Herbal Treatment of Irritable Bowel Syndrome and Inflammatory Bowel Disease
by Paul Michael

The main difference between IBS (Irritable Bowel Syndrome) and IBD (Inflammatory Bowel Disease)
is that the former is a functional disorder with no structural changes, and the latter a functional and
structural disorder with pathological changes occurring. People suffering from these diseases can be
greatly affected, both psychologically and physiologically, resulting in a constant struggle for a better
quality of life. Even though we can consider IBS to be less severe than IBD, the effects can still be
disabling. However, patients suffering from IBD do not only have to cope with the disastrous effects
of the disease, but also have to deal with the side-effects of the potent drug treatments used.

Irritable Bowel Syndrome
The symptoms of IBS include; diarrhoea, constipation, abdominal spasm, bloating, and sometimes
the presence of mucus in the stools. Many people have bouts of diarrhoea that alternate with bouts
of constipation, and the pain felt can be mild to severe.
Inflammatory Bowel Disease
Crohn’s disease and ulcerative colitis fall under the category of IBD. They are chronic inflammatory
diseases and the symptoms include; chronic bloody diarrhoea with mucus, fever, malaise, weight
loss, abdominal pain, and anaemia if the blood loss is severe or prolonged. Crohn’s disease can affect
any part of the digestive tract, from the mouth to the anus, with the most common site being the
terminal ileum. Ulcerative colitis only affects the colon and rectum.
Many of the symptoms of IBS and IBD are similar, but unique to IBD are the actual pathological and
morphological changes, which are evident in the ulceration that occurs.

Herbal Treatment of IBS and IBD
It is important to state that herbal medicines are not orthodox drugs; they are not to be viewed or
used in the same way. In herbal medicine a single herb is almost never used on its own to treat an
ailment. Several herbs are usually combined together to produce a formula, and in most cases are
given either in liquid form, or in the form of a tea. In herbal medicine the concept of synergy is a very
important one. Indeed, the philosophy and mode of action of herbal medicines is very different to
conventional medications. Many herbs are often needed, as each one will be targeted at a specific
pathway involved in the disease process and not on a purely symptomatic level. In this way, the
deeper-seated endocrinological (hormonal), metabolic and nervous system dysfunctions are
addressed, thus bringing about greater therapeutic change.

Different Levels of Treatment
In IBS and IBD, herbal medicines can be used therapeutically on different levels. These levels of
treatment, starting with the simplest to the most complex are:
1.    Symptomatic treatment;
2.    Drainage of the organs of elimination;
3.    Nervous system; specifically the
treatment of autonomic nervous system dysfunction;
4.    Endocrine system; treatment of underlying endocrine imbalances.

1.    Symptomatic treatment

•    Anti-spasmodics and astringents
Symptoms such as diarrhoea and spasm, which occur in IBS and IBD, can be treated with astringent
and anti-spasmodic herbs. Astringents, used in the treatment of diarrhoea, work by tightening the
mucous membrane of the intestines thus reducing secretion and excretion. Such herbs include
agrimony and sage. To relieve spasm, anti-spasmodics such as chamomile and peppermint may be
used. This symptomatic level of treatment may bring about some relief, but will not bring about a
lasting therapeutic change.

•    Anti-inflammatories
In addition to astringents and anti-spasmodics, anti-inflammatories are crucial in dealing with the
chronic inflammation that occurs. This chronic inflammation causes many of the symptoms seen in
IBD. One such herbal anti-inflammatory is licorice root, which works in part by prolonging the life of
cortisol[1] (a powerful anti-inflammatory and vital stress control hormone produced in the body).
Studies have also shown that licorice root inhibits the activity of phospholipase A2, as well as
inhibiting cyclooxygenase and prostaglandin formation. Its anti-inflammatory action has been
likened to that of hydrocortisone.[2]
Indeed in many IBD patients the adrenal gland (a gland situated above the kidneys which produces
cortisol) may not be functioning efficiently due to underlying hormonal imbalances or chronic stress,
from the disease itself. Also, the adrenal gland may be affected by long-term steroid use, again
resulting in a diminished production of cortisol. In such cases licorice root and blackcurrant bud are
vital in supporting and restoring proper function to the adrenal glands.


Frankincense is another herb that shows promising results in the treatment of IBD. Clinical trials
have shown beneficial results when using preparations of frankincense in the treatment of a number
of chronic inflammatory diseases, including Crohn’s disease and ulcerative colitis.[3] Boswellic acids
found in frankincense (Boswellia serrata) were found to inhibit 5-lipoxygenase, a key enzyme
involved in the inflammatory process in colitis. In a study involving 30 patients suffering from chronic
colitis, 20 patients were treated with frankincense resin and ten with sulfasalazine for six weeks.
Seventy percent of the patients treated with frankincense resin went into remission, as apposed to
40% of patients on sulfasalazine.[4]
•    Mucus Membrane Trophorestoratives
Mucus membrane trophorestoratives, which are an important group of herbs, also find their way
into the armoury of the herbalist in the treatment of IBD. These herbs help to restore the integrity of
the mucus membrane of the intestines, thus preventing antigens from penetrating it and causing
inflammation. Such herbs include Golden seal and Ground ivy. Golden seal has the added benefit of
being anti-microbial and haemostatic, so is useful in the treatment of gastric infections and blood
2.    Drainage
If a healthy digestive system is to be maintained with proper absorption of nutrients, then it is
imperative that the organs involved in all stages of digestion function properly. The right amount of
hydrochloric acid (HCL), digestive enzymes, which are secreted from the pancreas and bile, are
essential for proper breakdown and emulsification of foods. This ensures that undigested foods that
can potentially irritate the intestines further along the digestive tract and cause inflammation get
properly broken down.
Often, the pancreas, liver and gallbladder can become congested, and the proper drainage of these
organs can be of great value in the treatment of IBS and IBD. Many of the herbs used in the drainage
of these organs are classed as bitters, or have a bitter element to them. These include agrimony,
fumitory, burdock root, green walnut leaf, wormwood, dandelion root and globe artichoke. The
main way that bitters work is by reflex action. Once the tongue detects the bitter taste, the digestive
organs are stimulated and drainage occurs.
Globe artichoke is a potent herb used in the drainage of the liver and gallbladder. In fact, its
choleretic action (its ability to increase the flow of bile from the liver) was found to last longer than
that of sodium dehydrocholate (bile salt); also an increase in the excretion of cholesterol and solids
in the bile were found. An advantage that Globe artichoke has over bile salts is that it stimulates the
liver to produce more bile without impairing its excretory function.[5] The way in which Globe
artichoke leaf exhibits its choleretic action is by increasing the number and size of the bile vesicles
within the liver cells, which results in an increase in bile flow.[6] With regard to the treatment of IBS,
a study conducted in Reading in 2004 showed that artichoke leaf reduced the symptoms of those
suffering from this condition by 41%.[7]

3.    The Autonomic Nervous System
The nervous system, specifically the autonomic nervous system, plays a major role in both IBS and
IBD. It either increases or decreases the secretions from the digestive organs, and increases or
decreases the motility of the intestines. If there is a dysfunction of the autonomic nervous system,
then some of the symptoms seen in IBS and IBD present themselves. Furthermore, dysfunction of
the autonomic nervous system affects the endocrine system and vice versa. If a patient is highly
stressed they will have a high alpha sympathetic activity, which may cause contraction of the
digestive sphincters, leading to constipation. If a patient presents with an increase in mucus
secretions, diarrhoea and spasm, then parasympathetic activity may be high. However, this is a
simple illustration of the intricate autonomic nervous system which has a much more complex
relationship between alpha, beta and parasympathetic activity. Regulation of the autonomic nervous
system can bring about relief of symptoms, but involves a deeper level of treatment to those
mentioned earlier.
Some examples of herbs that can affect the autonomic nervous system are:
Herbs that decrease parasympathetic activity:
Herbs that decrease alpha sympathetic activity:
Lemon balm
Herbs that increase beta sympathetic activity:
Blackcurrant bud
Licorice root

4.    The Endocrine System
On the deepest level of treatment, one must look at the endocrine system, which is the global
manager of the body. According to Dr C Duraffourd, in Crohn’s disease, there is an insufficient
thyroid activity, which results in an increase in TSH (Thyroid Stimulating Hormone) to the demand
created by FSH (Follicle Stimulating Hormone). This causes a compensatory metabolic shift away
from glucides to lipids. As a result, there is a disturbance in liver function, which causes a change in
the intestinal micro flora causing dysbiosis and thus, chronic inflammation.[8]
If we are to consider these endocrine imbalances, then of course we must consider how best to
correct them without using aggressive treatments that may block certain hormones, and in so doing
cause other problems. Using herbal medicines one can gently bring about lasting therapeutic

change. The complex nature of the agents that cause disease are perfectly matched by the complex
nature of plant medicines.8
Some examples of herbs that can affect the endocrine system are:
Herbs that decrease FSH levels:
Herbs that improve thyroid function:
Oat seed

As seen above, there are many levels of treatment. Some patients may find benefit from only the
first one or two levels. However, for others it may be necessary to treat at the deeper third and
fourth levels described, in order to provide effective relief from the complex disease processes
involved. The correct identification of the mechanism of disease, or at the very least the pathways
involved, as well as the correct choice of plant medicines, is crucial in providing successful

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1.    Mills S and Bone K. Principles and Practice of Phytotherapy. Church Livingstone. London. p469.
ISBN 0-443-060169. 2001.
2.    Thorn Research Inc. Glycyrrhiza Glabra Monograph. Alternative Medicine Review. 10(3): 230-
237. 2005.
3.    Ammon HP. Boswellic Acids in Chronic Inflammatory disease. Planta Med. 72(12): 1100-16.
4.    Gupta I et al. Effects of Gum Resin of Boswellia Serrata in Patients with Chronic Colitis. Planta
Med. 67(5): 391-395. 2001.
5.    Rodriguez T et al. Choleretic Activity and Biliary Elimination of Lipids and Bile Acids Induced by
an Artichoke Leaf Extract in Rats. Phytomedicine. 9(8): 687-693. 2002.
6.    Morien K. Benefits of Artichoke Leaf Extract in Hypercholesterolemia, Dyspepsia and Liver
Function. Herbalgram. 44: 21-22. 1998.
7.    Bundy R. Artichoke Leaf Extract Reduces Symptoms of Irritable Bowel Syndrome and Improves
Quality of Life in Otherwise Healthy Volunteers Suffering from Concomitant Dyspepsia: A Subset
analysis. J Altern Complement Med. 10(4): 667-669. 2004.
8.    Duraffourd C. Illustration of the Unity of the Terrain. British Journal of Phytotherapy. 4(2): 66-71.
Olukoga A and Donaldson D. The History of Liquorice: The Plant, Its Extract, Cultivation,
Commercialization and Etymology. J Roy Soc Health. 118(5): 300-304. 1998.
Speroni E et al. Efficacy of Different Cynara Scolymus Preparations on Liver Complaints. J
Ethnopharmacol. 86(2-3): 203-211. 2003.
Further Information
Middlesex University’s Medicinal Herb Garden Website is highly informative:
www.hebes.mdx.ac.uk/teaching/ learning/Garden/