(01/09) via JS

Dr Alexander Ford and colleagues from the gastroenterology division of McMaster University, Ontario combined the results from studies comparing fibre, antispasmodic drugs, and peppermint oil in the treatment of IBS. Although there were fewer peppermint oil studies, the trials were well designed and showed peppermint oil to be effective.
Based on the data, the researchers estimated that one in 2.5 patients would get significant relief if treated with peppermint oil, compared to one in five patients taking antispasmodics and one in 11 patients taking fibre.

Peppermint oil is sold in capsules, and the study participants took about 200 milligrams two or three times a day.
Insoluble bran-based fibres were not very effective, but soluble psyllium-based fibre treatments like Metamucil were with one in six treated patients having a significant improvement in symptoms.

When the 22 antispasmodic studies were combined, the drug scopolamine was among the most effective. The researchers recommend scopolamine, which is extracted from the corkwood tree, as the first-line antispasmodic treatment for IBS.

Ford and colleagues concluded that psyllium-fibre therapy is a good first-line treatment for constipation- predominant IBS, while peppermint oil and scopolamine are good choices for diarrhea-predominant IBS.

The analysis appears in the latest issue of BMJ Online

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