The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data

Abstract

BackgroundPeppermint oil (PO) has intrinsic properties that may benefit patients with irritable bowel syndrome (IBS) symptoms. The study objective was to determine the effect of peppermint oil in the treatment of the IBS.MethodsWe systematically searched MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (Cochrane CENTRAL), ClinicalTrials.gov, EMBASE (Ovid), and Web of Science for randomized controlled trials (RCTs) of PO for IBS. We appraised the eligible studies by the Cochrane risk of bias tool. We performed random-effects meta-analysis on primary outcomes including global improvement in IBS symptoms and abdominal pain. A PRISMA-compliant study protocol is registered in PROSPERO Register [2016, CRD42016050917].ResultsTwelve randomized trials with 835 patients were included. For global symptom improvement, the risk ratio (RR) from seven RCTs for the effect of PO (n = 253) versus placebo (n = 254) on global symptoms was 2.39 [95% confidence interval (CI): 1.93, 2.97], I2 = 0%, z = 7.93 (p < 0.00001). Regarding abdominal pain, the RR from six RCTs for the effect of PO (n = 278) versus placebo (n = 278) was 1.78 [95% CI: 1.43, 2.20], I2 = 0%, z = 5.23 (p < 0.00001). Overall, there were no differences in the reported adverse effects: PO (32 events, 344 total, 9.3%) versus placebo (20 events, 327 total, 6.1%) for eight RCTs; RR 1.40 [95% CI: 0.87, 2.26] I2 = 0%, z = 1.39 (p = 0.16). The number needed to treat with PO to prevent one patient from having persistent symptoms was three for global symptoms and four for abdominal pain.ConclusionsIn the most comprehensive meta-analysis to date, PO was shown to be a safe and effective therapy for pain and global symptoms in adults with IBS.Electronic supplementary materialThe online version of this article (10.1186/s12906-018-2409-0) contains supplementary material, which is available to authorized users.

Food supplements and diet as treatment options in irritable bowel syndrome

“…A systematic review and meta‐analysis of 12 RCTs consisting of 835 patients with IBS concluded peppermint oil to be safe and effective in improving IBS symptoms 22 . It showed a benefit of peppermint oil compared to placebo on risk of global symptoms (RR of improvement 2.4, 95% CI 1.9‐3.0, P < .001) and abdominal pain (RR of improvement 1.8, 95% CI 1.4‐2.2, P < .001) 22 . More recently, a systematic review and network meta‐analysis compared the impact of peppermint oil, soluble fiber, antispasmodic drugs, and gut‐brain modulators in IBS 23 .…”

Herbal Therapies in Functional Gastrointestinal Disorders: A Narrative Review and Clinical Implication

“…Evidence from in vitro studies and clinical trials indicate that PMO seems to alleviate IBS symptoms, mainly abdominal pain, by relaxing smooth muscles in the gut. A recent meta-analysis examining 12 randomized controlled trials showed that PMO was beneficial in the management of IBS and an Asian consensus on IBS mentioned its potential efficacy in treating IBS with a high level of agreement (8,63). However, any benefit of PMO remains unclear in other FGIDs such as FD owing to the paucity of reliable preclinical and clinical data.…”

Irritable bowel syndrome - risk factors, pathogenesis and treatment options

“…Data shows that FODMAP diet significantly improves general symptoms and quality of life in patients with irritable bowel syndrome [49]. Peppermint oil (PO) (Mentha Piperita) is a naturally-occurring carminative herb containing monoterpene compounds that target the pathophysiology of IBS [50]. For centuries peppermint oil has been used for gastrointestinal ailments [51].…”