Irritable Bowel Syndrome Message Boards

Hi there,

Peppermint is contraindicated for people with GERD/Reflux/chronic heartburn. Many people with IBS often have these conditions, so we worked around it by enteric coating the peppermint oil capsules. This helps them to pass through the stomach without dissolving by making them resistant to the stomach acid. In fact, we doubled the enteric coating on our peppermint caps because we found it helped people with these conditions to be able to use them to manage their IBS without aggravating their upper GI issues.

However, some people with severe GERD/Reflux/chronic heartburn still have problems with the peppermint capsules because they will dissolve in the stomach before reaching the intestines. The antispasmodic effect you want to happen in your intestines will then occur in the stomach and this relaxes the sphincters at the top of the stomach. If this happens, it can lead to heartburn.

There are a few things we have found that help to prevent this from happening:

1)Take the peppermint capsules on an empty stomach an hour before the meal to allow them time to reach the intestines and dissolve before the food arrives. Taking them too close to meal time can be problematic for people with reflux.

2)The peppermint caps should not be taken during or after a meal because the food will block them from reaching the intestines and this could cause them to dissolve in the stomach.

3) Drinking only enough liquid to swallow the capsules seems to help them pass through without dissolving in the stomach. The enteric coating makes them resistant to stomach acid, but they are still water soluble. Limiting the amount of liquid they'll be floating around in will help them reach their destination.

4)You shouldn't take them at the same time as any medication (prescription or over-the-counter) designed to lower the stomach acid. Lowering the stomach acid makes the enteric coating less likely to work (remember it is resistant to high acid). For folks who need to take these medications, what we came up with is taking the peppermint caps about an hour before you take the acid lowering/blocking medication. This will give them a better chance of making it down to the intestines where they will dissolve and start to take effect without affecting the upper GI.

On a related note, not being able to tolerate the enteric coated peppermint oil capsules because they are dissolving in the stomach and causing heartburn or peppermint burping might indicate low stomach acid. In my masters of science in nutrition program, we learned to use enteric coated capsules as an informal way to assess whether the stomach acid was adequate. If the stomach acid is high enough, they should not dissolve until they reach the intestines where the acid is low. This means you shouldn't burp up anything or have any upper GI complications at all. In naturopathic medicine, heartburn is often thought to be caused by low stomach acid which causes the undigested food to sit in the stomach too long and create pressure. It can also contribute to inadequately digested protein in the stomach. This can disrupt the digestive process downstream as well. If you followed the three tips I listed above and still experienced heartburn, you might want to follow up with a provider to test your stomach acid levels. A naturopath or nutritionist would probably be the best type of provider to address this for you.

Of course if you are unable to take the peppermint oil capsules, please feel free to return them even if you have used part of the bottle. Just mail them to the address below my name with enough information so I can find you in our database. We will process a credit to your card and send you a confirmation email once the transaction has been completed.

I hope this helps!

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Erin Dudley, MS, CN
Certified Nutritionist
Heather's Tummy Care / Heather & Company for IBS, LLC
IBS Education, Support, & Products
Toll Free: 866 640 4942 Direct: 206 264 8069 Fx: 206 264 8072
80 S. Washington St. #304, Seattle, WA 98104 USA

Patient Support Site: HelpForIBS.com
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LEGAL DISCLAIMER - This email is not intended to replace the services of a physician, nor does it constitute a doctor-patient relationship. Any application of the recommendations in this email is at the reader's discretion. Heather Van Vorous and Heather & Company for IBS, LLC are not liable for any direct or indirect claim, loss or damage resulting from use of this email and/or any web site(s) linked to/from it. Readers should consult their own physicians concerning the recommendations in this email

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