Alleviating Irritable Bowel Syndrome (Ibs) With Peppermint

Introduction

Many of us have come across peppermint in a variety of forms, as it’s used for a multitude of purposes: chewing gum, toothpaste, candy, sprays, tea… and even as a treatment to deal with the help with symptoms of irritable bowel syndrome (IBS). The perennial herb (scientifically named: Mentha x Piperita), is a hybrid plant, stemming from two mint species varieties: watermint and spearmint.¹ 

The medicinal use of peppermint is to be supported, given its rich history in traditional medicine, across several parts of the world. Peppermint can be recommended for dental health, heartburns, IBS, headaches, skin rashes and nausea. In this article, we will explore the use of peppermint in managing and alleviating IBS symptoms.

Symptoms of irritable bowel syndrome

In a research carried out by Lovell and Ford, it was found that the global prevalence of IBS is 11.2%.² It largely affects female people assigned female at birth, and its age of onset is often below 50 years. The exact pathophysiology of this chronic gastrointestinal disorder is complex.

The interplay of factors includes but is not limited to, gastrointestinal motility, psychosocial stresses, genetic predisposition, dysregulations of the gut-brain axis and food reactions.³ With most people, it is difficult to pinpoint the exact root of their symptoms, but a diagnosis of IBS is made based on exclusion.

This means that physicians will rule out other potential causes of your symptoms, such as infections, coeliac disease, and inflammatory bowel disease (IBD, which is not to be confused with IBS), before diagnosing IBS.

The main symptoms of IBS are abdominal pain, bloating and changes in bowel habits. The intensity of these symptoms can range anywhere on the spectrum from mild to severe and may be described differently by each patient.

Stomach and abdominal discomfort in IBS patients is often reported to improve after defecation/passing stool, but this is not always the case. IBS patients may also be more likely to experience heartburn and indigestion, as well as constipation, diarrhoea, and flatulence. Given that manythat, many of these symptoms are either non-specific or overlap with other conditions, individuals must seek professional medical advice, to rule out any other causes.

As this is a chronic, functional gastrointestinal disorder, it can affect the daily lives of those living with IBS. It may lead to absences from work/school/other commitments due to pain and discomfort. It may also lead to increased stress around meal times, surrounding what someone may or may not be able to eat. Thus, although IBS is not identified as a sinister disorder, it can heavily impact a person’s life and confidence.

Benefits of peppermint for IBS

There are several ways by which peppermint targets the pathophysiology of IBS.⁴ One essential component of peppermint is L-Menthol, which effectively works on the smooth muscles of the gut. It blocks the calcium channels in smooth muscles and therefore prevents contractions,- this gives peppermint its antispasmodic effects on the gastrointestinal tract.

Peppermint also has antimicrobial, antioxidant, anti-inflammatory and anaesthetic properties. Some research also reported immunomodulating activities. For IBS in particular, the antispasmodic and anti-inflammatory properties are likely the most significant.

A systematic review focusing on the impact of peppermint oil on IBS collected results from clinical trials and concluded an improvement in symptoms following the use of peppermint oil.³ The improvements were evident in both the short-term and long-term, but there were methodological inconsistencies among the studies.

Different forms of peppermint for IBS relief

Peppermint can be taken in various forms for the management of IBS symptoms. If you have fresh peppermint leaves, put some leaves in a cup with hot water and this can be a simple but great recipe for relief. Peppermint tea is also available in many stores and can serve the same purpose. You may purchase peppermint oil capsules from pharmacies and over the counter in other stores. Follow the instructions on the product, but the usual dose advised by the NHS is 1-2 capsules, taken 3 times a day before meals.⁵

Unfortunately, a common side effect of ingesting peppermint is increased heartburn and gastric irritation.^5,6 This is why many IBS-specific preparations of peppermint are slow or sustained-release formulations. You can purchase enteric-coated tablets, which do not release the peppermint into the stomach, but only later when the tablet is in the lower gastrointestinal tract. In other words, if the target organ is the colon or intestines (like in IBS), immediate-release formulations would not only be irritating to the stomach lining but inadequate, as the active ingredients are not acting on the target organ.⁴

Who cannot take peppermint?

Peppermint is generally safe and can be taken by adults and children over the age of 12 years. Some products may only be suitable for those aged 15 years or older, so check any leaflets for the right dosage that comes with the medications you have. To ensure that peppermint is safe for you to use, ask your doctor or pharmacist before starting. Certain individuals should be cautious with peppermint or seek medical advice, as listed below. Please seek medical advice if:

• You get an allergic reaction to peppermint (in any form/preparation)
• You notice unintentional weight loss
• There is blood in your stools/ during defecation
• You have nausea and/or vomiting
• PregnancyYou are pregnant
• You experience digestive problems, e.g., peptic ulcers, acid reflux, severe constipation, and ulcerative colitis (IBD)
• You are aged 40+ and have a known diagnosis of IBS, but have not had an attack/symptoms for a while
• You have liver disease

Summary

Many peppermint-based formulations are available for the management of IBS symptoms, such as IBgard^©, Colpermin^© and BuscoMint^©. The antispasmodic and anti-inflammatory properties of peppermint have been documented in clinical research. There is evidence that peppermint can reduce the symptom burden of IBS, including pain and bloating. Caution should be taken as peppermint can irritate the lining of the stomach, particularly in people with pre-existing gastric issues.