Diana Nguyen

Student #: 0925834
nguyed17@uw.edu

February 28, 2015

Dear Ian,
I am writing back to let you know about some research I found about
peppermint and its effectiveness and safety with the use for irritable bowel
syndrome (IBS). As you know, after our grandmothers recent diagnosis of
IBS, shes been experiencing severe abdominal discomfort and cramping.
Natural Medicines, a large database on natural products and supplements,
standardizes a specific guaranteed amount of peppermint oil to be not less
than 50% methnol (the active ingredient) and not less than 5% as esters
(specifically menthyl acetate). Menthol blocks calcium channels, which in
result relaxes the smooth muscle in the GI tract, thus reducing abdominal
pain.
The peppermints leaf and oil are often used to reduce the symptoms
associated with the common cold, sinus and respiratory infections, and
digestive complications. The oil seems to be the most common form used
for IBS. In 2009, a study conducted by Merat et al, used enteric coated,
delayed release peppermint oil (specific brand was Colpermin) on 90 patients
with IBS. The patients were randomized into those who took the peppermint
oil (dose was 187 mg or 0.2 mL) and those in a placebo group. Based on the
study, patients who took the peppermint oil had very mild side effects and
was overall well tolerated. It is important to note that heartburn was the
most reported adverse side effect, but only a small sample from both the
control and peppermint oil group had experienced such effects. The eight
week long study had showed that majority of the patients started to
experience reduction in abdominal pain as early as one week starting
treatment. Significant improvements of pain reduction increased throughout
the rest of the study.
I had also looked into a review on how well peppermint oil fared with
other medications prescribed for IBS. The review done by Trinkley, talks
about how very few prescribed medications showed strong evidence of
safety and efficacy in treating IBS. Some examples like lubiprostone, and
linaclotide demonstrated both criteria, but the downside was that they were
quite new and expensive. Peppermint oil on the other hand not only had a
number of studies done that seemed to support the oils use for IBS, but it
was also more readily accessible as an OTC product and less expensive.
After digging through quite a bit of information, I recommend we get
our grandmother to try peppermint oil to relieve some of her abdominal
cramping. The product had very few adverse side effects and it appears to
work wonders, especially to the set of symptoms shes currently
experiencing. I believe like with most medications, we should start with a

Diana Nguyen
Student #: 0925834
nguyed17@uw.edu

low dose of 187 mg to about 3 times a day and have her take it 15-30
minutes before a meal. We should also have her watch her diet and do
several follow-ups to monitor her progress. Let me know what you think.
From your dearest cousin, Diana

Sources
Merat S, Khalili S, Mostajabi P, Ghorbani A, Ansari R, Malekzadeh R. The
Effect of Enteric-Coated, Delayed Release Peppermint Oil on Irritable Bowel
Syndrome. Dig Dis Sci. 2010;55(5):1385-1390.
http://link.springer.com.offcampus.lib.washington.edu/article/10.1007%2Fs10
620-009-0854-9
Accessed February 24, 2015
Peppermint. In: Natural Medicines Comprehensive Database.
Somerville, (MA): Peppermint Professional Monograph [updated 02/16/15;
accessed 02/20/15]
https://naturalmedicinestherapeuticresearchcom.offcampus.lib.washington.e
du/databases/food,-herbs-supplements/professional.aspx?
productid=705#dosing Accessed February 24, 2015
Trinkley K, E, Nahata M, C, Medication Management of Irritable Bowel
Syndrome. Digestion 2014;89:253-267
http://www.karger.com.offcampus.lib.washington.edu/Article/Pdf/362405.
Accessed February 24, 2015