Does peppermint help with IBS?

For adults, peppermint oil in enteric-coated capsules probably helps, and the evidence is weaker than the number of meta-analyses suggests. The most complete one pooled 10 randomized trials in 1030 people with IBS. On peppermint oil the risk of overall symptoms not improving was 0.65 of the risk on placebo, which works out at one extra person improving for every four treated. The authors rated the quality of that evidence very low. We found no randomized trial of peppermint tea for IBS, and in children the largest trial found no benefit from capsules or from peppermint sweets.

Established. Across five meta-analyses of randomized trials, peppermint oil capsules did better than placebo for overall IBS symptoms in adults. Every one of them points the same way.

Unsettled. How much it helps is the open question. The reviews disagree on how trustworthy the trials are, from very low quality in the 2022 review to moderate to high in a GRADE assessment of trials up to 2020. The best designed single trial, 189 adults in the Netherlands, did not reach significance on its main outcome. No trial ran longer than 12 weeks.

What the trials found

The meta-analyses

The 2022 review in Alimentary Pharmacology and Therapeutics is the one to read first, because it is recent, limited to peppermint oil, and includes the large Dutch trial. Besides overall symptoms, it found the risk of abdominal pain not improving was 0.76 of placebo, an interval of 0.62 to 0.93, which means one extra person with less pain for every seven treated.

A network meta-analysis of 51 randomized trials in 4644 adults compared the traditional IBS treatments with each other over 4 to 12 weeks. Peppermint oil capsules ranked first for overall symptoms, with a risk ratio of 0.63 for treatment failure, and tricyclic antidepressants came second at 0.66. On indirect comparison no active treatment was significantly better than another, and only 13 of the 51 trials were at low risk of bias.

Older and newer syntheses agree on the direction. A 2019 meta-analysis of enteric-coated oil found overall improvement 2.39 times as likely as on placebo in 7 trials with 507 adults, though six of the twelve trials in that review were at high risk of bias from dropouts. The 2008 BMJ review put the risk of persistent symptoms at 0.43 of placebo in 4 trials with 392 adults. A 2026 review of plant treatments found a risk ratio of 1.63 for symptom response across 7 peppermint oil studies. A Cochrane review of 29 antispasmodic trials in 2333 patients listed peppermint oil among the agents with a significant benefit, without a separate figure for it in the abstract. The early estimates are the most flattering ones, and the effect shrinks as the trials get larger and newer.

The best single trial

PERSUADE gave 189 adults with IBS by Rome IV criteria 182 mg of peppermint oil three times a day for 8 weeks, at four Dutch hospitals. On the abdominal pain response the FDA uses for IBS drugs, 46.8 percent responded on small-intestinal-release oil against 34.4 percent on placebo, and that difference did not reach statistical significance. The secondary measures of pain, discomfort and IBS severity did improve.

Children

The two trials in children disagree. In 2001, a 2 week trial in 42 children reported that 75 percent of those on enteric-coated peppermint oil had less severe pain, and the abstract does not give the figure for placebo. In 2026 a trial at 13 Dutch hospitals randomized 228 children aged 8 to 18 with IBS or functional abdominal pain. After 8 weeks, treatment success was 44.0 percent on peppermint oil capsules and 37.3 per cent on placebo, an odds ratio of 1.33 with an interval from 0.58 to 3.09. Peppermint sweets came in at 38.7 percent, an odds ratio of 1.05. The larger and newer trial is the one that found nothing.

Tea and other food forms

Every positive trial on this page used peppermint oil in capsules, most of them coated to open past the stomach. The only food form that has been tested against placebo is the peppermint sweet in that 2026 trial, and it did no better than placebo. We found no randomized trial of peppermint tea or peppermint leaf for IBS, so the evidence for the capsules does not tell you what a cup of tea will do.

Who should be careful

Not for everyone. In the 2022 meta-analysis, side effects were more common on peppermint oil than on placebo, with a risk ratio of 1.57 and an interval from 1.04 to 2.37. The abstract gives no absolute rates, so we cannot say how many extra people that is. The NIH complementary health center lists heartburn, nausea, abdominal pain and dry mouth as possible side effects of oil taken by mouth, and notes that the enteric coating is used to reduce heartburn.

Medicines are the second caution. In a crossover study of 12 healthy adults, a single 600 mg dose of peppermint oil raised blood levels of the blood pressure drug felodipine to 140 percent of the level with water, with individual results ranging from 77 to 262 percent. Grapefruit juice in the same study raised it to 173 percent. That dose is higher than a typical IBS capsule, and nobody has shown whether the effect matters in practice. If you take felodipine or a similar drug, ask your pharmacist before starting peppermint oil.

The same NIH page says there is not enough information on medicinal amounts of peppermint oil in pregnancy or breastfeeding. For children, the largest trial found no benefit, so peppermint oil is a weak choice for a child with abdominal pain.

What expert bodies say

The NIH National Center for Complementary and Integrative Health says a small amount of research suggests enteric-coated peppermint oil capsules may improve IBS symptoms in adults. A 2025 European expert consensus on functional bloating, from the European Society of Neurogastroenterology and Motility and United European Gastroenterology, lists peppermint oil among the antispasmodic options, next to diet changes and probiotics. That consensus is about bloating rather than IBS as a whole. We could not quote the 2021 American and British gastroenterology guidelines, because their abstracts do not mention peppermint and we could not get the full texts.

How we searched

What would change this answer

• A trial longer than 12 weeks. Nobody knows whether the benefit holds over months, and IBS lasts years.
• A randomized trial of peppermint tea in adults with IBS. None has been registered.
• Another large trial in adults with a strict main outcome, to settle whether PERSUADE or the older trials are closer to the truth.
• Absolute side effect rates from the meta-analyses, so the trade between benefit and heartburn can be put in numbers.

More on peppermint as a drink, and why the gut evidence belongs to the oil, is on the peppermint tea page.

Sources

1. ev-pmibs-01 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials, random effects · n = 10 RCTs, 1030 patients
   Peppermint oil was more efficacious than placebo for global IBS symptoms (RR of not improving = 0.65; 95% CI 0.43-0.98, number needed to treat [NNT] = 4; 95% CI 2.5-71), and abdominal pain (RR of abdominal pain not improving = 0.76; 95% CI 0.62-0.93, NNT = 7; 95% CI 4-24).
   
   Who: adults with irritable bowel syndrome in randomized placebo-controlled trials of peppermint oil
   Effect: global IBS symptoms not improving RR 0.65 (95% CI 0.43 to 0.98), NNT 4; abdominal pain not improving RR 0.76 (0.62 to 0.93), NNT 7
   Certainty: The most complete and newest MA on peppermint oil only; includes PERSUADE. The authors rate the quality as very low; the effect on pain is more modest than in older MAs. Abstract outside the corpus (Europe PMC).
   Alimentary Pharmacology & Therapeutics, 2022 · checked 2026-10-07 · we read the abstract
2. ev-pmibs-02 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials, random effects · n = 10 RCTs, 1030 patients
   Adverse event rates were significantly higher with peppermint oil (RR of any adverse event = 1.57; 95% CI 1.04-2.37).
   
   Who: adults with irritable bowel syndrome in randomized placebo-controlled trials of peppermint oil
   Effect: any adverse event RR 1.57 (95% CI 1.04 to 2.37) vs placebo; gastro-esophageal reflux assessed as a safety outcome
   Certainty: Side effects mostly mild (heartburn, reflux per the PERSUADE RCT and NCCIH); the 2019 MA found no difference in side effects (RR 1.40, 0.87-2.26).
   Alimentary Pharmacology & Therapeutics, 2022 · checked 2026-10-07 · we read the abstract
3. ev-pmibs-03 · Meta-analysis or systematic review · systematic review and network meta-analysis of randomized controlled trials · n = 51 RCTs, 4644 patients
   Based on an endpoint of failure to achieve improvement in global IBS symptoms at 4-12 weeks, peppermint oil capsules were ranked first for efficacy (RR 0·63, 95% CI 0·48-0·83, P-score 0·84) and tricyclic antidepressants were ranked second (0·66, 0·53-0·83, P-score 0·77).
   
   Who: adults aged at least 18 years with IBS of any subtype, 4 to 12 weeks of treatment
   Effect: failure to improve global IBS symptoms RR 0.63 (95% CI 0.48 to 0.83), P-score 0.84; no significant difference between active treatments on indirect comparison
   Certainty: Only 13 of 51 RCTs at low risk of bias; the authors write of considerable uncertainty; long-term effect unknown.
   Lancet Gastroenterol Hepatol, 2020 · checked 2026-10-07 · we read the abstract
4. ev-pmibs-04 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials, random effects · n = 60 studies, 6329 patients overall; peppermint oil 7 studies
   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).
   
   Who: patients with irritable bowel syndrome in trials of plant-based preparations, searched to May 2024
   Effect: peppermint oil RR 1.63 (95% CI 1.33 to 2.00) for improvement in IBS symptoms; fiber RR 1.22 (1.00 to 1.49)
   Certainty: The newest synthesis; the authors note the limited quality of many studies.
   Phytother Res, 2026 · checked 2026-10-07 · we read the abstract
5. ev-pmibs-05 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials, Cochrane risk of bias · n = 7 RCTs, 507 patients (12 RCTs, 835 patients in the review)
   The risk ratio (RR) for seven RCTs for the effect of PO (n = 253) versus placebo (n = 254) on global symptoms was 2.39 [95% confidence interval (CI): 1.93, 2.97], I2 = 0%, z = 7.93 (p < 0.00001) (Fig. 3a).
   
   Who: adults with IBS (Manning or Rome criteria) randomized to enteric-coated peppermint oil or placebo for at least 2 weeks
   Effect: global symptom improvement RR 2.39 (95% CI 1.93 to 2.97), I2 0%, NNT 3; abdominal pain RR 1.78 (1.43 to 2.20), NNT 4
   Certainty: Duration 2-12 weeks; six of 12 RCTs have a high risk of bias due to dropout; without PERSUADE.
   BMC Complementary and Alternative Medicine, 2019 · checked 2026-10-07 · we read the fulltext
6. ev-pmibs-06 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials · n = 4 RCTs, 392 patients
   Four trials compared peppermint oil with placebo in 392 patients (0.43, 0.32 to 0.59).
   
   Who: adults with irritable bowel syndrome, therapy of at least one week
   Effect: relative risk of persistent symptoms 0.43 (95% CI 0.32 to 0.59) vs placebo
   Certainty: Early synthesis from a small number of RCTs; later meta-analyses give a smaller effect.
   BMJ, 2008 · checked 2026-10-07 · we read the abstract
7. ev-pmibs-07 · Meta-analysis or systematic review · Cochrane systematic review and meta-analysis of randomized controlled trials · n = 29 antispasmodic studies, 2333 patients
   Subgroup analyses for different types of antispasmodics found statistically significant benefits for cimteropium/ dicyclomine, peppermint oil, pinaverium and trimebutine.
   
   Who: patients with irritable bowel syndrome aged over 12 years
   Effect: antispasmodics vs placebo, abdominal pain RR 1.32 (95% CI 1.12 to 1.55), NNT 7; subgroup benefit for peppermint oil
   Certainty: There is no separate figure for peppermint oil in the abstract; a 2011 review.
   Cochrane Database Syst Rev, 2011 · checked 2026-10-07 · we read the abstract
8. ev-pmibs-08 · Randomized controlled trial(s) · randomized double-blind placebo-controlled trial, three arms · n = 189
   Abdominal pain response did not differ significantly between the peppermint oil and placebo groups: 29 of 62 patients in the small-intestinal-release peppermint oil group had a response (46.8%, P = .170 vs placebo), 26 of 63 patients in the ileocolonic-release peppermint oil group had a response (41.3%, P = .385 vs placebo), and 22 of 64 patients in the placebo group had a response (34.4%).
   
   Who: adults with IBS by Rome IV criteria at 4 Dutch hospitals; 182 mg peppermint oil three times daily for 8 weeks; mean age 34.0, 77.8% female
   Effect: abdominal pain response 46.8% small-intestinal-release vs 34.4% placebo (P = .170); secondary outcomes of pain, discomfort and IBS severity improved; adverse events more common (P < .005)
   Certainty: The highest-quality RCT; primary endpoint not reached, secondary ones yes. Abstract outside the corpus.
   Gastroenterology, 2020 · checked 2026-10-07 · we read the abstract
9. ev-pmibs-09 · Randomized controlled trial(s) · randomized controlled trial, double-blind for capsules, open-label sweets arm · n = 228
   In 228 children (8-11 years: n = 92; 12-18 years: n = 135; 75-78 per group), treatment success was comparable between patients receiving peppermint oil (n = 30; 44.0%) and placebo (n = 28; 37.3%) (odds ratio [OR], 1.33; 97.5% confidence interval [CI], 0.58-3.09; P = .44), and between placebo and peppermint sweets (n = 30; 38.7%) (OR, 1.05; 97.5% CI, 0.45-2.44; P = .91).
   
   Who: children aged 8-18 years with IBS or FAP-NOS at 13 Dutch hospitals; 182 mg peppermint oil capsules or peppermint sweets, two or three times daily for 8 weeks
   Effect: treatment success 44.0% peppermint oil vs 37.3% placebo, OR 1.33 (97.5% CI 0.58 to 3.09); sweets vs placebo OR 1.05 (0.45 to 2.44)
   Certainty: The largest pediatric RCT; contradicts the small RCT from 2001. Mint candies are the food form, and it did not help.
   Clinical Gastroenterology and Hepatology, 2026 · checked 2026-10-07 · we read the abstract
10. ev-pmibs-10 · Randomized controlled trial(s) · randomized double-blind controlled trial · n = 42
    After 2 weeks, 75% of those receiving peppermint oil had reduced severity of pain associated with IBS.
    
    Who: children with irritable bowel syndrome, pH-dependent enteric-coated peppermint oil capsules vs placebo, 2 weeks
    Effect: 75% of the peppermint oil group had reduced pain severity at 2 weeks (placebo figure not given in the abstract)
    Certainty: Small, short RCT from 2001; abstract without the placebo number; full text is paywalled (no_pmc).
    Journal of Pediatrics, 2001 · checked 2026-10-07 · we read the abstract
11. ev-pmibs-11 · Randomized controlled trial(s) · randomized crossover pharmacokinetic study · n = 12
    Grapefruit juice and peppermint oil increased the area under the curve (AUC) values of felodipine to 173% (range, 94%-280%; P <.01) and 140% (range, 77%-262%; P <.05), respectively, of those with water.
    
    Who: healthy volunteers, single dose, 4-way crossover
    Effect: felodipine AUC 140% (range 77% to 262%) vs water, P < .05; grapefruit juice 173%
    Certainty: A single 600 mg dose is higher than a typical IBS capsule (180-200 mg); CYP3A4 interaction signal, clinical significance unknown.
    Clin Pharmacol Ther, 2002 · checked 2026-10-07 · we read the abstract
12. ev-pmibs-12 · Position of an expert body · agency consumer fact sheet · n = —
    Possible side effects of peppermint oil taken orally include heartburn, nausea, abdominal pain, and dry mouth.
    
    Who: general public, oral peppermint oil
    Effect: possible oral side effects: heartburn, nausea, abdominal pain, dry mouth; enteric coating used to reduce heartburn
    Certainty: T2; no own analysis. The same page: data on medicinal doses in pregnancy and breastfeeding are insufficient.
    NIH National Center for Complementary and Integrative Health, Peppermint Oil (last updated May 2025) · checked 2026-10-07 · we read the section
13. ev-pmibs-13 · Position of an expert body · agency consumer fact sheet · n = —
    A small amount of research suggests that peppermint oil in enteric-coated capsules may improve IBS symptoms in adults.
    
    Who: adults with IBS
    Effect: cautious positive position limited to enteric-coated capsules in adults
    Certainty: T2, no own analysis; relies on the 2022 meta-analysis (card ev-pmibs-01).
    NIH National Center for Complementary and Integrative Health, Peppermint Oil (last updated May 2025) · checked 2026-10-07 · we read the section
14. ev-pmibs-14 · Position of an expert body · Delphi expert consensus, ESNM/UEG · n = —
    Treatment may include dietary modifications (e.g. lactose-limiting diet and low FODMAP diet), probiotics, antispasmodics (e.g., otilonium bromide, peppermint oil), rifaximin, secretagogues (e.g., linaclotide), neuromodulators (e.g., serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, buspirone), and plethysmography-based biofeedback.
    
    Who: adults with functional bloating and abdominal distension, often overlapping with IBS
    Effect: peppermint oil named as an antispasmodic treatment option for bloating
    Certainty: Expert position (E), about bloating, not about IBS in general.
    United European Gastroenterol J, 2025 · checked 2026-10-07 · we read the abstract
15. ev-pmibs-15 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials, GRADE · n = 23 trials
    Resveratrol (for UC and CD participants) and peppermint oil (for IBS participants) had greater certainty in the evidence for improving GIS and QoL (GRADE: moderate to high).
    
    Who: adults with Crohn's disease, ulcerative colitis or IBS in randomized trials to April 2020
    Effect: peppermint oil for IBS: greater certainty of evidence (GRADE moderate to high) for gastrointestinal symptoms and quality of life; no effect on adverse events overall
    Certainty: Diverges from the 2022 meta-analysis (very low) in quality assessment: different sample and endpoints.
    Nutr Diet, 2022 · checked 2026-10-07 · we read the abstract