Peppermint oil 400mg/50ml enema

Background: Nausea and vomiting frequently occur during postoperative recovery, chemotherapy, and pregnancy. While peppermint oil is traditionally used to relieve these symptoms, its efficacy remains uncertain. This systematic review and meta-analysis evaluates the efficacy of peppermint oil inhalation for postoperative (PONV), chemotherapy-induced (CINV), and pregnancy-related nausea and vomiting (NVP). Methods: Following PRISMA guidelines, we searched five databases (Scopus, Embase, the Cochrane Central Register of Controlled Trials, MEDLINE, and Web of Science) in November 2022, with an update in December 2024. Randomised controlled trials were included, comparing peppermint oil inhalation to a control in patients with PONV, CINV, and NVP. Separate meta-analyses were conducted for each patient group using R, focusing on the severity of the nausea and vomiting. Results: Nineteen RCTs were included. In three PONV studies, peppermint oil inhalation was associated with a reduction in nausea 2 to 6 h after the intervention (MD: -0.60 points, 95% confidence interval (CI): -0.77 to -0.44, p = 0.004). In three NVP studies, daily peppermint oil treatment was linked to lower symptom severity at 48 h (MD: -0.51, 95% CI: -0.78 to -0.24, p = 0.015) and 96 h (MD: -0.68, 95% CI: -1.09 to -0.27, p = 0.019). In three CINV studies, peppermint oil inhalation appeared to reduce symptoms at all time points, with the most notable reduction at 48 h (MD: -2.23, 95% CI: -3.13 to -1.34, p p = 0.010). Conclusions: Peppermint oil inhalation may be a promising complementary therapy for reducing nausea and vomiting in postoperative, chemotherapy, and pregnancy settings.

Abstract licence: CC BY

Irritable Bowel Syndrome (IBS) affects 4-15% of the global population, and the limited efficacy of existing pharmacologic therapies has driven growing interest in plant-based therapeutic options among both patients and clinicians. A comprehensive assessment of all plant extracts investigated in IBS is therefore essential, given the limited effectiveness of conventional treatments and the increasing interest in complementary approaches. Evidence from recent systematic reviews and meta-analyses consistently indicates that peppermint oil is the most effective botanical agent, particularly for reducing abdominal pain and overall IBS symptom severity. Iberogast (STW-5 and STW-5 II) has also demonstrated clinical improvements across multiple trials, while curcumin shows mechanistic and preliminary clinical potential by modulating several IBS-related pathways. In contrast, extracts such as Curcuma xanthorrhiza, Fumaria officinalis, and various Ayurvedic formulations have not shown significant clinical benefit. Other agents, including Aloe vera, flavonoids, St John's wort, and ginger, exhibit mixed or inconsistent results, reflecting heterogeneity in study designs and underlying mechanisms. A review of international guidelines reveals that peppermint oil is the only plant-based therapy consistently acknowledged across adult and pediatric recommendations. The aim of this review is to summarize, compare, and critically evaluate all plant extracts studied for the prevention and treatment of IBS, integrating mechanistic pathways, clinical evidence, and current international guideline recommendations to clarify their therapeutic relevance for clinical practice.

Abstract licence: CC BY

Irritable bowel syndrome (IBS) is a common disorder of brain-gut interaction that presents with abdominal pain, bloating associated with variable stool consistency. Many IBS patients prefer plant-based preparations to pharmacological therapy; however, the utility of this approach is not well established. To address this issue, a systematic review with meta-analysis to assess the efficacy and safety of plant-based therapy in IBS patients was performed. Literature search with 3 electronic databases (Medline via PubMed, Embase via Ovid, and Web of Science Core Collection) from inception to May 2024. Efficacy was assessed using dichotomous ratings of change in IBS symptoms. A random effects model with 95% confidence intervals was used. Through the screening process, 60 eligible studies were identified (6329 patients). Meta-analysis was performed for fiber (8 studies, RR = 1.22; 95% CI: 1.00-1.49), peppermint oil (7 studies, RR = 1.63; 95% CI: 1.33-2.00), Aloe vera (3 studies, RR = 1.25; 95% CI: 0.76-2.06), and Chinese herbal medicine (7 studies, RR = 1.56; 95% CI: 1.27-1.92). For other plant-based substances investigated in at least one randomized controlled trial (RCT) (e.g., St. John's wort, Anise oil), there were insufficient data for a meta-analysis. The quality of many studies was limited. The findings demonstrate that the treatment of IBS patients with peppermint oil and Chinese herbal medicine were more effective than placebo and had a good safety profile. Dietary fiber showed effects that approached significance. Further, well-powered RCTs are needed to establish the place of plant-based preparations in IBS treatment.

Abstract licence: CC BY