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Peppermint Oil for Irritable Bowel Syndrome (IBS): A Meta-Analysis

12/3/2019 4:31:12 PM
smooth musclePeppermint oil (Mentha piperita) potentially targets multiple aspects of the pathophysiology of irritable bowel syndrome (IBS). L-menthol in peppermint oil blocks calcium channels in smooth muscle to exert an antispasmodic effect on the gastrointestinal tract. Peppermint oil also has antimicrobial, anti-inflammatory, antioxidant, and immunomodulating effects.
 
The most comprehensive meta-analysis of peppermint oil for IBS was published in 2019 in BMC Complementary and Alternative Medicine. The review included 12 studies and 835 patients. The studies spanned from 1979 to 2016. Most were double-blind RCTs with follow-ups of 3 to 12 weeks.

Studes examine peppermint oil for IBS relief

Seven studies reported treatment outcomes for global improvement of IBS symptoms. The risk ratio (RR) for the benefit of peppermint oil versus placebo on global symptoms was 2.39 (95% CI, 1.93-2.97). The number of patients needed to be treated with peppermint oil to prevent one person from having persistent symptoms was 3.
 
Six studies reported treatment outcomes for the improvement of abdominal pain. The RR for the benefit of peppermint oil versus placebo on abdominal pain was 1.78 (95% CI, 1.43-2.20). The number of patients needed to be treated with peppermint oil to see improvements in one person for abdominal pain was 4.

Peppermint relieves symptoms with minimal side effects

Only a few adverse events were reported overall, and most were mild and transient. They included heartburn, dry mouth, belching, peppermint taste, rash, dizziness, and headache. There was no statistical difference in adverse events between peppermint oil and placebo.
 
The GRADE criteria were used to evaluate the quality of evidence. The global improvement in IBS was considered to be of high quality because of the large magnitude of effect. The improvement in abdominal pain was considered to be of moderate quality because of the risk of bias.
 
This meta-analysis represented the most extensive review of RCTs of peppermint oil in IBS spanning 5 decades and representing patients around the world. The authors concluded that enteric-coated peppermint oil is a “safe and effective therapy for the relief of abdominal pain and global symptoms in adults with IBS.”
 
Reference
Alammar N, Wang L, Saberi B et al. The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC Complement Altern Med. 2019; 19: 21.