Peppermint oil (enteric-coated)

Tier 2 — promising · IBS · Gut motility · Pain

Enteric-coated peppermint oil acts as a calcium-channel blocker in intestinal smooth muscle (antispasmodic), relaxing the gut wall and relieving IBS pain, bloating, and urgency. The 2022 Ingrosso meta-analysis (10 RCTs, 1,030 patients, PMID 35942669) confirmed peppermint oil outperforms placebo for global IBS symptoms (RR not improving 0.65, NNT=4) and abdominal pain (RR 0.76, NNT=7), though quality of evidence was rated very low and adverse events were more frequent than with placebo. The 2025 Zeraattalab-Motlagh umbrella review (PMID 39110917) corroborates benefit but similarly rates…

Dose: 0.2–0.4 mL enteric-coated capsule × 3 daily, taken 30–60 minutes before meals on an empty stomach