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Peppermint Oil for Irritable bowel syndrome (IBS) |
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Peppermint Oil for IBS
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Darrell Miller | 03/24/07 |
Date:
March 24, 2007 11:01 AM
Author: Darrell Miller
(dm@vitanetonline.com)
Subject: Peppermint Oil for IBS
Irritable bowel syndrome (IBS) is a painful and frequently frustrating disorder of the intestines that’s often difficult to treat. Fortunately, there are scientifically studied natural products that effectively reduce the distressing symptoms of IBS.
Q. What is IBS?
A. IBS causes crampy pain, gassiness, bloating, and alterations in bowel habits. IBS is termed a functional disorder, because when the colon is examined, there is no visible sign of disease. While IBS causes significant pain and distress, no actual damage is occurring in the intestines.
There is a wide variability in IBS. Symptoms may be mild and fairly well tolerated. Or, the pain, discomfort, and bowel dysfunction may be disabling, limiting social interactions, employment, or travel.
While some individuals with IBS have diarrhea (frequent, loose stools with an urgent need to move the bowels), others have constipation (hard, infrequent stools that are difficult to pass). And, still others may experience both. Individuals with IBS also may have painful abdominal cramps and feel an urgent need to move the bowels, but are unable to do so.
Q. What causes IBS?
A. The small intestine receives digestive material from the stomach and delivers it to the large intestine (colon). About two quarts (2,000 ml) of digestive material enter the colon from the small intestine every day. The colon absorbs water and salts from the material, which is progressively moved through the colon. This progressive movement continues until most of the fluid and salts are absorbed into the body and stool is formed. The stool passes to the left side of the colon, where it is stored until a bowel movement occurs.
Because researchers haven’t been able to find actual damage in the colon, it once was suggested that individuals with IBS have emotional problems or are overly susceptible to stress. While stress may cause symptoms of IBS to intensify, it doesn’t cause the condition.
Recent study has determined the colon muscle of an individual with IBS spasms after only mild stimulation. It’s thought the symptoms of IBS are produced by hyperactivity of the intestines. In other words, the intestines of individuals with IBS are more reactive to stressors and diet than usual. Almost everyone has experienced abdominal queasiness in response to everyday stress or certain foods. This may result in a brief bout of diarrhea or an upset stomach. However, this response is exaggerated in individuals with IBS.
Q. How prevalent is IBS?
A. IBS is very common. In fact, it’s one of the most frequent problems seen by family physicians. It’s the most common disorder diagnosed by gastroenterologists (physicians specializing in the treatment of digestive disorders). The overall prevalence rates range from 10% to 20% of the general population in most industrialized countries. As a result, the pain and disabling symptoms associated with IBS result in significant socioeconomic costs, as wall as reduction in quality of life for many individuals.
Q. What are the symptoms of IBS?
A. Normal bowel function varies from person to person. Some people move their bowels daily, while others may only have two to three stools a week. A normal bowel movement is soft, formed, and is easily passed without cramping or pain.
IBS, however, causes abdominal cramps and pain, which are often severe and disabling. Bowel movements may be irregular and alternate between diarrhea and constipation. The diarrhea may be quite loose and watery. Mucous may be passed. There is often much straining, urgency, and feeling of incomplete evacuation (emptying). Abdominal bloating and passing of gas is common. Nausea, lack of appetite, heartburn, and belching may also be present. Sleep may be disrupted resulting in fatigue and lack of energy. Understandably, persons with IBS often feel anxious and depressed.
Diagnosis of IBS is usually based on the continuous presence or recurrence of these symptoms for at least three months. Other intestinal conditions must be ruled out. These include Chron’s disease, ulcerative colitis, inflammatory bowel disease, colon cancer, inflammatory conditions of the stomach or pancreas, ulcers, infectious disease, or gastroesphageal reflux disease.
Q. Are there clinically demonstrated natural alternatives to the over-the-counter drugs prescribed by my doctor?
A. Yes, both enteric-coated peppermint oil and clown’s mustard (in combination with other herbs) have significant scientific research behind them. Both have been demonstrated to benefit individuals with IBS.
Q. What is clown’s mustard and what does it do?
A. The scientific name for clown’s mustard is Iberis amara. Other names for this herb are wild candytuft and bitter candytuft. Clown’s mustard is a white-flowering plant from Spain, where it grows in dry soil on hillsides and in cornfields. It is also grown in Britain, France, and the United States. Iberis amara is a member of the Brassicaceae family. Iberis refers to its place of origin, the Iberian Peninsula. Amara means bitter. The key components of clown’s mustard are glycosides and flavonoids that have specific actions on gastrointestinal tract tone.
Q. Is there scientific evidence that clown’s mustard benefits people with IBS?
A. There has been very impressive research on clown’s mustard (in combination with other herbs). And, it has been used with great success in Germany for many years to treat IBS and other gastrointestinal diseases.
In a study of an herbal combination containing clown’s mustard, 20 patients were given the herbal combination for three to 32 days. They all had been diagnosed with chronic functional disorders for at least one to 20 years. The symptoms the patients experienced included pressure and pain in the abdomen, belching, heartburn, vomiting, nausea, fullness, lack of appetite, constipation, and diarrhea. The patients have been treated for their problems with a variety of antacids, anti-spasmodic agents, and motility-inducing substances. For the purposes of the study, the patients stopped taking these medications and received treatment only with the herbal combination.
Abdominal pressure and pain in the abdomen was the most common of all the experienced symptoms, with 11 of the patients rating it as severe. After six days of treatment, only sic of the patients continued to rate their abdominal pain and pressure as severe. After two weeks, this symptom had completely resolved for 16 of the patients. Diarrhea had been rated as severe in five of the patients. By day 14, only one patient continued to have moderate diarrhea.
Medications prescribed and taken for cardiovascular diseases, arthritis, and autoimmune diseases often cause gastrointestinal problems. Because these conditions are chronic, these medications must be taken for a long time, often for life. With long-term use, these medications can cause erosion of the stomach lining and actual ulcers. Many of these medication-caused symptoms are similar to IBS symptoms: pressure and pain in the upper abdomen, nausea, abdominal fullness, and lack of appetite. Most, if not all, of the individuals who have gastrointestinal problems caused from medications experience two or more of these IBS symptoms.
Forty patients who were taking medications for various types of cardiovascular disease and arthritis, and who are experiencing gastrointestinal problems related to their medications, were enrolled in a study. These symptoms included pressure and pain in the upper abdomen, nausea, abdominal fullness, and lack of appetite. Twenty patients received clown’s mustard combined with other herbs that support gastrointestinal motility. Three days after the trial started, a significant improvement of all s symptoms was noted in those taking this combination. By day 14, abdominal pressure and pain, nausea, and heartburn were completely eliminated in the herbal combination group. Several other clinical trials that were conducted in Germany report similar results.
Q. How does this herb compare to prescription drugs?
A. A study compared clown’s mustard (combined with other herbs) to Reglan (metoclopramide), which is frequently prescribed to reduce the symptoms of IBS. While metoclopramide is a very effective medication, it also has numerous side effects. Metoclopramide can cause fatigue, anxiety, agitation, jitteriness, insomnia, yellowing of the skin or eyes, changes in vision, hallucinations, and seizures. Because of these serious side effects, metoclopramide must not be taken longer than 12 weeks.
In comparison study, 77 subjects were randomized to receive treatment of either clown’s mustard in a combination with other herbs, or metoclopramide. All subjects had pain and pressure in the abdomen, cramping, abdominal fullness, nausea, heartburn, and lack of appetite. The subjects took 20 drops of their assigned treatment after meals three times daily. The duration of treatment was one to two weeks.
In both groups, a parallel improvement of all symptoms was observed. At no point in the study was a statistically significant difference in symptoms found. Both treatments significantly reduced pain and pressure in the abdomen, cramping, abdominal fullness, nausea, heartburn, and lack of appetite. In short, both metoclopramide and the clown’s mustard herbal combination worked well at reducing the symptoms of IBS.
However, side effects occurred more frequently and severely in the metoclopramide group. Given the lack of differences noted between the products at reducing symptoms of IBS, it would seem sensible to choose the treatment with the fewest reported side effects and no limits on duration of use.
Q. What evidence supports use of enteric-coated peppermint oil capsules for IBS?
A. Peppermint oil has been shown to relax intestinal smooth muscle. In Great Britain, peppermint oil is currently being prescribed for IBS by physicians and it has been used as a digestive aid and to soothe upset stomachs for generations.
Peppermint oil has also been studied for use in an important examination of the colon. A colonoscopy is a procedure of viewing the interior lining of the large intestine (colon) using a colonoscope, a slender, flexible, hollow, lighted tube about the thickness of a finger. A study published in the New England Journal of Medicine supports the idea that even people who are not at risk for colon cancer should have this test. The American Cancer Society recommends that men and women at average risk of colon cancer should have a colonoscopy every 10 years, beginning at age 50.
During a colonoscopy, individuals are sedated and almost no discomfort is experienced. The insertion of the colonoscope into the rectum and up through the colon causes some spasming. This is a natural and expected event and the physician performing the exam administers medications that effectively reduce the spasms.
A recent study compared the use of peppermint oil and commonly used medications to reduce the colonic spasming in colonoscopy. The peppermint oil was introduced directly into the colon. Effective reduction of colon spasming was observed in 88% of the patients.
In a critical review and meta-analysis of peppermint oil for irritable bowel syndrome published in The American Journal of Gastroenterology, eight randomized controlled trials were identified. The studies collectively showed peppermint oil is superior to placebo in improvement of the symptoms of IBS. Because of the good results of these trials, the authors of the review urged additional study of peppermint oil in IBS.
However, straight peppermint oil is rapidly absorbed into the blood stream from the stomach. In recent studies comparing enteric-coated peppermint oil capsules and non-enteric coated oil, both preparations provided effective symptom relief. However, the studies concluded the enteric-coated capsules delivered the benefit of the peppermint oil directly to the intestines. In the treatment of IBS, enteric-coated supplemental peppermint is most definitely preferred.
In fact, an enteric-coated peppermint oil capsule containing rosemary and thyme is extremely effective in the treatment of IBS. All three of these oils are classified as volatile oils, derivatives found in plants that impart taste and aroma. The combination of peppermint, thyme, and rosemary oils in enteric-coated capsules provides significant relief in IBS-related pain.
Q. Can clown’s mustard and other herbs be taken with enteric-coated peppermint oil?
A. Yes, peppermint oil capsules and clown’s mustard can be used together. However, depending on the symptoms, individuals with IBS may want to start with one supplement and then add the other if needed.
Q. How do consumers find these formulas?
A. Fortunately, herbal combinations containing clown’s mustard and enteric-coated peppermint oil capsules are both available at health food stores, natural product supermarkets, pharmacies, and from health professionals. Most knowledgeable sales personnel and health professionals can direct consumers to the most effective products.
Q. What should customers look for when purchasing peppermint oil?
A. As mentioned before, enteric coating of the peppermint oil is extremely important. The coating prevents the oil from being absorbed in the stomach. The enteric coated-capsule moves through the stomach to the small intestine and eventually to the colon, where it is released for maximum benefit.
Q. What is the dosage for peppermint oil?
A. The German Commission E approved peppermint oil for the treatment of irritable colon. In enteric-coated form, the Commission E recommends 0.6 ml per day. Enteric-coated peppermint capsules are available.
Q. Are there side effects or other contraindications?
A. Sometimes, the enteric-coated peppermint oil capsules may cause a transient burning sensation in the rectum when moving bowls. Reducing the dose will correct this.
Individuals who must refrain from alcohol should not take clown’s mustard in an herbal tincture, which may contain alcohol.
Q. What else can IBS patients do to feel better?
A. Food allergies or food intolerance may be associated with IBS. Dairy products and certain grains may trigger a painful episode of IBS. Determining those foods that initiate the problems and eliminating them from your diet can be very helpful.
Many people report their symptoms occur after a meal. Hyperactivity of the intestine of IBS is the response. Often, the strength of this response after a meal is in direct relation to the number of calories and he amount of fat in the meal. Reducing saturated fat, limiting calories, and increasing fiber intake may be helpful.
Stress also stimulates the intestinal hyperactivity. Relaxation training may reduce some IBS symptoms. Listening to therapeutic audiotapes, hypnosis, counseling, and biofeedback all have been shown to improve the healing response in persons with IBS.
Conclusion
IBS can be painful and frustrating, capable of causing much distress. While currently there is no cure for IBS, the symptoms can be managed. The pain, abdominal discomfort, and bowel problems of IBS all respond well to treatment with the use of key herbs, including clown’s mustard, and enteric-coated peppermint oil. These herbal combinations can be both effective and safe in treating IBS. Clown’s mustard and enteric-coated peppermint oil are both effective front-line natural alternatives for IBS treatment.
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