As a hydrating agent, cabbage juice may help relieve symptoms of irritable bowel syndrome (IBS) with constipation, but components of cabbage could exacerbate IBS with diarrhea. Its prebiotic properties, however, may promote a healthy microbiome over the long term. Hmm … What's best for you, you ask?
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Read more: What Vegetables Can I Eat With IBS?
IBS and Cabbage
IBS is a relatively common digestive disorder of the large bowel, characterized by symptoms of gas and bloating, abdominal pain, and diarrhea or constipation, according to the Mayo Clinic. While severe IBS may require medication and counseling, many people can manage IBS with lifestyle modifications. Dietary choices — what to consume and what to avoid — play a large role.
The notion that cabbage juice is beneficial for IBS may stem from its use as a home remedy for stomach ulcers. To date, however, there is no robust evidence to support cabbage juice as an ulcer treatment.
"Cabbage juice contains the same potentially beneficial anti-inflammatory compounds found in cabbage," says Will Bulsiewicz, MD, MSCI, a gastroenterologist at Lowcountry Gastroenterology in Mount Pleasant, South Carolina. "Some animal studies suggest cabbage juice could heal ulcer disease in the stomach, but there really are no good human studies."
Also, stomach ulcers, which are most commonly caused by a Helicobacter pylori infection, and IBS are different diseases — what cures one won't necessarily benefit the other.
In general though, anti-inflammatory compounds are thought to have a healing effect throughout the body, including the gut. Is it possible, then, that cabbage juice may be beneficial to people with IBS when used with moderation — and perhaps a little caution?
What About Cabbage Juice?
According to Dr. Bulsiewicz, juicing vegetables removes all of the insoluble fiber, a substance that's good for people with IBS and most everyone else, too. However, some soluble fiber remains in cabbage juice. "Soluble fiber is prebiotic and feeds the healthy bacteria that live inside our gut, which has beneficial effects to the microbiome," he says.
Dr. Bulsiewicz adds, though, that cabbage also contains some elements that may be troublesome for people with IBS. One is raffinose, a trisaccharide common to many vegetables, beans, lentils and whole grains. He describes it as "a sugar that can produce gas and potentially exacerbate diarrhea."
In addition, cabbage and cabbage juice contain carbohydrates classified as FODMAPs — fermentable oligosaccharides, disaccharides, monosaccharides and polyols. High-FODMAP foods can be problematic for people with IBS, according to a study published in August 2017 in the journal Nutrients. But that's not the entire story.
Fructans: Your Optimal Amount
"The FODMAPs in cabbage are fructans, which in excess can cause distress in people with IBS," says Dr. Bulsiewicz. "But those fructans are also prebiotic — they can be really good for you in the right amount."
He acknowledges that this dichotomy can be a bit confusing. "The point is that drinking cabbage juice in the appropriate quantity could be beneficial from both a gut and a global health perspective, but if you binge on cabbage juice, the excessive amounts of raffinose and fructans can cause distress," explains Dr. Bulsiewicz. "So, there is some window of opportunity where cabbage juice is beneficial."
How large that window, or how big the glass, is not yet clear; no studies have established a safe or beneficial amount of cabbage juice for people with IBS.
"Some people may be able to drink more than others," Dr. Bulsiewicz says. "Personally, I do not advocate drinking more than 8 ounces a day, and I don't think you would have to consume it on a daily basis to experience the benefits."
On that note, people who find the thought of consuming raw cabbage juice unpleasant may want to keep an eye out for future studies of sauerkraut.
A pilot study published in October 2018 in Food & Function found an improvement in IBS symptoms and gut microbiota in people who ate sauerkraut for six weeks. The authors attribute this effect to the prebiotics in lacto-fermented sauerkraut. With only 34 subjects and no control group, the study was too small to draw meaningful conclusions but is still promising.
Is This an Emergency?
- Mayo Clinic: “Irritable Bowel Syndrome”
- Will Bulsiewicz, MD, MSCI, gastroenterologist, Lowcountry Gastroenterology, Mount Pleasant, South Carolina, and author, "Fiber Fueled"
- Nutrients: “Low FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis”
- Food & Function: “Lacto-Fermented Sauerkraut Improves Symptoms in IBS Patients Independent of Product Pasteurization – A Pilot Study”