Näytönastekatsaukset

The effect of peppermint oil on pain of patients with irritable bowel syndrome

Näytönastekatsaukset

3.3.2026

Annikka Kalliokoski and Aleksi Raudasoja

Level of evidence: D

A systematic review with meta-analysis «Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-941 »1 compared peppermint oil with placebo and found a favorable effect on global IBS symptoms and abdominal pain with peppermint oil. However, the results were inconsistent, and dichotomized outcomes decreased the interpretability of clinical relevance.

Table 1. Description of the included studies
Reference	Study type	Population	Intervention and comparison	Outcomes	Risk of bias
RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis
«Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-941 »1	SR/MA; 10 RCTs, 1030 patients	Patients 18 years or older, with a diagnosis of IBS based on clinician's opinion or specific diagnostic criteria. Minimum duration of therapy 4 weeks.	Peppermint oil or placebo (525/505)	Primary: Proportion of patients failing to achieve an improvement in global IBS symptoms and/or abdominal pain	High

Table 2. Additional comments for included studies
Reference	Comments
«Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-941 »1	Individual studies had differing definitions of IBS, mostly small sample sizes, short duration of treatment (4-12 weeks), different peppermint oil preparations used (small intestine-relase peppermint oil, ileocolonic-release peppermint oil) High risk of bias due to high dropout rates and incomplete reporting of allocation concealment. Furthermore, unblinding likely due to smell/taste of peppermint oil. Secondary outcomes: number of people with any adverse event or gastro-oesophageal reflux symptoms

Results

Table 3. Outcome 1: Effect on either global IBS symptoms or abdominal pain; unimproved symptoms
Reference	Number of studies and number of patients (I/C)	Follow-up time	Absolute number of events (%) I	Absolute number of events (%) C	Relative effect (95% CI)
Level of evidence: very low The quality of evidence it was limited by study limitations, imprecision and inconsistency. I=intervention; C=comparison; CI=confidence interval
«Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-941 »1	10 RCTs 1 030 patients (I525, C 505)	4-12 weeks	285 (54.3 %)	365 (72.3 %)	RR 0.65 (0.47;0.88)

Table 4. Outcome 2: Effect on global IBS symptoms; unimproved symptoms
Reference	Number of studies and number of patients (I/C)	Follow-up time	Absolute number of events (%) I	Absolute number of events (%) C	Relative effect (95% CI)
Level of evidence: very low The quality of evidence it was limited by study limitations, imprecision and inconsistency. I=intervention; C=comparison; CI=confidence interval
«Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-941 »1	7 RCTs 756 patients (I388, C 368)	4-12 weeks	217 (55.9 %)	259 (70.4 %)	RR 0.65 (0.43;0.98)

Table 5. Outcome 3: Effect on abdominal pain; unimproved symptoms
Reference	Number of studies and number of patients (I/C)	Follow-up time	Absolute number of events (%) I	Absolute number of events (%) C	Relative effect (95% CI)
I=intervention; C=comparison; CI=confidence interval
«Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-941 »1	7 RCTs 748 patients (I383, C 365)	4-8 weeks	181 (47.3 %)	218 (59.7 %)	RR 0.76 (0.62;0.93)

Table 6. Outcome 4: Effect on adverse events; number of adverse events
Reference	Number of studies and number of patients (I/C)	Follow-up time	Absolute number of events (%) I	Absolute number of events (%) CS	Relative effect (95% CI)
I=intervention; C=comparison; CI=confidence interval
«Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-941 »1 Any adverse event	7 RCTs 720 patients (I340, C 380)	4-12 weeks	58 (17.1 %)	46 (12.1 %)	RR 1.57 (1.04;2.37)
«Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-941 »1 Gastro-oesophageal reflux symptoms	8 RCTs 973 patients (I465, C 444)	4-12 weeks	83 (17.9 %)	34 (7.7 %)	RR 1.67 (1.18;2.38)

Ingrosso MR, Ianiro G, Nee J, et al. Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther 2022;56(6):932-941 «PMID: 35942669»PubMed
Weerts ZZRM, Masclee AAM, Witteman BJM, et al. Efficacy and Safety of Peppermint Oil in a Randomized, Double-Blind Trial of Patients With Irritable Bowel Syndrome. Gastroenterology 2020;158(1):123-136 «PMID: 31470006»PubMed
Nee J, Ballou S, Kelley JM, et al. Peppermint Oil Treatment for Irritable Bowel Syndrome: A Randomized Placebo-Controlled Trial. Am J Gastroenterol 2021;116(11):2279-2285 «PMID: 34319275»PubMed