Peppermint oil potential treatment for esophagus disorders

Peppermint oil could improve symptoms, including difficulty swallowing and non-cardiac chest pain, in patients with esophagus disorders, according to a new study published in the journal Digestive Diseases and Sciences.

Researchers from the Medical University of South Carolina in Charleston enrolled 38 patients with dysphagia or chest pain in the pilot study. From 2013 to 2016, participants were given concentrated peppermint oil in the form of a commercially available peppermint tablet. Those with dysphagia were instructed to take two tablets before meals, and those with chest pain on an as-needed basis. Study participants self-reported symptom response using a modified five-point Likert scale.

The study found 63 percent of patients reported improvement in symptoms, with 12 percent saying symptoms were much better and 12 percent slightly better. Of the patients, 14 experienced no change, though none reported feeling worse. In addition patients with distal esophageal spasm and esophagogastric junction outflow obstruction appeared to demonstrate the best subjective improvement, 83 percent and 100 percent, respectively.

Peppermint oil has been known to have therapeutic effects in multiple disorders due to its muscle-relaxing properties. However, only two previous studies have investigated its role in the upper digestive tract.

Current standard of care calls for these disorders involves trying multiple drugs, including tricyclic antidepressants and calcium channel blockers, and hoping that one works. Peppermint offers an attractive first line of defense for these patients, who experience intermittent symptoms, because they can take it freely as symptoms occur.

This study highlights the effects of the so-called Charleston Approach, which advocates a "start low and go slow" treatment strategy. The Charleston Approach differs from current standard of care in that it uses peppermint oil as a first attempt to relieve symptoms.

Researchers did not know the precise dosage of peppermint being given since it was a commercial candy with a proprietary recipe. The study also relied on self-reporting by patients to determine whether symptoms improved.

Although the preliminary findings of this study are promising, they need to be confirmed in a trial that compares outcomes in patients who receive a specific dose of peppermint oil and those who receive only a placebo. In the meantime, however, researchers say patients who have been diagnosed as having spastic disorders of the esophagus and who have no heart disease or obstruction can try using peppermint to see if it relieves their symptoms.