![]() ![]() In addition, the risk-benefit profile of PO has been evolving as new RCTs continue to arise. Some more recent systematic reviews of RCTs of PO for IBS treatment were limited in the lack of evidence for adverse events. Earlier systematic reviews of RCTs of PO for IBS treatment revealed trial design flaws (e.g., no washout period for crossover trials), short follow-up duration, and conflicting trial results. Several case reports, observational studies, and randomized clinical trials (RCTs) with methodological inconsistencies and heterogeneous outcomes have been reported since the research conducted by Rees et al. PO possesses antimicrobial, anti-inflammatory, antioxidant, immunomodulating, and anesthetic activities, all of which may be relevant for the treatment of IBS. PO contains L-menthol, which blocks calcium channels in smooth muscle, thus producing antispasmodic effects on the gastrointestinal tract. Peppermint oil (PO) ( Mentha Piperita) is a naturally-occurring carminative herb containing monoterpene compounds that target the pathophysiology of IBS. Smooth muscle relaxants and antispasmodics can also be used to help with IBS symptoms, especially abdominal pain and bloating. IBS patients with mild and intermittent symptoms usually benefit from lifestyle and dietary modification, which includes a diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) and in some cases, lactose and gluten avoidance. The pathophysiology of IBS is complex and involves an interaction of various factors, which includes, but is not limited to, genetic predisposition, gut-brain axis, visceral sensitivity, gastrointestinal motility, gut dysbiosis, neurotransmitters, food reactions, intestinal permeability, bile acids, inflammatory mediators, early-life stressors, psychosocial maladaptation, and somatization, among others. ![]() IBS accounts for a significant number of annual visits to primary care physicians, health-care utilization, quality of life, and adverse economics owing to absenteeism from work. In their research, Lovell and Ford found the global prevalence of IBS to be 11.2% (95% confidence interval, 9.8–12.8%). ![]() Lovell and Ford conducted a meta-analysis of the world’s literature and reported that, on a global scale, IBS is seen predominantly in females, and the age of onset is typically under 50 years-of-age. As a common digestive tract disorder, IBS affects an estimated 5–15% of Western populations. The irritable bowel syndrome (IBS) is a chronic, functional gastrointestinal syndrome characterized by relapsing abdominal pain and altered bowel habits, with either predominant symptoms of diarrhea (IBS-D), constipation (IBS-C), both (IBS-M), or undetermined (IBS-U), and is categorized according to the Rome IV criteria. ![]()
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