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Peppermint and Probiotics for IBS

Symptoms of IBS include pain, constipation, diarrhea, bloating & gas. Enteric-coated peppermint oil helps reduce such symptoms.

Irritable bowel syndrome (IBS) is common, affecting 7 to 16 percent of the population in the US (JAMA, March 2, 2021). This diagnosis often frustrates both patients and physicians. People experiencing IBS have abdominal pain and changes in their bowel habits (either constipation or diarrhea), but their doctors can’t find any obvious reason to explain these problems. As a result, experts urge clinicians to check carefully so they can rule out other possible causes of these symptoms. (They are looking for “organic disease” as compared to “functional disorder.”) Could nondrug approaches such as probiotics or enteric-coated peppermint oil help ease the discomfort of IBS?

Enteric-Coated Peppermint Oil for IBS:

Q. I’ve had IBS most of my life. When I lived overseas many years ago, a doctor prescribed peppermint oil capsules. They worked wonderfully and were available at pharmacies.

When I moved back to the United States, my doctor had never heard of peppermint oil. Back then, I couldn’t find it anywhere. I wish more US doctors would recommend safe, natural and affordable products.

A. IBS stands for irritable bowel syndrome. Symptoms include stomachache, bloating, gas and either constipation or diarrhea. Both stress and certain foods may make symptoms worse.

Enteric-coated peppermint oil may alleviate abdominal cramps, and doctors in Europe sometimes prescribe it (Deutsche Medizinische Wochenschrift, Oct. 2021).  There are conflicting studies in the medical literature, however. Although a number conclude that enteric-coated peppermint oil is effective for abdominal discomfort, others indicate that it is no better than placebo (Alimentary Pharmacology & Therapeutics, March 2018; American Journal of Gastroenterology, Nov. 1, 2021). Peppermint oil releasing in the small intestine were better than placebo at relieving abdominal pain and overall IBS severity, although not in “overall relief” (Gastroenterology, Jan. 2020).

Possible side effects include heartburn, nausea or stomachache. For the most part, however, enteric-coated peppermint oil capsules appear to be safe.

What Natural Approaches Can Help IBS Symptoms?

Q. I have had irritable bowel syndrome (IBS) for two years. I have constipation (can’t “go” for a week). When I finally can go, I can’t stop. At that point the stool is soft and runny.

I also have cramps, bloating, painful gas and hemorrhoids. When my IBS flares up, it is quite debilitating.

I know there are some prescription drugs I could take, but the side effects worry me. Are there any natural remedies for this condition? I’d be grateful for any information you may have about this disorder.

A. Millions of people suffer from symptoms of IBS as you have described them. It can be difficult to diagnose since there is no obvious cause. Celiac disease (an intolerance to gluten found in wheat, rye and barley) should always be ruled out with a blood test.

Several natural approaches have scientific support. Enteric-coated peppermint oil has been shown helpful in controlled trials (BMJ, Nov. 14, 2008). Probiotics and soluble fiber (psyllium) also appear to ease symptoms (Nutrients, Sep. 2, 2019).

Testimonial on Enteric-Coated Peppermint Oil:

Here is a message we received several years ago about the power of peppermint for IBS:

Q. I have had irritable bowel syndrome for more than 25 years. I’ve tried all sorts of remedies including coconut macaroon cookies. I ate so many I can’t stand even looking at them!

Then I remembered you had mentioned special peppermint pills. I found them at the health food store, and they work so fantastically well, I can’t believe it.

I have an almost normal life again. You can’t go out very much with this disease, especially if the diarrhea is severe as mine was.

A. Symptoms of irritable bowel syndrome include abdominal pain, constipation, diarrhea, bloating and gas. One study demonstrated that enteric-coated peppermint oil could significantly reduce such symptoms.

The enteric coating ensures that peppermint oil is delivered to the small intestine, where it helps to ease spasms, instead of to the stomach, where it could aggravate heartburn. It can be purchased at health food stores. One brand name to look for is Pepogest.

We are delighted that peppermint has worked so well for you. Others should check with their doctors or pharmacists before taking this herb. Research shows that peppermint oil can interact with prescription medications in the same way as grapefruit. Blood levels of many medicines could rise, leading to side effects.

Learn More:

The People’s Pharmacy Quick & Handy Home Remedies describes these and other natural approaches to dealing with digestive distress. You may also wish to listen to Dr. Robynne Chutkan discuss a range of intestinal problems in Show 1224: What Is the Best Way to Manage Your Heartburn?

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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  • Camilleri M, "Diagnosis and treatment of Irritable Bowel Syndrome: A review." JAMA, March 2, 2021. DOI: 10.1001/jama.2020.22532
  • von Schassen H et al, "[The new guideline on irritable bowel syndrome: what is new?]" Deutsche Medizinische Wochenschrift, Oct. 2021. DOI: 10.1055/a-1331-6478
  • Chumpitazi BP et al, "Review article: the physiological effects and safety of peppermint oil and its efficacy in irritable bowel syndrome and other functional disorders." Alimentary Pharmacology & Therapeutics, March 2018. DOI: 10.1111/apt.14519
  • Nee J et al, "Peppermint oil treatment for Irritable Bowel Syndrome: A randomized placebo-controlled trial." American Journal of Gastroenterology, Nov. 1, 2021. DOI: 10.14309/ajg.0000000000001395
  • Weerts ZZRM et al, "Efficacy and safety of peppermint oil in a randomized, double-blind trial of patients with Irritable Bowel Syndrome." Gastroenterology, Jan. 2020. DOI: 10.1053/j.gastro.2019.08.026
  • Ford AC et al, "Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis." BMJ, Nov. 14, 2008. doi: https://doi.org/10.1136/bmj.a2313
  • Dale HF et al, "Probiotics in Irritable Bowel Syndrome: An up-to-date systematic review." Nutrients, Sep. 2, 2019. DOI: 10.3390/nu11092048
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