Behind the headlines: Can peppermint oil treat IBS?

Peppermint oil is the most effective treatment for irritable bowel syndrome (IBS), media reports suggest.

Canadian research found that the oil, which is cheap and readily available without a prescription, was more effective at treating IBS than antispasmodics and controlling fibre intake.

NICE currently recommends antispasmodic agents and soluble fibre as the first-line treatments for IBS.

What is the research?
The findings are based on a meta-analysis of 35 studies that investigated the effectiveness of antispasmodics, fibre and peppermint oil against placebo on the treatment of IBS among 2,500 patients with IBS.

The findings were pooled to calculate a relative risk of symptoms after treatment.

Overall, the researchers found that antispasmodics, fibre and peppermint oil could all help to reduce symptoms of IBS such as abdominal pain and bloating, but that peppermint oil was the most effective treatment.

Peppermint oil reduced IBS symptoms by 67 per cent, compared with 32 per cent for antispasmodics and 13 per cent for fibre treatment. Treatment with fibre prevented IBS symptoms in one patient in 11, antispasmodics one in five, and peppermint oil one in 2.5.

What do the researchers say?
Lead researcher Dr Alex Ford, from the gastroenterology division at McMaster University, in Ontario, said: 'Peppermint oil should be considered as a first-line treatment, two capsules taken three times per day.'

But it is also reasonable to try antispasmodics and fibre if single therapy with peppermint oil is ineffective, he said.

More research is required, but peppermint oil may prevent IBS symptoms by relaxing smooth muscle, reducing colonic contractility and pain, due to calcium-channel blocking activity, added Dr Ford.

What do other researchers say?
Roger Jones, professor of primary care at King's College London and a GI specialist, said that the findings should 'reawaken interest in the pharmacotherapy of IBS and stimulate further research'.

But it is important that this new evidence does not detract from the need to take an integrated approach to the treatment of IBS which takes account of the physical, psychological, and social factors, he added.

Informing patients

- Peppermint oil could reduce symptoms of IBS by 67 per cent.

- The researchers say NICE should recommend peppermint oil as a first-line treatment.

- Further research is required to understand how peppermint oil reduces IBS symptoms.

sanjay.tanday@haymarket.com

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