Peppermint is a hybrid mint plant. It is a cross between watermint and spearmint.1 Peppermint is native to Europe, but the herb has now grown widespread worldwide.2 People everywhere value mint for it’s strong cooling scent, it’s cooling sensation on the skin, and it’s flavoring capabilities in baking, candy making, and drink preparation.
Peppermint has a long tradition of herbal use and is used by the Egyptians, Greeks, and the Europeans for medicinal purposes.3 Peppermint has been studied intensively for its use in the treatment of IBS and other intestinal disorders.4 Peppermint is known to have a high natural menthol content, contributing to its use throughout history to soothe sore throats. Menthol vapors that are produced from its oil can be inhaled to relax bronchial passages and relieve congestion.5
On the Importance of Menthol
Menthol is an organic compound that can be obtained from peppermint oil. Menthol has many known medicinal properties, including:
- Pain relief – Menthol weakly activates the k-opioid receptors, which can be beneficial for pain relief.6 Different substances can activate the Kappa-opioid receptors in the brain. When the receptors are activated by these different substances (including menthol), they change both the perception of pain by the brain and reduce inflammatory pain nerve signaling pathways in the body, increasing the pain threshold.7
- Muscle relaxant – Menthol’s mechanism of action as a muscle relaxant is blocking voltage-sensitive sodium channels in the neuromuscular junction. This blockage reduces neural activity in the muscles, which relaxes the muscles and reduces muscle spasms.8
- Vasodilation – Menthol is a known vasodilator when applied to the skin. It increases blood flow to capillaries in the skin by dilating the veins close to the dermis, or the top layer of the skin.9
- Activating TRPM8 receptors – Menthol can chemically activate the TRPM8 receptors in the skin. These receptors are responsible for the cooling sensation that menthol is known for when menthol is inhaled, eaten, or applied topically to the skin.10 Activating the TRPM8 receptors has also been theorized to be a potential treatment protocol for eliminating prostate cancer.11 Finally, TRPM8 receptors that are activated in the intestinal tract modulate inflammatory responses and can help correct an overactive immune system in people suffering from inflammatory bowel diseases.12
- Relieving congestion and pain from sore throats – Menthol has been used for centuries to help relieve bronchial/nasal congestion and sore throat pain by reducing inflammation and relaxing nasal, bronchial, and throat passageways.13
Uses of Peppermint Oil for Digestive Purposes
- Peppermint oil has strong antibacterial properties.14 15
- Relaxes the lower esophageal sphincter (LES), which can benefit people suffering from achalasia. Relaxing the LES can worsen heartburn symptoms in people with GERD. People with GERD (gastroesophageal reflux disease) should only use ECPO.16
- Peppermint oil reduces spasms of the intestines.17
- Peppermint oil can help relieve constipation.18
- Peppermint oil may help relieve abdominal pain.19
- Peppermint oil is used to treat IBS (irritable bowel disease)20 and SIBO (small intestinal overgrowth syndrome).21
- Topical peppermint oil cream can be used to help treat hemorrhoids.22
Enteric-Coated Peppermint Oil: Magic Bullet for Intestinal Issues?
Enteric-coated peppermint oil (ECPO) is extremely versatile in treating intestinal issues. It can be used to treat intestinal infections, SIBO, IBS, chronic functional abdominal pain (CFAP), inflammatory bowel diseases, and hemorrhoids. It even helps relieve chronic constipation.
In a 2007 study, 75% of the patients in the study took enteric-coated peppermint oil for four weeks and had a major reduction in IBS symptoms. Some patients even went into remission during the study (compared to the 38% that took a placebo).23 Another study using ECPO was conducted in Iran in 2009 and produced similar treatment results. Results from the study concluded ECPO significantly reduced symptoms of IBS and can be theoretically used in the treatment of chronic functional abdominal pain.24
It has been theorized that ECPO is very effective in treating both IBS and CFAP. The proposed mechanism of action is that the oil both reduces intestinal spasms25 and increases the pain threshold by activating k-opioid and TRPM8 receptors. Peppermint oil eliminates opportunistic colon and/or small intestine bacteria linked to one of the possible causes of IBS26 27 and the leading cause of SIBO.28
Supplementation of peppermint oil for a short period may produce loose stools and help relieve constipation. The mechanism of action for loosening stools may be that menthol is a mild irritant to the intestines and causes the intestines to draw in more water, causing it to act as an osmotic laxative to loosen stools. A reverse reaction may occur in people with IBS-D, the peppermint oil may calm intestinal spasms and regulate bowel movements so that their diarrhea is relieved instead.
Lastly, peppermint oil has even been used in a few natural hemorrhoid creams to help treat and alleviate the pain caused by hemorrhoids. The peppermint oil in the cream acts as a vasodilator to the hemorrhoid tissue and helps increase blood flow to the afflicted area. Increasing blood flow to the tissue promotes healing by reducing swelling and the size of the hemorrhoid. Peppermint oil would also activate the k-opioid and TRPM8 receptors on the hemorrhoid tissue and relieve pain.
When Should Peppermint Oil Not Be Used?
I do not recommend peppermint oil in people with severe constipation or methane dominant archaea SIBO. Peppermint oil, especially enteric-coated peppermint oil, can slow down the third wave of the MMC. The third wave of the MMC moves food into the duodenum from the stomach during digestion and propels food through the small intestine. By interrupting the MMC, peppermint oil can lead to further constipation and hinder recovery.29 30
I recommend Enteric coated peppermint oil spastic IBS (caused by vagal over-stimulation) or SIBO-D. It can also help with Chronic Functional Abdominal Pain not caused by SIBO as long as motility is functioning properly.
Recommended Forms of Peppermint Oil
Recommended forms of enteric-coated peppermint oil (known non-phthalate coating):
- Enzymatic Therapy peppermint plus
- Colpermin peppermint oil capsules (does contain peanut oil)
Other recommendation (possible phthalate coating):
Liquid peppermint oil (use very little, follow bottle instructions):
Peppermint oil hemorrhoid cream:
- http://bioweb.uwlax.edu/bio203/s2009/johnson_nic4/Classification.htm ↩
- http://ag.arizona.edu/yavapai/publications/yavcobulletins/Growing%20Herbs.pdf ↩
- http://www.greenmedinfo.com/blog/power-peppermint-15-health-benefits-revealed ↩
- http://www.greenmedinfo.com/blog/power-peppermint-15-health-benefits-revealed ↩
- http://umm.edu/health/medical/altmed/herb/peppermint ↩
- http://www.ncbi.nlm.nih.gov/pubmed/11897159 ↩
- http://www.painresearchforum.org/news/8488-kappa-opioid-receptors-rekindling-flame ↩
- http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=464364 ↩
- http://www.karger.com/Article/FullText/89139 ↩
- http://onlinelibrary.wiley.com/doi/10.1111/j.2042-7158.1994.tb03871.x/pdf ↩
- http://cancerres.aacrjournals.org/content/64/22/8365 ↩
- http://www.findaphd.com/search/ProjectDetails.aspx?PJID=47927 ↩
- http://onlinelibrary.wiley.com/doi/10.1111/j.2042-7158.1994.tb03871.x/pdf ↩
- http://www.sciencedirect.com/science/article/pii/S1878535211000232 ↩
- http://www.ncbi.nlm.nih.gov/pubmed/8893526 ↩
- http://www.aafp.org/afp/2007/0401/p1027.html ↩
- http://www.med.nyu.edu/content?ChunkIID=21838 ↩
- http://www.patient.co.uk/medicine/peppermint-oil-capsules-colpermin-mintec-apercap ↩
- http://umm.edu/health/medical/altmed/herb/peppermint ↩
- http://umm.edu/health/medical/altmed/herb/peppermint ↩
- http://www.altmedrev.com/publications/7/5/410.pdf ↩
- http://www.alleviatehemorrhoids.com/9-miracles/ ↩
- http://www.sciencedirect.com/science/article/pii/S1590865807000618 ↩
- http://www.ncbi.nlm.nih.gov/pubmed/19507027 ↩
- http://www.med.nyu.edu/content?ChunkIID=21838 ↩
- http://www.sciencedaily.com/releases/2012/05/120525103354.htm ↩
- http://www.ncbi.nlm.nih.gov/pubmed/17261128 ↩
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099351/ ↩
- http://www.ncbi.nlm.nih.gov/pubmed/10641042 ↩
- http://www.ncbi.nlm.nih.gov/pubmed/12601675 ↩
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Any thoughts positive or negative on IBguard brand capsules?
I have sibo which leads to constant wind and pressure but I also have a sluggish bowel can I still take apercap once a day as it helps relieve wind.
I have constipation/methane SIBO. I’m taking enteric coated peppermint oil and it is not only curing my constipation but it’s killing off my Sibo. My constipation is gone. My gut bloating is much improved and I can see what looks like bio-film in the toilet.
You dont recommend the use of peppermint oil in people with severe constipation or methane dominant archaea SIBO. But so far it’s working for me. What are your thoughts?
Continue with it if it is helping, just watch out for constipation. If it reoccurs, discontinue the peppermint oil.
Dude, that’s awesome, what brand of Peppermint oil did you take? and how are things now?
i’ve been prescribed Apercap for my bloated stomach, however, it has done the opposite, i now have worse bloating, accompanied with loose bowels! Is this normal?
It can happen, the peppermint might be causing die off of bacteria which causes them to release more hydrogen and triggering bloating. When the bacteria die they release toxins which can irritate the MMC and trigger loose stools.
HI DOES BLOATING WITH NOT YOUR NORMAL BOWEL MOVEMENTS MEAN I HAVE SIBO I WAS TOLD I HAVE IBS BY DOCTORS AND I DID EXTENSIVE RESEARCH WHICH SAYS IBS IS MOST OF THE TIME UNDERLYING SIBO INFECTION. IT ALL STARTED WHEN I TOOK THIS SUPPLEMENT THAT HAD BETA ALANINE IN IT AND I BELIEVE IT DEPLETED MY TAURINE STORES IN MY LIVER MESSING WITH MY BILE OUTPUT I DONT KNOW WHAT TO DO PLEASE HELP
https://fixyourgut.com/excess-fat-diet-cause-issues-improve-digestion/
Hi. You said you do not recommend the use of peppermint oil in people with severe constipation or methane based Archaea SIBO – I have both. What would you recommend instead? Thank you.
Interesting info. I thought about it…but as man in his 40’s fighting father time, I’m scared off by numerous studies reporting that peppermint may be antiandrogenic and lower free testosterone and libido in men. It’d probably be a good idea to update this article with this info as a warning to men out there. There are numerous studies on PubMed about this.
It rats, yes. https://www.ncbi.nlm.nih.gov/pubmed/15302514. Have any human studies?
Can this help with my Eczema?? Can it??
Long-term effects are unknown, and it is a strong antimicrobial agent. I would not take it any longer and try to address the bacterial overgrowth through a low FODMAP diet.
Hi,
I was wondering if you had any thoughts on ECPO’s safety/potential side effects. I’ve been on it for almost two months (1x daily, now 2x) in combination with Iberogast and HCL and am getting a lot of relief. I am actually leaving the country for two weeks’ vacation. But I don’t want to be on it long-term; I have read that it can lower testosterone levels. Do you have any experience or thoughts on this?
Thanks.
JN