For patients with IBS, there’s overall limited disease-altering pharmacotherapy, and we primarily focus on symptom management. Physicians typically use a combination of bulking agents, antispasmodics, and antidepressants for management; antispasmodics and antidepressants seem to have the most evidence supporting their effectiveness. A Cochrane Review examined several of these agents, and Peppermint Oil emerged as a supplement of interest. They found potential benefit for improvement in symptoms of abdominal pain when compared to placebo. One of these randomized-controlled trials examined the use of enteric-coated peppermint oil capsules versus placebo in 57 patients with IBS. After 4 weeks of therapy, they found that 75% of patients in the experimental group showed a greater than 50% reduction in their symptoms, compared to 38% in the placebo group. Factors to consider include the dose used (225 mg, compared to the typical 50 mg in available over the counter pills), as well as the duration of follow up at only 4 weeks. You may consider a short trial of this supplement in your patients, or if patients have already started taking it, this may provide some support for allowing them to complete a course.
References: Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome