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Systematic review and meta-analysis: Efficacy of peppermint oil in irritable bowel syndrome
Abstract
Summary: Background: Irritable bowel syndrome (IBS) is one of the most common disorders of gut‐brain interaction, with a complex pathophysiology. Antispasmodics are prescribed as first‐line therapy because of their action on gut dysmotility. In this regard, peppermint oil also has antispasmodic properties. Aim: To update our previous meta‐analysis to assess efficacy and safety of peppermint oil, particularly as recent studies have cast doubt on its role in the treatment of IBS Methods: We searched the medical literature up to 2nd April 2022 to identify randomised controlled trials (RCTs) of peppermint oil in IBS. Efficacy and safety were judged using dichotomous assessments of effect on global IBS symptoms or abdominal pain, and occurrence of any adverse event or of gastro‐oesophageal reflux. Data were pooled using a random effects model, with efficacy and safety reported as pooled relative risks (RRs) with 95% confidence intervals (CIs). Results: We identified 10 eligible RCTs (1030 patients). Peppermint oil was more efficacious than placebo for global IBS symptoms (RR of not improving = 0.65; 95% CI 0.43–0.98, number needed to treat [NNT] = 4; 95% CI 2.5–71), and abdominal pain (RR of abdominal pain not improving = 0.76; 95% CI 0.62–0.93, NNT = 7; 95% CI 4–24). Adverse event rates were significantly higher with peppermint oil (RR of any adverse event = 1.57; 95% CI 1.04–2.37). Conclusions: Peppermint oil was superior to placebo for the treatment of IBS, but adverse events were more frequent, and quality of evidence was very low. Adequately powered RCTs of peppermint oil as first‐line treatment for IBS are needed.
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“The efficacy of peppermint oil in IBS is also corroborated by two recent systematic reviews and meta-analyses of eligible trials, which found that this plant extract was safe and superior to placebo in reducing abdominal pain and global IBS symptoms.”
From Plant-Derived Treatments for IBS: Clinical Outcomes, Mechanistic Insights, and Their Position in International Guidelines (2026) · cites this paper as [33]
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“Evidence from recent systematic reviews and meta-analyses consistently indicates that peppermint oil is the most effective botanical agent, particularly for reducing abdominal pain and overall IBS symptom severity.”
From Plant-Derived Treatments for IBS: Clinical Outcomes, Mechanistic Insights, and Their Position in International Guidelines (2026) · cites this paper as [33]
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Rome IV—Functional GI Disorders: Disorders of Gut-Brain Interaction
Drossman, D. A., & Hasler, W. L. (2016) · Gastroenterology · doi:10.1053/j.gastro.2016.03.035 · Cited by 1,928
ACG Clinical Guideline: Management of Irritable Bowel Syndrome
Lacy, B. E., Pimentel, M., Brenner, D. M., Chey, W. D., Keefer, L. A., Long, M. D., & Moshiree, B. (2021) · American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001036 · Cited by 893
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Self-citationBritish Society of Gastroenterology guidelines on the management of irritable bowel syndrome
Vasant, D. H., Paine, P. A., Black, C. J., Houghton, L. A., Everitt, H. A., Corsetti, M., Agrawal, A., Aziz, I., Farmer, A. D., Eugenicos, M. P., et al. (2021) · Gut · doi:10.1136/gutjnl-2021-324598 · Cited by 592
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Cited by
An evidence-based update on the diagnosis and management of irritable bowel syndrome
Black, C. J., & Ford, A. C. (2025) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2025.2455586 · Cited by 27
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Metadata
- Authors
- Ingrosso, M. R., Ianiro, G., Nee, J., Lembo, A. J., Moayyedi, P., Black, C. J., & Ford, A. C.
- Affiliations
- Digestive Disease Center Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy
- Department of Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USA
- Farncombe Family Digestive Health Research Institute McMaster University Hamilton Ontario Canada
- Leeds Gastroenterology Institute St. James's University Hospital Leeds UK
- ORCID
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2022-08-09
- Volume
- 56
- Issue
- 6
- Pages
- 932-941
- ISSN
- 0269-2813
- 1365-2036
- Cited by
- 55
- References
- 11
- Language
- en
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