It was a meta-analysis and review of all randomized controlled studies comparing antispasmodics, fiber, and peppermint oil with placebo, or no treatment, in persons with IBS.

IBS is a gastrointestinal disorder that causes discomfort or abdominal pain, and it is common for sufferers to experience chronic bouts of diarrhea or constipation, or both. The exact root of the problem is not known, but messed up interactions between brain and nervous systems with the gut are involved, producing spasms in the colon.

In recent years, new drugs have been developed for the condition, but these are expensive and in some cases, a couple of drugs have been removed from the market and some have been found ineffective. Because of this, investigating simpler, less-expensive treatments may prove to be valuable. In this study, a total of 591 patients in 12 studies were subjected to treatment with fiber, twenty two studies (1778 patients) compared antispasmodics with placebo, and 392 patients (four trials) had been investigated for the effects of peppermint oil versus placebo.

The results showed that all three agents were more effective than placebo in improving the symptoms in IBS patients, however peppermint oil appeared to be the most effective therapy. In terms of actual numbers, the fiber patients had 48% improved compared to 43% on placebo or low fiber diet; antispasmodic trials showed 61% of patients improved compared to 43% on placebo; while 74% treated with peppermint oil no longer had persistent symptoms compared to 35% in the placebo groups.

From this research, it is clear that peppermint oil is the most effective treatment studied. Dr. Alex Ford, the lead researcher from McMaster University, Health Sciences Centre in Ontario, Canada, advised: “Physicians, particularly those in primary care, who are being asked to take increasing responsibility for the management of IBS, should consider the use of these agents as first-line therapies for IBS.”
For those dealing with IBS, it is important to note that the researchers found that insoluble fiber such as wheat bran did not improve the symptoms of IBS sufferers. Only soluble fiber was found to be somewhat effective.

Peppermint oil is an essential oil and is quite volatile. It can break down quickly in the presence of stomach acids and in some people can induce heartburn. To avoid this, it is recommended that people use enteric coated peppermint oil capsules and consume them at least 30 minutes before a meal (empty stomach). This will ensure delivery to the intestines to maximize effectiveness while dramatically reducing the possibility of any stomach upset.