Diarrhea-IBS

2 Capsules

once per day

Take with food

Ongoing

Additional notes

"Why it is here: For bloating, distention, and multi-symptom discomfort that feels gas-driven. Begin one product from this protocol at a time, not several. How to take: With a meal; mild abdominal discomfort can occur on an empty stomach. The guide gives 2 capsules up to 3 times daily, maximum 6 a day, stepping down as symptoms improve; this entry shows 2 once a day. Published evidence: The controlled research is on the original Atrantil blend, in constipation-predominant IBS. Atrantil PRO has not been studied in a controlled trial in any IBS subtype. Clinical experience (observation): I use Atrantil PRO for IBS-D, and across many patients over many years the results have been exceptional. I am telling you where my experience and the literature part company. Most find rapid bowel improvement and symptom reduction in the first few days of use. Caution: Contains tree nut (horse chestnut extract). Not for use in pregnancy or nursing. Shares three Bacillus strains with RestorFlora, so there is little reason to run both. Review: Track stool form, urgency, pain, bloating, and any side effects in your log. Add the next product only after this one's effect is clear."

1 Rounded Teaspoon

twice per day

Take with water

Ongoing

Additional notes

"Why it is here: For post-inflammatory irritation, or barrier support when the gut lining seems tender and reactive. Begin one product from this protocol at a time, not several. How to take: Mix 1 rounded teaspoon in a beverage, twice a day to begin; as tolerated, three times a day, as the label directs. Published evidence: No controlled trial of this product has been published. The most relevant trial studied glutamine on its own, 15 g a day, in post-infectious IBS-D. This product's glutamine dose is lower and is not disclosed on the label; the trial should not be read as evidence for this product. Clinical experience (observation): I use this when the gut lining itself seems to be the problem — a tender, reactive gut after infection, antibiotics, or a long period of inflammation. I start low and titrate the dose as tolerated. Caution: Contains shellfish (lobster, crab, and/or shrimp) and milk. Each rounded teaspoon also supplies 8 mg of zinc (24 mg a day at three). The label lists xylitol, a sugar alcohol. Review: Track stool form, urgency, pain, bloating, and any side effects in your log. Add the next product only after this one's effect is clear."

1 Capsule

once per day

Take with food

Ongoing

Additional notes

"Why it is here: For a structured probiotic trial when dysbiosis or prior gut disruption seems relevant. Begin one product from this protocol at a time, not several. How to take: 1 capsule a day with a meal. The guide gives 1 to 2 a day. Fullscript's label copy: 1 twice a day for a week, then 1 a day. Published evidence: No controlled trial of this product in IBS-D has been published. Its yeast, S. boulardii, is well studied for antibiotic-associated and infectious diarrhea, which is not the same as evidence in IBS-D. Clinical experience (observation): When I trial a probiotic in IBS-D, this is the one I choose, and I give it a full 30 to 90 days before judging it. I stop it if symptoms worsen after an initial two-week trial phase. Caution: Contains a live yeast. Saccharomyces fungemia has been reported in critically ill and immunocompromised patients and in those with central venous catheters; use clinician oversight if these apply. Shares three Bacillus strains with Atrantil PRO, so there is little reason to run both. Review: Track stool form, urgency, pain, bloating, and any side effects in your log. Add the next product only after this one's effect is clear."

2.00 Capsules

once per day

Take with food

Ongoing

Additional notes

"Why it is here: For meals that reliably trigger gas, bloating, cramping, or loose stool because of high-FODMAP foods. Begin one product from this protocol at a time, not several. How to take: With a known trigger meal. The guide gives 2 capsules with a meal, 2 to 3 times a day; this entry shows one meal. Published evidence: No controlled trial of this product has been published. The rationale is mechanistic: enzymes break down fermentable carbohydrates before they reach the colon. Polyols are not broken down. Clinical experience (observation): I use this as a bridge, not a treatment — for the patient who has already learned that FODMAPs drive their flares but finds it difficult to remain on a restricted diet. Best used situationally around known trigger meals, or scheduled with meals during a reintroduction phase. Caution: Do not take it close to a prebiotic supplement, which it would also digest. Fullscript's label copy says to limit use to a 3-month interval. Ask your clinician how long to continue. Review: Track stool form, urgency, pain, bloating, and any side effects in your log. Add the next product only after this one's effect is clear."

1 Softgel

once per day

Take with water

Ongoing

Additional notes

"Why it is here: For abdominal pain, cramping, and bowel irritation as the dominant complaint. Begin one product from this protocol at a time, not several. How to take: 30 minutes before a meal. The label directs 1 to 2 softgels, 1 to 3 times daily; this protocol uses 1 once a day. Published evidence: A meta-analysis of 10 randomized trials found peppermint oil superior to placebo for global IBS symptoms and abdominal pain; the largest trial did not meet its primary endpoint. The trials studied peppermint oil alone; this product also contains ginger and fennel oil. Clinical experience (observation): The first thing I reach for when pain and cramping predominate the picture. Best avoided in patients with reflux or heartburn, or a mint allergy. I do not use it as a daily maintenance product. Caution: The label advises against use in pregnancy or lactation, with gallbladder problems, or with prescription medication, except as advised by your clinician. Contains bovine gelatin and soybean oil. Review: Track stool form, urgency, pain, bloating, and any side effects in your log. Add the next product only after this one's effect is clear."

1 Scoop

once per day

Take with water

Ongoing

Additional notes

"Why it is here: The supplement guide names low-dose soluble fiber, especially products such as Sunfiber®, as a gentle way to support stool consistency and gut health. Begin one product from this protocol at a time, not several. How to take: Mix about one scoop (7 g, supplying 6 g of soluble fiber) into 6 to 8 ounces of water or any non-carbonated beverage, as the label directs. The guides give no amount for Sunfiber®; they say to increase soluble fiber slowly and always with adequate fluid. Clinical experience (observation): This is my fiber of choice for people who failed psyllium or developed excessive gas from psyllium. I advise a 30-day trial. Caution: Do not assume all fiber is helpful during a flare. The label says to consult your healthcare practitioner if pregnant, nursing, or taking prescription drugs. Review: Track stool form, urgency, pain, bloating, and any side effects in your log. Add the next product only after this one's effect is clear."