Could Peppermint Oil Help Mitigate IBS Symptoms?

Researchers have found that IBgard, a slow-release peppermint oil for the dietary management of irritable bowel syndrome (IBS), may greatly reduce the abdominal symptoms of the condition.

A team led by Brooks Cash, MD, a professor of medicine at the University of South Alabama, recruited 35 patients who were assigned to treatment with peppermint oil, while another 37 patients were assigned to placebo. One patient in each arm withdrew from the study, for which all patients were required to meet the Rome III criteria for IBS, and had to have an average daily score of 4 or greater on a 10-point scale, as well as a Total IBS Symptom Score of 2 or higher. The mean age of patients—80% of whom were women—was about 40 years old, and the majority of participants were Caucasian.
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Patients rated IBS symptoms such as abdominal pain or discomfort, abdominal bloating, constipation, and passage of gas or mucus as “severe” or “unbearable.” Between the 2 groups, reduction in symptoms ranged from 30% to 50% at 1 hour, while the reduction in symptoms after 28 days ranged from 70% to 90%. At the 28-day mark, patients in the peppermint oil group reported the number of severe and unbearable symptoms being reduced by 66%. In comparison, 42% of patients on placebo demonstrated the same reduction in symptoms.

These findings “should serve as a reminder to primary care physicians that there are multiple options available for them, in addition to prescription agents, for the management of patients with irritable bowel syndrome,” says Cash, who notes that peppermint oil and its components are thought to have multiple mechanisms of action, including smooth muscle relaxation, pain relieving and carminative effects, anti-inflammatory and anti-microbial actions, and serotonergic antagonism.

While the concept of using peppermint oil for digestive symptoms is “not new,” its tolerability can be an issue, he says, “with reports of heartburn, dyspepsia, and anal burning in patients taking traditional formulations of peppermint oil.”

In this study, it’s the formulation that “is really the advance,” he says. “The site-specific targeting technology used in the current study consists of peppermint oil that is trapped inside microparticles that are each triple-coated, designed to exit the stomach quickly and release in the small intestine.”

Primary care practitioners should be reassured that “there is an additional, effective, over-the-counter option for patients fulfilling typical IBS-D or IBS-M clinical criteria,” says Cash. “The most impressive results point to abdominal pain and bloating as very responsive symptoms, and the rapid response seen within 24 hours in some patients suggests that there may be some value in using this preparation in an as-needed fashion.

The findings were originally presented at the Digestive Disease Week 2015 meeting, held May 16-19 in Washington, D.C.

—Mark McGraw