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Hi Susan,
I know you didn’t ask, but I couldn’t help. You are a very devoted person for Patches wellness. If everyone is as half as devoted you are, there would be less suffering pets in the world for sure. I’m sorry for the on-going IBS troubles Patch has to go through 🙁 I’ve had my good share of sleepless nights with my pups over the years, but it pales in comparison the everyday struggles you have to bear with Patch.

I’m glad to hear you are using slippery elm to help his gut wall integrity. I hear good things about it for IBS. If I may contribute, and you may have already doing this, if so, tell me – but I wanted to mention about another herb just in case because I don’t want to deprive you from options for Patch.

With that said, have you heard of the efficacy of peppermint oil for severe IBS symptoms? There are studies to prove it helps with bloating, gas and abdominal pains, and it is safe for children, too. It does not cure IBS, but it alleviates serious digestive symptoms. Strong peppermint tea would do the trick a lot of the times, but I’m doubtful Patch would volunteer to drink it, so you would probably need to get enteric-coated capsules of peppermint oil for sever bouts of upsets like Patch’s, but I don’t think it’s hard to find it nowadays. Don’t take my word for it – Here are studies behind it:

“Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children”, Kline, Robert M., et al. Journal of Pediatrics

“Effect of acute peppermint oil administration on gastric sensorimotor function and nutrient tolerance in health”, Papathanasopoulous, A., et al. Neurogastroenterrology & Motility

“The effect of enteric-coated, delayed-release peppermint oil on irritable bowel syndrome”, Merat, Shahin, et al., Digestive Diseases and Sciences

I think there are more, but I think you can get the ideas, and I hope this help you decide if peppermint oil make sense for Patch or not in addition to slippery elm.

One other thing: If you are feeding kibbles with probiotics, avoid ones that include “Enterococus Faecium”. This strain causes more potential to cause damages than good for animals (including humans) with weakened immune systems and IBS. Off the top of my head, Whole Earth Farms/Merrick, Diamond, Victor, I & Love & You include this strain in their formulas.