The aim of this case series was to retrospectively examine the symptom response of irritable bowel syndrome with constipation(IBS-C) patients administered an herbal extract in a real-world setting. Twenty-four IBS-C patients in a community office practice were provided a combination over-the-counter dietary supplement composed of quebracho(150 mg), conker tree(470 mg) and M. balsamea Willd(0.2 mL) extracts(Atrantil?) and chose to take the formulation for a minimum of 2 wk in an attempt to manage their symptoms. Patient responses to the supplement were assessed by visual analogue scale(VAS) for abdominal pain, constipation and bloating at baseline and at 2 wk as part of standard-of-care. Patient scores from VAS assessments recorded in medical chart data were retrospectively compiled and assessed for the effects of the combined extract on symptoms. Sign tests were used to compare changes from baseline to 2 wk of taking the extract. Significance was defined as P < 0.05. Twenty-one of 24 patients(88%) responded to the dietary supplement as measured by individual improvements in VAS scores for abdominal pain, bloating and constipation symptoms comparing scores prior to administration of the extract against those reported after 2 wk. There were also significant improvements in individual as well as mean VAS scores after 2 wk of administration of the combinedextract compared to baseline for abdominal pain [8.0(6.5, 9.0) vs 2.0(1.0, 3.0), P < 0.001], bloating [8.0(7.0, 9.0) vs 1.0(1.0, 2.0), P < 0.001] and constipation [6.0(3.0, 8.0) vs 2.0(1.0, 3.0), P < 0.001], respectively. In addition, 21 of 24 patients expressed improved quality of life while taking the formulation. There were no reported side effects to administration of the dietary supplement in this practice population suggesting excellent tolerance of the formulation. This pilot retrospective analysis of symptom scores from patients before and after consuming a quebracho/conker tree/M. balsamea Wil d extract may support the formulation’s use in IBS-C. The aim of this case series was to retrospectively examine the symptom response of irritable bowel syndrome with constipation (IBS-C) patients administered an herbal extract in a real-world setting. Twenty-four IBS-C patients in a community office practice were provided a combination over-the-counter dietary supplement composed of quebracho (150 mg), conker tree (470 mg) and M. balsamea Willd (0.2 mL) extracts (Atrantil ™) and chose to take the formulation for a minimum of 2 wk in an attempt to manage their symptoms. Patient scores to the supplement analog by scale (VAS) for abdominal pain, constipation and bloating at baseline and at 2 wk as part of standard-of-care. Patient scores from VAS assessed recorded in Medical chart data were retrospectively compiled and assessed for the effects of the combined extract on symptoms. Sign tests were used to compare changes from baseline to 2 weeks before taking the extract. Significance was defined as P <0.05. Twenty-one of 24 p atients (88%) responded to the dietary supplement as measured by individual improvements in VAS scores for abdominal pain, bloating and constipation symptoms comparing scores prior to administration of the extract against those reported after 2 weeks. There were also significant improvements in individual as well as mean VAS scores after 2 wk of administration of the combinationdextract compared to baseline for abdominal pain [8.0 (6.5, 9.0) vs 2.0 (1.0, 3.0), P <0.001] , 2.0), P <0.001] and constipation [6.0 (3.0, 8.0) vs 2.0 (1.0, 3.0), respectively, P <0.001] were no reported side effects to administration of the dietary supplement in this practice population suggesting excellent tolerance of the formulation. This pilot retrospective analysis of symptom scores from patients before and after consuming a quebracho / conker tree / M. balsamea Wil d extract may support the formulation’s use in IBS-C.