Heartburn is a painful burning sensation experienced in the upper gastrointestinal tract or in the oesophagus. The burning sensation has nothing to do with the heart but occurs due to the reflux of acid up in the oesophagus.
The acid comes up due to several reasons such as overproduction of acid, relaxation of lower oesophageal sphincter muscle or indigestion.
Poor diet and lifestyle promotes all these factors and cause heartburns or its chronic form, gastro oesophageal reflux disease.
Effects of peppermint on heartburn
Peppermint is a plant derived flavouring and medicinal agent, commonly used in gums, toothpastes and herbal treatments. It is known for its soothing, cooling and relaxing action and thus is used in the treatment of indigestion, irritable bowel syndrome, anxiety, nausea, skin irritations, headaches and tooth problems among many others.
In test tubes, peppermint can kill some of the bacteria and fungi, indicating towards its antibacterial and antifungal activities.
Despite all of its soothing effects on different parts of the body, including gut, peppermint per se is not considered good for heartburn. It has been found that peppermint if taken alone can aggravate GERD or chronic heartburn by relaxing the lower oesophageal sphincter which gives way to the acid and stomach contents to flow up .
However, some studies show that peppermint can actually cure low levels of heartburns or occasional heartburns by aiding in digestion .
One reason given as to why peppermint might act differently in different people by either causing or relieving heartburn is that peppermint oil gets dissolved in the stomach too quickly if there is relatively low acid and it can act on the sphincter muscle strongly causing heartburn. However, in an acidic environment, it dissolves slowly and its soothing effects are more prevalent .
Thus there has not been proper research and a consensus about peppermint, if it induces or reduces heartburn.
There are a variety of modus operandi, proposed for peppermints action to possibly relieve heartburns which are still in their initial stages. It is considered a strictly prohibited food item in advanced or chronic heartburns or GERD.
Peppermint cures indigestion
Peppermint has long been used for the treatment of non ulcer and functional dyspepsia or indigestion. In numerous clinical trials done, it has been shown to reduce the symptoms of indigestion and pain caused due to it without showing any side effects. However, there has not been any study conducted as to how it actually works to reduce indigestion.
Several other effects of peppermint stated later can be correlated with its overall ability to cure indigestion but the basic digestive action is yet to be discovered. Peppermint oil along with caraway oil has been proven to be most effective as compared to all other preparations of peppermint to cure indigestion .
Peppermint reduces pain
Heartburn can cause serious ulceration and damage to gut mucosal layer, causing inflammation and pain. Peppermint contains analgesic compounds like menthol and menthone which can soothe the gut walls and relieve the pain caused due to acid reflux.
The major effect peppermint exerts is by stimulating the peripheral nervous system to relax the gut mucosal layer and reduce the production of pain and inflammation inducing molecules, which ultimately results in heartburn relief. No comparative studies have been done though for its analgesic effects to be better in peppermint oil or tea or any other preparations .
Peppermint reduces the contractions in lower gastro intestinal tract
A mixture of peppermint and caraway oils helps in reducing the motility of the stomach and the intestine by reducing the contractions and inducing relaxations. This is probably another reason why peppermint shows and immediate soothing effect on heartburns and other inflammations caused due to poor gut health .
Patients suffering from chronic GERD usually undergo endoscopy to treat that which even if successfully treated poses additional post surgery problems. One of them is spasms in the oesophagus which induce pains. Peppermint oil has been shown to be an effective antispasmodic natural drug after endoscopic surgeries, reducing pain of both heartburn and endoscopy .
Peppermint reduces the feeling of fullness
Usually, after heavy meals, chances of heartburn increase exponentially, especially if a heavy meal is taken at the night time. Peppermint preparations like gum, tea or oil with caraway oil have been shown to reduce the feeling of fullness and spasms in the stomach, reducing heartburn occurrences after a heavy meal .
Peppermint increases the rate of gastric emptying
Gastric emptying rate is an important parameter in deciding the prevalence of the symptoms of heartburn. The longer the food stays in the stomach, the more acid is secreted to digest it and the more are the chances of acid reflux.
Conversely, the faster the food is emptied from the stomach and passed on to the intestines, the better is the digestion and lower is the chance of acid refluxes. Peppermint has been shown to positively increase the rates of gastric emptying, reducing the incidences of gastro intestinal tract disorders including heartburn. This proves its prevalence as a medicine used to treat functional gut problems .
Peppermint shows a cooling effect on the gut
Heartburn and other gut disorders, predominantly dyspepsia and ulcers come with an additional problem of intense burning pain caused due to inflammation. This pain is counteracted and reduced by the cooling action of peppermint.
Peppermint liquid, powder or cold peppermint preparations along with peppermint oil, all have been shown to cool down the heat and the burning sensation in the stomach and the chest caused due to acid reflux .
Dosage and consumption
Peppermint and peppermint supplements or preparations are widely available over the counter as medications taken by mouth. Mostly, peppermint powder, prepared from dried leaves is used for addition in food items and as medicines.
Peppermint tincture, which is made from 10% peppermint oil and 1% peppermint leaf extract dissolved in alcohol, is also a popular choice of consumption of peppermint after or during meals. Enteric coated capsules are also available that contain peppermint oil inside and get dissolved slowly in the acidic environment in the stomach, giving its full effect .
Peppermint is generally considered safe for consumption for pregnant ladies in the first few months of their pregnancy. Peppermint tea is found to be the best way to combat heartburn and morning sickness in pregnancy without giving any side effects.
The tea can be prepared with certain other ingredients such as caraway, clowns mustard plant, German chamomile and dandelion, all of which are known heartburn relievers .
In general, peppermint is not advised to be given to infants and new born babies, but a definitive clinical trial has not been performed to prove this notion. For digestive problems in children, 1-2 mL peppermint glycerite can be given per day only with doctor’s prescription.
For adults, peppermint can be taken as tea, which can be prepared by boiling 1 tsp dried peppermint leaves in 1 cup boiling water for 10 minutes, strained and cooled. This can be taken up to 4-5 times between meals.
Enteric coated capsules, each containing 0.2 ml peppermint oil are taken 2-3 times a day as a single or double coated capsule. However, it is advised to start with the lowest possible dose and go higher until heartburn symptoms are relieved .
Possible Side effects and precautions
There are a number of precautions to be taken while consuming peppermint alongside other drugs. If peppermint is taken with antacids, it may cause heartburn, instead of relieving it. Antacids reduce the level of acid in the stomach, making peppermint capsules dissolve earlier and exert and opposite heartburn inducing effect on the stomach.
Thus both peppermint capsules and antacids should never be paired up together.
Peppermint also reacts with immunosuppressive medicines like cyclosporine by reducing the speed of breakdown of this drug, causing immune system related problems.
Peppermint has a synergistic effect with antihypertensive drugs and anti-diabetic drugs. Taking peppermint along with these drugs might reduce blood pressure and blood sugar at a greater extent than required, giving rise to hypotension and hypoglycaemia .
Peppermint in large quantities positively exacerbates heartburn and thus it is advised to start with the lowest possible doses to test if there is any relief or increase in the discomfort.
Other than that, there are no side effects that peppermint is known to cause. However, it is advised to always consult a doctor before taking any kind of natural or synthetic drug to avoid any further discomforts .
Peppermint has been a debated herbal product in case of heartburn. While it is known to promote digestion, soothe gut mucosa and treat irritable bowel syndrome, it can promote heartburn if taken in large quantities.
However, basal heartburn levels have been reported to be successfully treated by peppermint oil, peppermint tea and other peppermint preparations along with other known heartburn alleviating drugs.
The use of peppermint in acid reflux treatment, thus, should always be monitored and prescribed.