Peppermint is a plant that is used in traditional medicine preparations for a variety of conditions. It functions as an antispasmodic that helps to relax and calm muscles as well as potentially having antibacterial and antifungal properties.

Evidence suggests that peppermint oil is helpful in small intestinal bacterial overgrowth (SIBO) as well as irritable bowel syndrome (IBS) and proves more beneficial than placebo in clinical trials. It has also been used in:

  • Cough and cold symptoms, when used topically or inhaled
  • Pain, headaches, and arthritis, when used topically
  • Bloating and indigestion, when used orally

 

Peppermint is available as whole leaf, teas, or enteric coated capsules that are designed to digest in the small intestine, minimizing heart burn and indigestion. For teas, steeping 1 teaspoon of dried peppermint leaves in 1 cup of boiling water for 10 minutes is often sufficient to aid in digestion. 1-2 enteric coated capsules containing 180-225 mg of peppermint oil 2-3 times a day has been reported to be beneficial in treating symptoms of IBS.

As with any medication or supplement, peppermint oil comes with side effects and precautions:

  • Digestive Distress: It is important to note that capsules of peppermint oil need to be enteric coated, meaning they dissolve in the intestines instead of the stomach, to reduce the likelihood of heartburn. As peppermint does relax muscles, it can relax the lower esophageal sphincter (LES) meaning that it can exacerbate symptoms of heartburn and reflux.
  • Irritation: Peppermint oil or menthol, the active ingredient, can cause skin irritation or a burning sensation if used too often or too liberally. As well, oral irritation called stomatitis can occur if too much tea or peppermint candies are ingested.
  • Drug interactions: As enteric coated capsules need to digest in the small intestine, antacids or acid suppressing medications can interact and reduce the pH of the stomach, potentially allowing the capsules to digest in the stomach not intestine.
  • Medical conditions: Peppermint can worsen gallstones and should not be used in pregnancy. Amounts found in food is safe however.
  • Breastfeeding mothers: Peppermint oil may decrease milk supply and supplementation should therefore be avoided.

 

Peppermint oil is a safe and traditional remedy and has been scientifically proven effective for IBS as compared to placebo. Side effects are minimal and can be minimized by using enteric-coated capsules and limiting the use to a few times a day.

The GutBiome Approach

The first step in treating IBS is modifications to diet, lifestyle, and stress management. However, in some cases these methods alone are insufficient for full symptom control.

Using a traditional remedy such as peppermint oil can be a safe and effective method to lessen the digestive symptoms associated with IBS. Peppermint oil acts as an antispasmodic and relaxes the smooth muscles in the intestine as well as helps to minimize symptoms of indigestion, gas, and bloating, all common with IBS.

It is important to note that if taking capsule forms of peppermint oil, they must be enteric coated in order for proper breakdown and absorption. This minimizes the potential digestive side effects. Avoid teas and peppermint flavored products, as they are insufficient for full symptom control and often lead to digestive side effects such as heart burn or irritation of the mouth.

Purchase the GutBiome Institute recommended peppermint oil supplement.

References

1. J Pediatr. 2015 Feb; 166(2):424-31.e6. doi: 10.1016/j.jpeds.2014.09.067. Epub 2014 Nov 8. Pharmacologic treatment in pediatric functional abdominal pain disorders: a systematic review. Korterink JJ, Rutten JM1, Venmans L, Benninga MA, Tabbers MM.

2. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. Ford AC, Talley NJ, Spiegel BM, Foxx-Orenstein AE, Schiller L, Quigley EM, Moayyedi P. BMJ. 2008 Nov 13; 337(): a2313.

3. The effect of enteric-coated, delayed-release peppermint oil on irritable bowel syndrome. Merat S, Khalili S, Mostajabi P, Ghorbani A, Ansari R, Malekzadeh R. Dig Dis Sci. 2010 May; 55(5):1385-90.

4. Peppermint oil. Kligler B, Chaudhary S. Am Fam Physician. 2007 Apr 1; 75(7):1027-30.

5. Peppermint Oil. BENJAMIN KLIGLER, M.D., M.P.H., Albert Einstein College of Medicine of Yeshiva University, Bronx, New York. SAPNA CHAUDHARY, D.O., Beth Israel Continuum Center for Health and Healing, New York, New York. Am Fam Physician. 2007 Apr 1;75(7):1027-1030.

6. BMJ. 2008; 337: a2313. Published online 2008 Nov 13. doi: 10.1136/bmj.a2313 PMCID: PMC2583392. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. Alexander C Ford, Nicholas J Talley, Brennan M R Spiegel, E Foxx-Orenstein, Lawrence Schiller, Eamonn M Quigley, and Paul Moayyedi.

7. Grigoleit HG, Grigoleit P. Peppermint oil in irritable bowel syndrome. Phytomedicine. 2005;12(8):601-606.

8. Pittler MH, Ernst E. Peppermint oil for irritable bowel syndrome: a critical review and metaanalysis. Am J Gastroenterol. 1998; 93(7):1131-1135.

9. Nair B. Final report on the safety assessment of Mentha piperita (peppermint) oil, Mentha piperita (peppermint) leaf extract, Mentha piperita (peppermint) leaf, and Mentha piperita (peppermint) leaf water. Int J Toxicol. 2001;20(suppl 3):61-73.

10. Kline RM, Kline JJ, Di Palma J, Barbero GJ. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. J Pediatr. 2001;138(1):125-128.

11. Nutr Clin Pract. 2008 Jun-Jul;23(3):284-92. doi: 10.1177/0884533608318677. Behavioral and complementary approaches for the treatment of irritable bowel syndrome. Wald A, Rakel D.

12. Ann Intern Med. 2000 Jul 18;133(2):136-47. Pharmacologic treatment of the irritable bowel syndrome: a systematic review of randomized, controlled trials. Jailwala J, Imperiale TF, Kroenke K.

13. University of Maryland Medical Center. Complimentary & Alternative Medicine Guide: Peppermint Oil. Last reviewed on 7/6/2014 by Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by the A.D.A.M. Editorial team.

14. WebMD. A to Z Guides: Peppermint Oil uses, benefits & effects. Reviewed by Melinda Ratini, DO, MS on April 15, 2015.