Systematic review and meta‐analysis: efficacy of peppermint oil in irritable bowel syndrome

Abstract

Summary Background Irritable bowel syndrome (IBS) is one of the most common disorders of gut‐brain interaction, with a complex pathophysiology. Antispasmodics are prescribed as first‐line therapy because of their action on gut dysmotility. In this regard, peppermint oil also has antispasmodic properties. Aim To update our previous meta‐analysis to assess efficacy and safety of peppermint oil, particularly as recent studies have cast doubt on its role in the treatment of IBS Methods We searched the medical literature up to 2nd April 2022 to identify randomised controlled trials (RCTs) of peppermint oil in IBS. Efficacy and safety were judged using dichotomous assessments of effect on global IBS symptoms or abdominal pain, and occurrence of any adverse event or of gastro‐oesophageal reflux. Data were pooled using a random effects model, with efficacy and safety reported as pooled relative risks (RRs) with 95% confidence intervals (CIs). Results We identified 10 eligible RCTs (1030 patients). Peppermint oil was more efficacious than placebo for global IBS symptoms (RR of not improving = 0.65; 95% CI 0.43–0.98, number needed to treat [NNT] = 4; 95% CI 2.5–71), and abdominal pain (RR of abdominal pain not improving = 0.76; 95% CI 0.62–0.93, NNT = 7; 95% CI 4–24). Adverse event rates were significantly higher with peppermint oil (RR of any adverse event = 1.57; 95% CI 1.04–2.37). Conclusions Peppermint oil was superior to placebo for the treatment of IBS, but adverse events were more frequent, and quality of evidence was very low. Adequately powered RCTs of peppermint oil as first‐line treatment for IBS are needed.

Plant Essential Oils as Healthy Functional Ingredients of Nutraceuticals and Diet Supplements: A Review

“…The effects of peppermint EO have been attributed to its antimicrobial and antispasmodic activity [ 32 ]. A recent systematic review and meta-analysis on the efficacy of peppermint EO in improving IBS analyzed, overall, 10 placebo-controlled randomized trials with minimum duration of four weeks, involving a total of 1030 patients [ 37 ]. Both small-intestine-release microencapsulated oil (182–540 mg/day) and regular peppermint oils (2 mL/day) were investigated in the different trials.…”

“…Both small-intestine-release microencapsulated oil (182–540 mg/day) and regular peppermint oils (2 mL/day) were investigated in the different trials. The analysis demonstrated that peppermint EO was more effective than placebo in all 10 trials in terms of either global symptoms or abdominal pain, concluding that peppermint is an efficacious treatment for IBS [ 37 ].…”

“…Since absorption occurs mainly in the small intestine [ 190 ], one additional advantage of gastro-resistant formulations is that they can deliver the EO where most of the absorption occurs, maximizing its efficacy and allowing a reduction of the effective dose. For instance, gastro-resistant forms of peppermint EO afforded clinical efficacy at a lower dose compared to conventional formulations in the treatment of IBS [ 37 ] (see Section 4 ).…”

Letter: efficacy of peppermint oil in irritable bowel syndrome

“…We read the study by Ingrosso et al 1 with interest. A previous network meta-analysis showed that peppermint oil, as an antispasmodic drug, is efficient in attenuating global IBS symptoms.…”

Grapefruit Seed Extract Reduces Gastrointestinal Symptoms

“…Herbal remedies exert a broad spectrum of pharmacological actions (multi-target approach) combined with proven good tolerability [ 8 ] . Some herbal compounds exert prokinetic or anti-infl ammatory actions; volatile essential oils like peppermint oil [ 9 ] or caraway oil have strong carminative eff ects due to defoaming and spasmolytic activities [ 10 ] . Other herbal compounds seem to in-fl uence the microbiome by antibacterial and antifungal eff ects.…”