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. In the most comprehensive meta-analysis to date, PO was shown to be a safe and effective therapy for pain and global symptoms in adults with IBS. The number needed to treat with PO to prevent one patient from having persistent symptoms was three for global symptoms and four for abdominal pain. Overall, there were no differences in the reported adverse effects: PO (32 events, 344 total, 9.3%) versus placebo (20 events, 327 total, 6.1%) for eight RCTs RR 1.40 I 2 = 0%, z = 1.39 ( p = 0.16). For global symptom improvement, the risk ratio (RR) from seven RCTs for the effect of PO ( n = 253) versus placebo ( n = 254) on global symptoms was 2.39, I 2 = 0%, z = 7.93 ( p < 0.00001). Twelve randomized trials with 835 patients were included. A PRISMA-compliant study protocol is registered in PROSPERO Register. We performed random-effects meta-analysis on primary outcomes including global improvement in IBS symptoms and abdominal pain. We appraised the eligible studies by the Cochrane risk of bias tool. We systematically searched MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (Cochrane CENTRAL),, EMBASE (Ovid), and Web of Science for randomized controlled trials (RCTs) of PO for IBS. The study objective was to determine the effect of peppermint oil in the treatment of the IBS. Peppermint oil (PO) has intrinsic properties that may benefit patients with irritable bowel syndrome (IBS) symptoms.
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