Peppermint and Caraway Oil Combination for Irritable Bowel Syndrome

Peppermint and Caraway Oil Combination for Irritable Bowel Syndrome

Reference: May B, Kuntz HD, Kieser M, Kohler S. Efficacy of a fixed peppermint/caraway oil combination in non-ulcer dyspepsia. Arzneim Forsch Drug Res 1996; 46:1149-53.

Summary: Fifty-four patients diagnosed with non-ulcer dyspepsia (e.g. irritable bowel syndrome) were given one enteric-coated capsule containing 90 mg of peppermint plus 50 mg caraway oil or placebo three times a day for four weeks. Clinical outcome was evaluated using the Clinical Global Impression (CGI) scale at weeks two and four. After 30 days, 63.2% of those patients treated with the peppermint/caraway combination reported being pain free, in contrast to only 25% in the placebo group (p = 0.005). At the end of the study, an improvement in pain intensity was noted in 89.5% of the subjects taking the herbal combination compared to 45% taking placebo (p = 0.015). Additionally, CGI values were recorded as improved in 94.7% of the active group, as compared to 55% in the placebo group (p = 0.04). Secondary symptoms such as feelings of pressure, heaviness, tension, fullness (p = 0.04), eructation (p = 0.04), and flatulence, (p = 0.012) were improved in patients taking the peppermint/caraway combination. Four individuals taking the active substance reported having mild side effects, including retrosternal burning with eructation and nausea.

Comments/Opinions: Irritable bowel syndrome (IBS) represents one of the most common clinical problems encountered by practitioners. In the United States, it is estimated that between 2.4 and 3.5 million physician visits per annum are by patients with IBS. This figure translates into well over $8 billion a year in medical charges (Talley NJ, Gabriel SE, Harmsen WS, et al. Medical costs in community subjects with irritable bowel syndrome. Gastroenterol 1995; 109:1736). Most of these individuals are given a wide number of medications ranging from anticholinergics and laxatives to visceral analgesics and antidepressants, depending on what presenting symptoms are most predominant. Unfortunately, the side effects encountered from these prescription medications are often worse than the underlying condition. As such, the work of Dr. May and his colleagues from the University Medical Clinic in Bochum, Germany, provide us with another useful therapeutic tool in the treatment of IBS and other types of functional bowel complaints. While most readers are familiar with the use of enteric-coated peppermint oil for IBS, the inclusion of caraway (Carum carvi) provides added advantages. Caraway oil contains several volatile compounds including carvone, dihydrocarvone, limonene and carvene. Like peppermint oil, the compounds exert a spasmolytic and carminative action. However, caraway oil also has some in vitro antibacterial action against such species as E. coli, Klebsiella, and Enterobacter aerogenes.

It is interesting to note that one of the side effects reported was retrosternal burning. This is not surprising as peppermint oil relaxes the upper esophageal sphincter of the stomach allowing for an easier reflux of gastric contents. While the use of caraway oil in smaller quantities is relatively safe, it can be an abortive and neurotoxic in excessive dosages. Therefore, expectant mothers as well as infants under the age of three years should not use caraway oil.

Natural Product Research Consultants, Inc.

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By R. Reichert

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