Peppermint oil for treatment of irritable bowel syndrome

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Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that affects 5–15% of people worldwide. ¹ Typically, patients with IBS experience abdominal pain or discomfort and constipation or diarrhea with other gastrointestinal symptoms, such as abdominal distention and bloating; these symptoms reduce quality of life and can be difficult to control with currently available prescription agents. For these reasons, patients are often compelled to try nonprescription therapies, including natural products. In studies conducted in Australia and the United Kingdom, about 20–50% of patients with IBS reported using complementary and alternative medicines. ^2,3 Thus, it is important that healthcare professionals are knowledgeable of these therapies, including dietary supplements such as peppermint oil.

Historically, the ingestion of peppermint oil has been associated with effects on the gastrointestinal tract. It is a classic essential oil known to have carminative properties (i.e., it is a naturally occurring remedy thought to help decrease bloating and gas by allowing passage of flatus) and may even be beneficial as an antiemetic. ^4,5 Peppermint oil comes from a perennial herb (Mentha × piperita), a plant found across North America and Europe. ^4,Mentha × piperita is a sterile hybrid of two herbs, spearmint (Menthaspicata) and water mint (Menthaaquatica). The main constituents of peppermint oil include menthol (35–55%), menthone (20–31%), menthyl acetate (3–10%), isomenthone, 1,8-cineole, limonene, β-myrcene, and carvone. Peppermint oil may be obtained through steam distillation of flowering parts that grow aboveground. It is a volatile oil, with menthol accounting for a majority of its potency. Due to the various constituents of peppermint oil, it has a variety of uses, including topical application as an antiseptic and for aches and pains, inhalation as aromatherapy, and oral formulations for flavoring or for use as digestive aids. Relaxation of intestinal muscle, both in vivo and in vitro, and relaxation of the lower esophageal sphincter have been reported with the use of peppermint oil, which is thought of as an antispasmodic that may confer benefits in conditions such as IBS. ^1,4,6,7 Several clinical studies of the use of peppermint oil for the treatment of IBS have been conducted; the findings will be summarized in this article.