Does Peppermint Oil Help IBS? Pooled Trials Say Yes, the Newest Ones Disagree
Meta-analyses find peppermint oil capsules beat placebo for IBS symptoms and pain, but the two most recent large trials missed their main goals. Heartburn is the usual trade-off.
By Kymata Health Editorial Published Last checked
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Key takeaways
From 6 sources- A 2022 meta-analysis of 10 trials (1,030 people) found peppermint oil beat placebo for overall IBS symptoms and abdominal pain; about 4 people had to take it for 1 extra person to improve overall (NNT 4), and 7 for pain (NNT 7)1.
- The same review rated the quality of evidence very low, and side effects were 1.57 times as common as with placebo1.
- In a Dutch trial of 189 people, 182 mg capsules for 8 weeks did not beat placebo on the regulator-defined pain or overall-relief endpoints3.
- In a US trial of enteric-coated oil at 180 mg three times a day for 6 weeks, both groups improved and the difference was not significant (P = 0.97)4.
- Heartburn, nausea and dry mouth are the common side effects; peppermint oil also raised levels of the blood pressure drug felodipine in a small study56.
What this article covers
1 evidence profileThe evidence, graded
Pulled from the trial tables in our evidence profiles. Grades follow our evidence-grading policy.
Graded findings
4 rows- BGrade BGlobal IBS symptoms and abdominal painImproved Fewer patients failed to improve on peppermint oil than placebo for global symptoms (RR 0.65, NNT 4) and abdominal pain (RR 0.76, NNT 7). Adverse events were more frequent (RR 1.57). Evidence quality was very low.Peppermint Oil · Meta-analysis · n=1,030 · 2022 · PMID 35942669
- BGrade BPersistent IBS symptomsImproved Persistent symptoms were less likely with peppermint oil than placebo (RR 0.43, 95% CI 0.32–0.59).Peppermint Oil · Meta-analysis · n=392 · 2008 · PMID 19008265
- BGrade BAbdominal pain response and overall relief (primary endpoints)No effect Neither formulation beat placebo on the FDA pain-response endpoint (46.8% and 41.3% vs 34.4%) or the EMA overall-relief endpoint. Small-intestinal release improved only secondary measures (pain, discomfort, IBS severity). Mild adverse events were more common.Peppermint Oil · RCT · n=189 · 2020 · PMID 31470006
- CGrade CIBS severity score (IBS-SSS)No effect Both groups improved substantially (90.8 vs 100.3 points); no significant difference on the primary or any secondary outcome (P = 0.97).Peppermint Oil · RCT · n=133 · 2021 · PMID 34319275
The short answer
Pooled trials favour peppermint oil for irritable bowel syndrome, but the two most recent large trials missed their main goals134. NCCIH says a small amount of research suggests enteric-coated peppermint oil may improve IBS symptoms in adults, and notes that a 2021 American College of Gastroenterology guideline recommended it for overall IBS symptoms6.
It is studied as symptom relief, and NCCIH advises talking with your health care provider about any complementary approach you use6.
What the meta-analyses found
A 2008 BMJ meta-analysis of 4 placebo-controlled trials (392 patients) found persistent IBS symptoms were less likely with peppermint oil (relative risk 0.43, 95% CI 0.32 to 0.59)2. Fibre, mainly ispaghula (psyllium), and antispasmodic drugs also beat placebo in the same review2.
A 2022 update by an overlapping team pooled 10 trials with 1,030 people1. The relative risk of global symptoms not improving was 0.65 (NNT 4, with a wide 95% CI of 2.5 to 71), and of abdominal pain not improving was 0.76 (NNT 7)1. Adverse events were more frequent (relative risk 1.57), and the authors rated the quality of evidence as very low1.
Why the newest trials matter
A Dutch trial randomized 190 adults meeting Rome IV criteria at 4 hospitals to small-intestinal-release peppermint oil, ileocolonic-release peppermint oil (182 mg each) or placebo for 8 weeks3. Abdominal pain response, as defined by the US FDA, was 46.8% and 41.3% with the two oils vs 34.4% with placebo, none significant3. Overall relief also did not differ3.
The small-intestinal-release version did improve secondary measures of abdominal pain, discomfort and IBS severity, and mild adverse events were more common with both oils (P < 0.005)3.
A US single-centre trial randomized people with moderate to severe IBS 1:2 to enteric-coated peppermint oil 180 mg three times daily or placebo for 6 weeks4. Severity scores fell substantially in both groups (90.8 and 100.3 points), with no significant difference on the main or any secondary outcome (P = 0.97)4. The authors called for larger rigorous trials4.
Safety and who should avoid it
- Heartburn or reflux: heartburn is a common side effect, and peppermint oil alone may worsen indigestion in some people6.
- People on felodipine or other drugs cleared by the CYP3A4 enzyme: a single 600 mg dose raised felodipine exposure to 140% of the water control in 12 volunteers5.
- Infants and young children: peppermint oil should not be applied to their faces, because inhaled menthol may affect breathing6.
- Pregnancy and breastfeeding: food amounts are likely safe, but little is known about medicinal oral amounts6.
- People taking any prescription medicine: NCCIH advises checking with a clinician first, because some herbs and medicines interact6.
Quick answers
Common questions
3 answersWhat dose was studied?
Is peppermint tea the same as peppermint oil capsules?
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Where to buy Peppermint Oil
Products from brands we partner with that contain Peppermint Oil. Check the amount per serving against the doses studied, and the label for other ingredients.
Peppermint Oil products from partner brands
1 product Paid links · we earn a commission- HerbsProNOW Foods Peppermint Gels, 90 Softgels
1 softgel: 181 mg (0.2 mL) peppermint oil with small amounts of ginger and fennel oils
$11.24one-timeChecked Oct 14, 2026
References
6 sources. Numbers in the text link here.
Sources cited in this article
6 sources- 1Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndromeAliment Pharmacol Ther, 2022 · PMID 35942669
- 2Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysisBMJ, 2008 · PMID 19008265
- 3Efficacy and Safety of Peppermint Oil in a Randomized, Double-Blind Trial of Patients With Irritable Bowel SyndromeGastroenterology, 2020 · PMID 31470006
- 4Peppermint Oil Treatment for Irritable Bowel Syndrome: A Randomized Placebo-Controlled TrialAm J Gastroenterol, 2021 · PMID 34319275
- 5Evaluation of peppermint oil and ascorbyl palmitate as inhibitors of cytochrome P4503A4 activity in vitro and in vivoClin Pharmacol Ther, 2002 · PMID 12235445
- 6Peppermint Oil: Usefulness and Safety (Last Updated: May 2025)National Center for Complementary and Integrative Health (NCCIH), 2025
Peppermint Oil and other dietary supplements are not intended to diagnose, treat, cure or prevent any disease, and these statements have not been evaluated by the FDA. Talk to your clinician or pharmacist before starting a supplement, especially if you take prescription medicines. Product links on this page are paid partner links.