Date of Award

Spring 2020

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Renee Langstaff

Abstract

Introduction: Irritable bowel syndrome (IBS), defined as a chronic functional disorder that is characterized by recurring abdominal pain and altered bowel habits, is the most commonly diagnosed gastrointestinal disease in Western populations. While not yet completely understood, IBS has multiple factors believed to contribute to its pathophysiology. There are several treatment methods regarding non-pharmacological (such as lifestyle modifications) and pharmacological options (including anti-spasmodics, opioid agonists, and anti-depressants). Peppermint oil is a product derived from the natural herb, Mentha Piperita, and has been used as a nonpharmacological method to treat abdominal pain. Therefore, this review analyzes the use of peppermint oil (I) for reduction of symptoms and improvement in quality of life in patients suffering from IBS-D (with prominent diarrhea) (P) compared to currently utilized pharmacological therapies (C).

Methods: A literature search was conducted through PubMed, Academic Search Premier, and Cochrane Library Database in September 2018. A total of 7 articles consisting of randomized control trials and systematic reviews were selected based on publication date, intervention technique, and sample populations utilized. The study design and results of these articles were then analyzed and compared.

Results: The evidence collected demonstrated varying improvement of IBS symptoms with peppermint oil. While three studies reviewed demonstrated statistically significant improvement in abdominal pain and quality of life, results varied for the other symptoms of IBS. All three studies however demonstrated excellent safety profile with minimal to no adverse effects. The four remaining studies examined the effects of physical activity and eluxadoline (separately). These found that physical activity improved quality of life IBS-SSS, and lifestyle functioning, while eluxadoline demonstrated statistically significant improvement in abdominal pain and most other IBS symptoms with very few serious adverse effects.

Discussion: Many significant results were demonstrated among the studies utilized for this systematic review. Peppermint oil was shown to have significant benefit for individuals suffering from IBS. However, many of the outcome measures and scoring systems utilized varied among the studies. Additionally, a limited sample size, shortened timelines, and lack of follow-up with participants prevented the findings from achieving statistical significance in efficacy between peppermint oil, physical activity, or eluxadoline.

Conclusion: There is a deficit of recent scientific studies which have explored the effects peppermint oil in the treatment of IBS, the most common chronic functional disorder that causes of abdominal pain. Many studies that investigated peppermint oil were conducted 25+ years ago. While most studies found that peppermint oil provided relief of abdominal pain, treatment results of the other common symptoms of IBS varied. Importantly, these studies demonstrated that peppermint oil did not cause significant adverse effects. Patients and providers can consider peppermint oil as an initial treatment option along with lifestyle modifications, prior to initiating pharmacological treatment. Future research is necessary to investigate the efficacy of peppermint oil compared to other current treatment options.

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The efficacy of peppermint oil and physical activity vs. eluxadoline for the treatment of irritable bowel syndrome

Introduction: Irritable bowel syndrome (IBS), defined as a chronic functional disorder that is characterized by recurring abdominal pain and altered bowel habits, is the most commonly diagnosed gastrointestinal disease in Western populations. While not yet completely understood, IBS has multiple factors believed to contribute to its pathophysiology. There are several treatment methods regarding non-pharmacological (such as lifestyle modifications) and pharmacological options (including anti-spasmodics, opioid agonists, and anti-depressants). Peppermint oil is a product derived from the natural herb, Mentha Piperita, and has been used as a nonpharmacological method to treat abdominal pain. Therefore, this review analyzes the use of peppermint oil (I) for reduction of symptoms and improvement in quality of life in patients suffering from IBS-D (with prominent diarrhea) (P) compared to currently utilized pharmacological therapies (C).

Methods: A literature search was conducted through PubMed, Academic Search Premier, and Cochrane Library Database in September 2018. A total of 7 articles consisting of randomized control trials and systematic reviews were selected based on publication date, intervention technique, and sample populations utilized. The study design and results of these articles were then analyzed and compared.

Results: The evidence collected demonstrated varying improvement of IBS symptoms with peppermint oil. While three studies reviewed demonstrated statistically significant improvement in abdominal pain and quality of life, results varied for the other symptoms of IBS. All three studies however demonstrated excellent safety profile with minimal to no adverse effects. The four remaining studies examined the effects of physical activity and eluxadoline (separately). These found that physical activity improved quality of life IBS-SSS, and lifestyle functioning, while eluxadoline demonstrated statistically significant improvement in abdominal pain and most other IBS symptoms with very few serious adverse effects.

Discussion: Many significant results were demonstrated among the studies utilized for this systematic review. Peppermint oil was shown to have significant benefit for individuals suffering from IBS. However, many of the outcome measures and scoring systems utilized varied among the studies. Additionally, a limited sample size, shortened timelines, and lack of follow-up with participants prevented the findings from achieving statistical significance in efficacy between peppermint oil, physical activity, or eluxadoline.

Conclusion: There is a deficit of recent scientific studies which have explored the effects peppermint oil in the treatment of IBS, the most common chronic functional disorder that causes of abdominal pain. Many studies that investigated peppermint oil were conducted 25+ years ago. While most studies found that peppermint oil provided relief of abdominal pain, treatment results of the other common symptoms of IBS varied. Importantly, these studies demonstrated that peppermint oil did not cause significant adverse effects. Patients and providers can consider peppermint oil as an initial treatment option along with lifestyle modifications, prior to initiating pharmacological treatment. Future research is necessary to investigate the efficacy of peppermint oil compared to other current treatment options.