An analysis of dozens of trials that looked at the effectiveness of peppermint oil, fiber and antispasmodic drugs in the treatment of irritable bowel syndrome (IBS), found that these older remedies were better at reducing the symptoms of IBS than newer medications.

The review, published in the British Medical Journal Online First, showed that only 26 percent of patients with IBS had symptoms when taking peppermint oil, compared with 65 percent of patients who were given a placebo (sugar pill), reducing overall risk of suffering from IBS symptoms by 57 percent. The data also found that psyllium-based fiber treatments such as Metamucil and antispasmodic drugs, especially scopolamine, which reduce muscle contractions and abdominal pain, were also effective.

It's believed that between five percent and 20 percent of people suffer from IBS, a disorder of the colon that causes a host of symptoms, including abdominal cramping, bloating, gas, diarrhea and/or constipation.

Newer prescription medications are available to treat IBS symptoms, but the results have been mixed. For example, Lotronex, a medication specifically approved for the treatment of IBS symptoms, was taken off the market because of potentially serious gastrointestinal side effects. The drug has now been reapproved by the U.S. Food and Drug Administration (FDA) but is restricted for use by women with severe IBS symptoms who have not responded to conventional therapy. However, the drug still carries serious side effects, including severe constipation or decreased blood flow to the colon. So caution must be used when taking the drug. Over-the-counter medications, such as laxatives and fiber supplements, also carry some unpleasant side effects like worsening abdominal bloating and gas from increased fiber intake and laxatives can become habit forming. Caution must also be taken when using these drugs.

Scientists analyzing the combined data from the review of the studies also concluded that:

  • One in 2.5 IBS sufferers would get significant relief from symptoms if they took peppermint oil, compared to one in five patients taking antispasmodics and one in 11 patients taking fiber. Study participants took 200 milligrams of peppermint oil two to three times a day.
  • Psyllium-fiber treatment, such as Metamucil, is a good first-line treatment for constipation-predominate IBS and peppermint oil and the drug scopolamine are good choices for diarrhea-predominate IBS.
  • The drug scopolamine is among the most effective of the antispasmodic medications and should be used as first-line treatment for IBS.

Before taking any over-the-counter remedy for your IBS symptoms, check with your doctor to determine which therapy might be best for you.