Peppermint and IBS: Does it work?

There are several alternative treatments that promise to help improve IBS symptoms and gut health. I see numerous patients who have spent a LOT of money on various supplements and herbal remedies but are they worth your hard-earned cash? 

I am going to be looking at the evidence behind some of these alternative approaches so you can make an informed decision. I will start off this series by discussing peppermint.

Peppermint is probably one of the most well-known herbs thought to help soothe your stomach. However, are these claims true? 

Peppermint contains L-menthol which helps relax smooth muscle in the gut providing a natural antispasmodic effect. A reduction in muscle contractions/ spasms is thought to lead to a reduction in pain and overall IBS symptoms and their severity (1,2,3). 

Peppermint oil capsules

There are a few randomised control trials and meta-analysis looking at the effect of peppermint oil on IBS symptoms. 

Do peppermint oil capsules improve IBS symptoms? 

Yes. Studies have shown taking peppermint oil; such as Mintec and Colpermin, helps improve abdominal pain and global IBS symptoms such as bloating, distension, gas, urgency, which led to improved quality of life (1,2). 

How is it taken?

One enteric coated peppermint oil capsule should be taken three times daily, 15-30 minutes before meals.

Side effects

As muscles in the gut relax this can cause the muscles which keep the opening of the stomach (the gastro-oesophageal junction) closed, to open as a result. This can lead to acid reflux and heartburn. These were the most common adverse side effects cited in studies (1,2).  

If you suffer with acid reflux, be aware that taking peppermint oil may worsen your symptoms. 

Conclusion

Peppermint oil tablets are safe and effective to use as an IBS treatment in the short term. All studies were carried over a period of a maximum of 12 weeks, therefore more studies looking at long term use are needed to assess their safety to use long-term (1,2).  

Due to this it would be recommended to use in the short term perhaps whilst symptoms are particularly bad, but should not be taken for longer than 2-3 months.

Do seek advice from your GP or pharmacist should you decide to start taking this supplement.

Peppermint tea

Unfortunately, there have been no good studies looking at the effects of peppermint tea in IBS. Clients with IBS usually report that they find having peppermint tea helpful and it helps ease their symptoms. So if you do enjoy peppermint tea and find it helps reduce your symptoms then continue taking it. 

Peppermint tea is low FODMAP therefore can be used whilst undertaking the low FODMAP diet. 

References:

  1. Khanna, R, MacDonald, J.K, Levesque, B.G. (2014). Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. J Clin Gastroenterol, 48(6):505-12 
  2. Alammar et al., (2019). The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC Complementary and Alternative Medicine, 19:21
  3. Shams, R, Oldfield, E.C, Copare, J, Johnson, D,A (2015). Peppermint Oil: Clinical Uses in the Treatment of Gastrointestinal Disease. JSM Gastroenterol Hepatol, 3(1): 1035

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