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IBS Treatment – Peppermint

There is good scientific evidence that peppermint is an effective treatment for irritable bowel syndrome (IBS).  Peppermint, or Mentha x piperita L, is a perennial herb found throughout North American and Europe.  Peppermint oil is obtained by steam distillation of the plant leaves.   Peppermint as well as one of its phytochemicals, menthol, is widely used in common preparations such as Ben-Gay, Vicks Vapo-Rub, Robitussin cough drops, and Listerine.  In addition to IBS, it has been used to relieve symptoms of colonic, gastric (stomach) and esophageal spasms, cough, dyspepsia, tension headaches, abdominal distension, asthma, nasal congestion, nausea, and nerve pain.

Pepperment oil is considered an antispasmodic.  The menthol in peppermint affects the GI tract by reducing smooth muscle motility.  It acts by interfering with the movement of calcium across the cell membrane, thus relaxing the GI musculature.  This is beneficial for people with GI motility disorders, such as IBS.  Peppermint also affects the histaminic, 5-hydroxytriptamin (5-HT), and cholinergic systems of the gut, which are the systems targeted in conventional therapies (e,g., alosetron, a 5HT3 antagonist; or dicyclomine and hyoscaymine, anticholinergics).  In several trials, peppermint significantly improved symptoms compared to placebo, or showed a reduction in abdominal pain, abdominal distention, and stool frequency. 

Peppermint is usually taken as 1 – 2 capsules of Colpermin (0.2-0.4 mL of peppermint oil or 187-374 mg of peppermint oil in a gel), 3 times a day.  It should be taken 15 -30 minutes before meals for up to one month.  Enteric coated tablets (180 – 200 mg) are also available. 

Adverse effects
Oral ingestion of peppermint oil maybe unsafe for infants, small children, and pregnant women.  It has been reported to cause lung and tongue spasms and respiratory arrest in children.  Peppermint may induce menstruation in pregnant women.  Injections (IV doses) of peppermint oil may result in damage to the lungs.  In some adults, it can cause heartburn by relaxing the esophageal muscles, so people with reflux disease should avoid it.  Using enteric coated tablets can decrease the adverse effects by slowing the quick absorption of menthol.  Other reported adverse events include hypersensitivity reactions, contact dermatitis, burning around the anus, slowed heartbeat, and muscle tremors.

References:

Natural Standard Research Collaboration. Peppermint Oil. web page] www.naturalstandard.com. Accessed June 23, 2008.