controlled, multi-centre trial","volume":"19","author":"Madisch","year":"2004","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Tu, X., Ren, H., and Bu, S. (2023). Therapeutic effects of curcumin on constipation-predominant irritable bowel syndrome is associated with modulating gut microbiota and neurotransmitters. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1274559"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s11011-014-9554-z","article-title":"The effect of curcumin on the brain-gut axis in rat model of irritable bowel syndrome: Involvement of 5-HT-dependent signaling","volume":"30","author":"Yu","year":"2015","journal-title":"Metab. Brain Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"4458","DOI":"10.12998\/wjcc.v11.i19.4458","article-title":"Molecular signalling during cross talk between gut brain axis regulation and progression of irritable bowel syndrome: A comprehensive review","volume":"11","author":"Singh","year":"2023","journal-title":"World J. Clin. Cases"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1089\/acm.2004.10.1015","article-title":"Turmeric extract may improve irritable bowel syndrome symptomology in otherwise healthy adults: A pilot study","volume":"10","author":"Bundy","year":"2004","journal-title":"J. Altern. Complement. Med."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Giacosa, A., Riva, A., Petrangolini, G., Allegrini, P., Fazia, T., Bernardinelli, L., Peroni, G., and Rondanelli, M. (2022). Beneficial Effects on Abdominal Bloating with an Innovative Food-Grade Formulation of Curcuma longa and Boswellia serrata Extracts in Subjects with Irritable Bowel Syndrome and Small Bowel Dysbiosis. Nutrients, 14.","DOI":"10.3390\/nu14030416"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.1002\/ptr.8189","article-title":"A systematic review of the efficacy and safety of turmeric in the treatment of digestive disorders","volume":"38","author":"Thavorn","year":"2024","journal-title":"Phytother. Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/s13020-021-00530-2","article-title":"Efficacy and safety of Chinese medicine JCM-16021 for diarrhea-predominant irritable bowel syndrome: Study protocol for a multi-center, randomized, double-blind, placebo controlled clinical trial","volume":"16","author":"Zheng","year":"2021","journal-title":"Chin. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"239638","DOI":"10.1155\/2012\/239638","article-title":"JCM-16021, a Chinese Herbal Formula, Attenuated Visceral Hyperalgesia in TNBS-Induced Postinflammatory Irritable Bowel Syndrome through Reducing Colonic EC Cell Hyperplasia and Serotonin Availability in Rats","volume":"2012","author":"Qin","year":"2012","journal-title":"Evid. Based Complement. Altern. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"157040","DOI":"10.1016\/j.phymed.2025.157040","article-title":"Butyrate-producing commensal bacteria mediates the efficacy of herbal medicine JCM-16021 on abdominal pain in diarrhea-predominant irritable bowel syndrome: A randomized clinical trial","volume":"145","author":"Zhai","year":"2025","journal-title":"Phytomedicine"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/apt.14817","article-title":"Randomised clinical trial: Tong-Xie-Yao-Fang granules versus placebo for patients with diarrhoea-predominant irritable bowel syndrome","volume":"48","author":"Chen","year":"2018","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"7748351","DOI":"10.1155\/mi\/7748351","article-title":"Based on Proteomics Data Revealing the Potential of Traditional Chinese Medicine in Treating Irritable Bowel Syndrome","volume":"2025","author":"Wu","year":"2025","journal-title":"Mediat. Inflamm."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Tominaga, K., and Arakawa, T. (2015). Clinical application of kampo medicine (rikkunshito) for common and\/or intractable symptoms of the gastrointestinal tract. Front. Pharmacol., 6.","DOI":"10.3389\/fphar.2015.00007"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"100433","DOI":"10.1016\/j.phanu.2025.100433","article-title":"Mechanism of Epigallocatechin-3-gallate in the prevention and treatment of irritable bowel syndrome: A network pharmacology and gene expression omnibus chip data-based study","volume":"31","author":"Ye","year":"2025","journal-title":"PharmaNutrition"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"111889","DOI":"10.1016\/j.jep.2019.111889","article-title":"The effect of Xiang-Sha-Liu-Jun-Zi tang (XSLJZT) on irritable bowel syndrome: A randomized, double-blind, placebo-controlled trial","volume":"238","author":"Shih","year":"2019","journal-title":"J. Ethnopharmacol."},{"key":"ref_60","first-page":"2752","article-title":"Therapy by Japanese Oriental medicine (kampo) in irritable bowel syndrome","volume":"50","author":"Tosa","year":"1992","journal-title":"Nihon Rinsho"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1751-0759-8-5","article-title":"JOPM-EBM Working Team Effects of Kampo on functional gastrointestinal disorders","volume":"8","author":"Oka","year":"2014","journal-title":"BioPsychoSoc. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s00535-020-01746-z","article-title":"Evidence-based clinical practice guidelines for irritable bowel syndrome 2020","volume":"56","author":"Fukudo","year":"2021","journal-title":"J. Gastroenterol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"343","DOI":"10.5056\/jnm19041","article-title":"Second Asian Consensus on Irritable Bowel Syndrome","volume":"25","author":"Gwee","year":"2019","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1080\/19768354.2025.2507327","article-title":"Scutellaria baicalensis extracts alleviate zymosan-induced irritable bowel syndrome symptoms by modulating inflammation and ion channel activity","volume":"29","author":"Choi","year":"2025","journal-title":"Anim. Cells Syst."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"118050","DOI":"10.1016\/j.jep.2024.118050","article-title":"A multi-omics study reveals the therapeutic effect of Linderae Radix water extract on irritable bowel syndrome (IBS-D)","volume":"328","author":"Ouyang","year":"2024","journal-title":"J. Ethnopharmacol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Ruiz-Malag\u00f3n, A.J., Rodr\u00edguez-Sanchez, M.J., Rodr\u00edguez-Sojo, M.J., Vezza, T., Pischel, I., Algieri, F., Rodr\u00edguez-Cabezas, M.E., Rodr\u00edguez-Nogales, A., and Galvez, J. (2022). Intestinal anti-inflammatory and visceral analgesic effects of a Serpylli herba extract in an experimental model of irritable bowel syndrome in rats. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.967644"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Wu, L., Gao, L., Jin, X., Chen, Z., Qiao, X., Cui, X., Gao, J., and Zhang, L. (2023). Ethanol Extract of Mao Jian Green Tea Attenuates Gastrointestinal Symptoms in a Rat Model of Irritable Bowel Syndrome with Constipation via the 5-hydroxytryptamine Signaling Pathway. Foods, 12.","DOI":"10.3390\/foods12051101"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"116499","DOI":"10.1016\/j.jep.2023.116499","article-title":"The traditional herbal medicines mixture, Banhasasim-tang, relieves the symptoms of irritable bowel syndrome via modulation of TRPA1, NaV1.5 and NaV1.7 channels","volume":"312","author":"Choi","year":"2023","journal-title":"J. Ethnopharmacol."},{"key":"ref_69","first-page":"12","article-title":"Bioactive flavonoids in medicinal plants: Structure, activity and biological fate","volume":"13","author":"Wang","year":"2018","journal-title":"Asian J. Pharm. Sci."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"4895","DOI":"10.2147\/DDDT.S515004","article-title":"Therapeutic Potential of Flavonoids and Flavonoid-Rich Compounds in Irritable Bowel Syndrome","volume":"19","author":"Xia","year":"2025","journal-title":"Drug Des. Devel. Ther."},{"key":"ref_71","unstructured":"Roshini, K.V., Anjitha, A., Arif, K.F., Maneesha, N.A., and Nahmath, K.S. (2024). Spasmolytic Effects of Medicinal Plants\u2014A Review. Int. J. Pharm. Sci., 2."},{"key":"ref_72","first-page":"170","article-title":"Soy Isoflavones Supplementation for Patients with Irritable Bowel Syndrome: A Randomized Double Blind Clinical Trial","volume":"7","author":"Jalili","year":"2015","journal-title":"Middle East. J. Dig. Dis."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Jalili, M., Hekmatdoost, A., Vahedi, H., Poustchi, H., Khademi, B., Saadi, M., Zemestani, M., and Janani, L. (2016). Co-Administration of Soy Isoflavones and Vitamin D in Management of Irritable Bowel Disease. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0158545"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1002\/fsn3.2806","article-title":"Effects of propolis supplementation on irritable bowel syndrome with constipation (IBS-C) and mixed (IBS-M) stool pattern: A randomized, double-blind clinical trial","volume":"10","author":"Miryan","year":"2022","journal-title":"Food Sci. Nutr."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"528","DOI":"10.5056\/jnm18077","article-title":"Aloe vera Is Effective and Safe in Short-term Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-analysis","volume":"24","author":"Hong","year":"2018","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1080\/10590501.2016.1166826","article-title":"Aloe vera: A review of toxicity and adverse clinical effects","volume":"34","author":"Guo","year":"2016","journal-title":"J. Environ. Sci. Health Part C"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"17562848211048133","DOI":"10.1177\/17562848211048133","article-title":"Aloe barbadensis Mill. extract improves symptoms in IBS patients with diarrhoea: Post hoc analysis of two randomized double-blind controlled studies","volume":"14","author":"Ahluwalia","year":"2021","journal-title":"Ther. Adv. Gastroenterol."},{"key":"ref_78","unstructured":"Gebhardt, C. (2025, January 03). Is Oral Aloe Vera Effective in Reducing Symptoms in Adults with Irritable Bowel Syndrome (IBS)? PCOM Physician Assistant Studies Student Scholarship. Available online: https:\/\/digitalcommons.pcom.edu\/pa_systematic_reviews\/390."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.pnpbp.2008.10.018","article-title":"Efficacy and tolerability of Hypericum perforatum in major depressive disorder in comparison with selective serotonin reuptake inhibitors: A meta-analysis","volume":"33","author":"Rahimi","year":"2009","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"45","DOI":"10.2190\/PM.40.1.d","article-title":"Effects of antidepressive treatment of Saint John\u2019s wort extract related to autonomic nervous function in women with irritable bowel syndrome","volume":"40","author":"Wan","year":"2010","journal-title":"Int. J. Psychiatry Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1038\/ajg.2009.577","article-title":"A randomized, double-blind, placebo-controlled trial of St John\u2019s wort for treating irritable bowel syndrome","volume":"105","author":"Saito","year":"2010","journal-title":"Am. J. Gastroenterol."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Zhang, C., Huang, Y., Li, P., Chen, X., Liu, F., and Hou, Q. (2020). Ginger relieves intestinal hypersensitivity of diarrhea predominant irritable bowel syndrome by inhibiting proinflammatory reaction. BMC Complement. Med. Ther., 20.","DOI":"10.1186\/s12906-020-03059-3"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1007\/s10620-005-2957-2","article-title":"Pharmacological basis for the medicinal use of ginger in gastrointestinal disorders","volume":"50","author":"Ghayur","year":"2005","journal-title":"Dig. Dis. Sci."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4103\/jrms.JRMS_905_16","article-title":"Evaluating the efficacy of mixture of Boswellia carterii, Zingiber officinale, and Achillea millefolium on severity of symptoms, anxiety, and depression in irritable bowel syndrome patients","volume":"22","author":"Kazemian","year":"2017","journal-title":"J. Res. Med. Sci."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.ctim.2013.12.015","article-title":"Is ginger effective for the treatment of irritable bowel syndrome? A double blind randomized controlled pilot trial","volume":"22","author":"Palsson","year":"2014","journal-title":"Complement. Ther. Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1080\/00365520510023134","article-title":"Herbal medicine with curcuma and fumitory in the treatment of irritable bowel syndrome: A randomized, placebo-controlled, double-blind clinical trial","volume":"40","author":"Brinkhaus","year":"2005","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ctim.2016.04.002","article-title":"Efficacy and safety of Ayurvedic herbs in diarrhoea-predominant irritable bowel syndrome: A randomised controlled crossover trial","volume":"26","author":"Lauche","year":"2016","journal-title":"Complement. Ther. Med."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/jcag\/gwy071","article-title":"Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS)","volume":"2","author":"Moayyedi","year":"2019","journal-title":"J. Can. Assoc. Gastroenterol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.rgmx.2024.10.003","article-title":"Pharmacologic treatment of irritable bowel syndrome. Position statement of the Asociaci\u00f3n Mexicana de Gastroenterolog\u00eda, 2024","volume":"90","author":"Schmulson","year":"2025","journal-title":"Rev. Gastroenterol. M\u00e9xico (Engl. Ed.)"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1136\/gutjnl-2021-324598","article-title":"British Society of Gastroenterology guidelines on the management of irritable bowel syndrome","volume":"70","author":"Vasant","year":"2021","journal-title":"Gut"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1002\/ueg2.12259","article-title":"Functional bowel disorders with diarrhoea: Clinical guidelines of the United European Gastroenterology and European Society for Neurogastroenterology and Motility","volume":"10","author":"Savarino","year":"2022","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1055\/a-1591-4794","article-title":"Update S3-Leitlinie Reizdarmsyndrom: Definition, Pathophysiologie, Diagnostik und Therapie. Gemeinsame Leitlinie der Deutschen Gesellschaft f\u00fcr Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft f\u00fcr Neurogastroenterologie und Motilit\u00e4t (DGNM)\u2014Juni 2021\u2014AWMF-Registriernummer: 021\/016","volume":"59","author":"Layer","year":"2021","journal-title":"Z. Gastroenterol."},{"key":"ref_93","first-page":"259","article-title":"Guidelines on the management of irritable bowel syndrome","volume":"13","author":"Pietrzak","year":"2018","journal-title":"Prz. Gastroenterol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"133","DOI":"10.5056\/jnm25007","article-title":"2025 Seoul Consensus on Clinical Practice Guidelines for Irritable Bowel Syndrome","volume":"31","author":"Choi","year":"2025","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_95","unstructured":"Council of Health Insurance (2023). Irritable bowel Syndrome (IBS): CHI formulary indication review. Indication update, Addendum to the CHI Original Irritable Bowel Syndrome Clinical Guidance."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1002\/jpn3.70070","article-title":"ESPGHAN\/NASPGHAN guidelines for treatment of irritable bowel syndrome and functional abdominal pain-not otherwise specified in children aged 4\u201318 years","volume":"81","author":"Groen","year":"2025","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/ajg.2012.414","article-title":"Relationship between patterns of alcohol consumption and gastrointestinal symptoms among patients with irritable bowel syndrome","volume":"108","author":"Reding","year":"2013","journal-title":"Am. J. Gastroenterol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/2\/183\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T09:45:03Z","timestamp":1767692703000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/2\/183"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":97,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["nu18020183"],"URL":"https:\/\/doi.org\/10.3390\/nu18020183","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]}}}