Using Peppermint to Manage IBS Symptoms
When it comes to managing IBS symptoms, there are a lot of tools clinicians have in their toolkit. At our dietitian practice, we like to think we have four different toolkits which we refer to as our four pillars of gut health. These pillars are: food, stress management, gut microbiome and medication. Within our medication management toolkit, there is peppermint oil. But what does the science say about peppermint oil and how do we use it for symptom management?
How does peppermint help IBS symptoms?
Peppermint has been used for centuries as a digestive aid so it’s no surprise researchers were interested in its use for symptom management of IBS. Peppermint oil works as an antispasmodic, relaxing smooth muscles in the gastrointestinal tract. It also works as an anti-inflammatory and has antimicrobial properties which are speculated to have potential benefits for people experiencing SIBO, though more research on this area is required.1
Research on peppermint oil
There have been a number of studies on peppermint oil and IBS symptoms. A 2014 meta-analysis included 9 randomized placebo-controlled studies and concluded that peppermint oil was two times more likely to improve global IBS symptoms and abdominal pain than a placebo.2 Additional studies have concluded that peppermint oil has reduced stool frequency in people with IBS.1
The adverse effect of taking peppermint oil is reflux and heartburn due to relaxation of the lower esophageal sphincter.3 If reflux is a concern for you, choosing a different mode of delivery can help! There are capsules available that are enteric-coated, which delay the release until the lower GI tract - where we want the peppermint oil to take action in your gut.
Preparation and dosing
Taking peppermint oil directly is not recommended as it’s concentrated and can have adverse effects, such as mouth and throat sores. Peppermint tea is an option although there is the potential for the side effect of heartburn. The amount menthol within tea is variable based on the type of tea and preparation and because tea is less concentrated than a peppermint oil supplement, it’s likely a less effective treatment. However, tea is an inexpensive option to trial and can be used as part of another tool for IBS management - stress reduction. Taking time to prepare and sip on tea can be used as a mindfulness and stress relieving strategy which has proven benefits to reduce IBS symptoms.
Most research conducted used enteric-coated peppermint oil capsules with 0.2mL-0.4mL 2-4 times per day. Peppermint oil capsules can be used as a preventative therapy, taken daily 15-30 minutes before meals, though there are no current studies on long-term effectiveness - it is generally recognized as safe. Alternatively, it may be used as symptom management therapy taken when symptoms arise or before a meal that’s known to cause GI distress.
Peppermint oil is one of the most researched herbals for IBS symptom management. More research is required to determine long-term effectiveness and how it works in different IBS subtypes. At our practice, we always like to work through diet and lifestyle factors to manage IBS before moving onto medication to limit additional side effects, as well as costs. Peppermint oil capsules or tea is a holistic strategy with limited adverse effects, therefore it’s a tool we recommend trying to get additional symptom relief and have our patients feeling better, sooner.4
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