İrritabl bağırsak sendromlu hastaların tedavisinde nane yağının etkinliği

Amaç: Çalışmamızın amacı irritabl bağırsak sendromu (İBS) tedavisinde kullandığımız klasik ajanların yanında kullanılan nane yağının tedavi başarısına olan etkisini araştırmaktır. Yöntem: Çalışmamıza ROMA IV kriterlerine göre İBS tanısı koyduğumuz hastalar dâhil edilmiştir. Hastalar randomize edilerek yalnızca ilaç kullanılacak grup ve ilaç + nane yağı kullanacak grup olmak üzere ikiye ayrılmıştır. Her iki gruba İBS semptom skorlama sistemi (İBS-SS) isimli İBS hastalarında semptom şiddetini ölçmeye yarayan anket ve 36 sorudan oluşan İBS hayat kalitesi ölçüm anketi (İBS-36) uygulanmıştır. 12 haftanın sonunda tedaviye alınan yanıtları değerlendirmek için her iki gruba İBS-SS ve İBS-36 anketleri tekrarlanmıştır. Bulgular: Gruplar İBS-SS açısından değerlendirildiğinde; ilaç grubunda da, ilaç + nane grubunda da başlangıçtan 3. aya kadar İBS-SS skorlarındaki değişim anlamlıdır (p<0.001). İlaç grubunda başlangıçtan 3. Aya kadar değişim medyan 62.5 iken ilaç + nane grubunda bu fark 85’tir. Aradaki fark istatistiksel olarak anlamlıdır (p<0.001). İBS-36'ya göre ilaç grubunda başlangıçtan üçüncü aya kadar medyan değişim 35.5 iken, ilaç+nane yağı grubunda bu fark 45.5'tir. Fark istatistiksel olarak anlamlıydı (p<0.001). Sonuçlar: İBS tedavisinde nane yağının klasik ilaçlar ile birlikte kullanımı tedavi başarısını arttıracaktır.

Anahtar Kelimeler:

konstipayon, diyare, irritabl bağırsak sendromu, bitki yağları

Efficiency of peppermint oil in the treatment of patients with irritable bowel syndrome

Aim: The purpose of our study is to examine the effect of mint oil, which is used together with the classical agents we use in the treatment of irritable bowel syndrome (IBS), on the success of treatment. Methods: Patients diagnosed with IBS based on the ROME IV criteria were included in our study. The patients were randomized and divided into two groups as the medication only group and the medication+peppermint oil group. A questionnaire called IBS symptom severity scoring system (IBS-SS) to measure the symptom severity of the IBS patients and IBS quality of life measurement questionnaire (IBS-36), consisting of 36 questions, was applied to both groups. At the end of 12 weeks, the IBS-SS and IBS-36 questionnaires were repeated in both groups to evaluate the response to treatment. Results: The change in IBS-SS scores from the beginning to the 3rd month was significant in both the medication group and the medication+peppermint group (p<0.001). According to IBS-SS the median change from the beginning to the 3rd month was 62.5 for the medication group, this difference was 85 for the medication+peppermint group. The difference was statistically significant (p<0.001). According to the IBS-36 the median change from the beginning to the third month was 35.5 for the medication group, this difference was 45.5 for the medication+mint oil group. The difference was statistically significant (p<0.001). Conclusion: The use of peppermint oil together with classical drugs in the treatment of IBS will increase the success of the treatment

Keywords:

constipation, diarrhea, irritable bowel syndrome, plant oils,

PDF

___

Akbaş, E., & Atasü, R. (2009). Modern çocukluk paradigmasının oluşumu, eleştirel bir değerlendirme. Toplum ve Sosyal Hizmet, 20 (1), 95-103.
Adam, B., Liebregts, T., Best, J., Bechmann, L., Lackner, C., Neumann, J., Koehler, S., & Holtmann, G. (2006). A combination of peppermint oil and caraway oil attenuates the post-inflammatory visceral hyperalgesia in a rat model. Scandinavian Journal of Gastroenterology, 41(2), 155– 160. https://doi.org/10.1080/00365520500206442
Begtrup, L. M., Engsbro, A. L., Kjeldsen, J., Larsen, P. V., Schaffalitzky de Muckadell, O., Bytzer, P., & Jarbøl, D. E. (2013). A positive diagnostic strategy is noninferior to a strategy of exclusion for patients with irritable bowel syndrome. Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association, 11(8), 956–962. https://doi.org/10.1016/j.cgh.2012.12.038
Borowiec, A. M., & Fedorak, R. N. (2007). The role of probiotics in management of irritable bowel syndrome. Current Gastroenterology Reports, 9(5), 393–400. https://doi.org/10.1007/s11894-007-0048-6
Cash, B. D., Epstein, M. S., & Shah, S. M. (2016). A novel delivery system of peppermint oil is an effective therapy for irritable bowel syndrome symptoms. Digestive Diseases and Sciences, 61(2), 560–571. https://doi.org/10.1007/s10620-015-3858-7
Drossman, D. A., Camilleri, M., Mayer, E. A., & Whitehead, W. E. (2002). AGA technical review on irritable bowel syndrome. Gastroenterology, 123(6), 2108–2131. https://doi.org/10.1053/gast.2002.37095
Enck, P., Aziz, Q., Barbara, G., Farmer, A. D., Fukudo, S., Mayer, E. A., Niesler, B., Quigley, E. M., Rajilić-Stojanović, M., Schemann, M., Schwille-Kiuntke, J., Simren, M., Zipfel, S., & Spiller, R. C. (2016). Irritable bowel syndrome. Nature Reviews. Disease Primers, 2, 16014. https://doi.org/10.1038/nrdp.2016.14
European Medicines Agency (2016). Public statement on the use of herbal medicinal products containing pulegone and menthofuran. 2016 Jul 12; Accessed from http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2016/07/WC500211079.pdf Accessed Date: 20.12.2021
Ford, A. C., Bercik, P., Morgan, D. G., Bolino, C., Pintos-Sanchez, M. I., & Moayyedi, P. (2013). Validation of the Rome III criteria for the diagnosis of irritable bowel syndrome in secondary care. Gastroenterology, 145(6), 1262–1270 https://doi.org/10.1053/j.gastro.2013.08.048
Ford, A. C., Moayyedi, P., Lacy, B. E., Lembo, A. J., Saito, Y. A., Schiller, L. R., Soffer, E. E., Spiegel, B. M., Quigley, E. M., & Task Force on the Management of Functional Bowel Disorders (2014). American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation. American Journal of Gastroenterology, 109(Suppl 1), S2–27. https://doi.org/10.1038/ajg.2014.187
Ford, A. C., Quigley, E. M., Lacy, B. E., Lembo, A. J., Saito, Y. A., Schiller, L. R., Soffer, E. E., Spiegel, B. M., & Moayyedi, P. (2014). Effect of antidepressants and psychological therapies, including hypnotherapy, in irritable bowel syndrome: systematic review and meta-analysis. American Journal of Gastroenterology, 109(9), 1350–66. https://doi.org/10.1038/ajg.2014.14
Ford, A. C., Talley, N. J., Spiegel, B. M., Foxx-Orenstein, A. E., Schiller, L., Quigley, E. M., & Moayyedi, P. (2008). Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ (Clinical research), 13,337, a2313. https://doi.org/10.1136/bmj.a2313
Francis, C. Y., Morris, J., & Whorwell, P. J. (1997). The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Alimentary Pharmacology & Therapeutics, 11(2), 395–402. https://doi.org/10.1046/j.1365-2036.1997.142318000.x
Grigoleit, H. G., & Grigoleit, P. (2005). Pharmacology and preclinical pharmacokinetics of peppermint oil. Phytomedicine: International Journal of Phytotherapy and Phytopharmacology, 12(8), 612–616. https://doi.org/10.1016/j.phymed.2004.10.007
Groll, D., Vanner, S. J., Depew, W. T., DaCosta, L. R., Simon, J. B., Groll, A., Roblin, N., & Paterson, W. G. (2002). The IBS-36: A new quality of life measure for irritable bowel syndrome. American Journal of Gastroenterology, 97(4), 962–971 https://doi.org/10.1111/j.1572-0241.2002.05616.x
Hills, J. M., & Aaronson, P. I. (1991). The mechanism of action of peppermint oil on gastrointestinal smooth muscle. An analysis using patch clamp electrophysiology and isolated tissue pharmacology in rabbit and guinea pig. Gastroenterology, 101(1), 55–65. https://doi.org/10.1016/0016-5085(91)90459-x
Juergens, U. R., Stöber, M., & Vetter, H. (1998). The anti-inflammatory activity of L-menthol compared to mint oil in human monocytes in vitro: a novel perspective for its therapeutic use in inflammatory diseases. European Journal of Medical Research, 3(12), 539–545.
Kamatou, G. P., Vermaak, I., Viljoen, A. M., & Lawrence, B. M. (2013). Menthol: a simple monoterpene with remarkable biological properties. Phytochemistry, 96, 15–25. https://doi.org/10.1016/j.phytochem.2013.08.005
Kearns, G. L., Chumpitazi, B. P., Abdel-Rahman, S. M., Garg, U., & Shulman, R. J. (2015). Systemic exposure to menthol following administration of peppermint oil to paediatric patients. BMJ Open, 12;5(8), e008375. https://doi.org/10.1136/bmjopen-2015-008375
Khanna, R., MacDonald, J. K., & Levesque, B. G. (2014). Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Journal of Clinical Gastroenterology, 48(6), 505–512. https://doi.org/10.1097/MCG.0b013e3182a88357
Lovell, R. M., & Ford, A. C. (2012). Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association, 10(7), 712–721. https://doi.org/10.1016/j.cgh.2012.02.029
Mearin, F., & Lacy, B. E. (2012). Diagnostic criteria in IBS: useful or not?. Neurogastroenterology and Motility: The Official Journal of the European Gastrointestinal Motility Society, 24(9), 791–801. https://doi.org/10.1111/j.1365-2982.2012.01992.x
Pimentel, M., Lembo, A., Chey, W. D., Zakko, S., Ringel, Y., Yu, J., Mareya, S. M., Shaw, A. L., Bortey, E., Forbes, W. P., & TARGET Study Group (2011). Rifaximin therapy for patients with irritable bowel syndrome without constipation. The New England Journal of Medicine, 364(1), 22–32. https://doi.org/10.1056/NEJMoa1004409
Pittler, M. H., & Ernst, E. (1998). Peppermint oil for irritable bowel syndrome: a critical review and metaanalysis. American Journal of Gastroenterology, 93(7), 1131–1135. https://doi.org/10.1111/j.1572-0241.1998.00343.x
Rios-Estepa, R., Turner, G. W., Lee, J. M., Croteau, R. B., & Lange, B. M. (2008). A systems biology approach identifies the biochemical mechanisms regulating monoterpenoid essential oil composition in peppermint. Proceedings of the National Academy of Sciences of the United States of America, 105(8), 2818–2823. https://doi.org/10.1073/pnas.0712314105
Umezu, T. (2009). Evidence for dopamine involvement in ambulation promoted by menthone in mice. Pharmacology, Biochemistry, and Behavior, 91(3), 315-320. https://doi.org/10.1016/j.pbb.2008.07.017
Weerts, Z., Masclee, A., Witteman, B., Clemens, C., Winkens, B., Brouwers, J., Frijlink, H. W., Muris, J., De Wit, N. J., Essers, B., Tack, J., Snijkers, J., Bours, A., de Ruiter-van der Ploeg, A. S., Jonkers, D., & Keszthelyi, D. (2020). Efficacy and safety of peppermint oil in a randomized, double-blind trial of patients with irritable bowel syndrome. Gastroenterology, 158(1), 123–136. https://doi.org/10.1053/j.gastro.2019.08.026
Wu, J. C. (2010). Complementary and alternative medicine modalities for the treatment of irritable bowel syndrome: facts or myths? Gastroenterology & Hepatology, 6(11), 705–711.