Peppermint Aromatherapy for Nausea

Peppermint Aromatherapy for Nausea
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Is the relief of nausea and vomiting after surgery from sniffing peppermint extract due to the mint, the alcohol vapors, or just the controlled breathing?

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One of the most common fears patients express when facing surgery is postoperative nausea and/or vomiting (PONV), which ranges from minor queasiness to protracted periods of vomiting. Feeling sick to one’s stomach and throwing up after surgery is a common problem, affecting between a quarter and half of those placed under general anesthesia, and more than half of those at high risk–meaning women who don’t smoke and have a history of motion sickness. I’ve explored the science behind treating nausea with ginger, but if you’re too nauseous to eat, what do you do? Well, people are often sent home with anti-nausea rectal suppositories. However, surveys show that cultural and sexual attitudes may make a number of people sensitive to anything involving the rectum, but the wording of the question they asked was, are you happy to have a drug put in your back passage? And I can imagine many of the respondents thinking well, maybe I wouldn’t so much mind, but I wouldn’t exactly be happy about it–especially when you’re feeling sick and throwing up.

And after a C-section, women might not want to take drugs–regardless of the orifice–if they’re breastfeeding, so researchers decided to put aromatherapy to the test. Research has shown that essential oils of both spearmint and peppermint are effective in reducing nausea and vomiting after chemotherapy, but this was after taking them internally: swallowing them. Would just the smell of peppermint help with nausea? They had women take deep whiffs of peppermint extract, like you’d buy at a store, and it seemed to work. While none sniffing plain water with green food coloring—the placebo—or the control group who didn’t sniff anything, felt better, 80% of the mint sniffers felt better within just a few minutes.

The study was criticized for being small, and for not using pure peppermint oil. Peppermint extract is peppermint oil plus alcohol—maybe it was the smell of alcohol that made people better! And that’s actually not much of a stretch. In 1997, researchers reported a simple, innocuous, and inexpensive treatment for postoperative nausea and vomiting—the smell of isopropyl alcohol, which is what’s found in those alcohol wipes, the little prep pads that nurses swab you with before shots. They found out that they could just effectively tear one open and wave it under someone’s nose, and relieve nausea and vomiting in more than 80% of folks after surgery. It’s been since shown to work as well as a leading anti-nausea drug, and may even work faster, cutting nausea in half within 10 to 15 minutes, rather than 20 or 25.

So was it the alcohol, the peppermint, or both? We didn’t know, until it was put to the test. Patients were instructed to take three slow, deep breaths, inhaling through the nose and exhaling through the mouth, smelling alcohol, peppermint, or nothing. The smell of peppermint cut nausea in half within 5 minutes. And so did the alcohol. But so did smelling nothing. So maybe it had nothing to do with the scent; maybe it was just the instruction to take slow, deep breaths. That would make it a really cost-effective intervention. Maybe it shouldn’t be so surprising, given the proximity of the vomiting and breathing centers within the brain.

And indeed, controlled breathing was effective with or without any scent. So next time you feel nauseous, inhale deeply through your nose to the count of three, hold your breath to the count of three, and exhale out the mouth to the count of three. And do that three times. Ironically, the researchers continued to advocate using that nasty smelling alcohol pad even though they showed it wasn’t any more effective than breathing alone. Why? Because since isopropyl alcohol has a readily detectable odor, patients are more likely to think that their post-operative nausea and vomiting are being actively treated when they inhale alcohol vapors rather than just engaging in breathing exercises.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to scribbletaylor via Flickr.

One of the most common fears patients express when facing surgery is postoperative nausea and/or vomiting (PONV), which ranges from minor queasiness to protracted periods of vomiting. Feeling sick to one’s stomach and throwing up after surgery is a common problem, affecting between a quarter and half of those placed under general anesthesia, and more than half of those at high risk–meaning women who don’t smoke and have a history of motion sickness. I’ve explored the science behind treating nausea with ginger, but if you’re too nauseous to eat, what do you do? Well, people are often sent home with anti-nausea rectal suppositories. However, surveys show that cultural and sexual attitudes may make a number of people sensitive to anything involving the rectum, but the wording of the question they asked was, are you happy to have a drug put in your back passage? And I can imagine many of the respondents thinking well, maybe I wouldn’t so much mind, but I wouldn’t exactly be happy about it–especially when you’re feeling sick and throwing up.

And after a C-section, women might not want to take drugs–regardless of the orifice–if they’re breastfeeding, so researchers decided to put aromatherapy to the test. Research has shown that essential oils of both spearmint and peppermint are effective in reducing nausea and vomiting after chemotherapy, but this was after taking them internally: swallowing them. Would just the smell of peppermint help with nausea? They had women take deep whiffs of peppermint extract, like you’d buy at a store, and it seemed to work. While none sniffing plain water with green food coloring—the placebo—or the control group who didn’t sniff anything, felt better, 80% of the mint sniffers felt better within just a few minutes.

The study was criticized for being small, and for not using pure peppermint oil. Peppermint extract is peppermint oil plus alcohol—maybe it was the smell of alcohol that made people better! And that’s actually not much of a stretch. In 1997, researchers reported a simple, innocuous, and inexpensive treatment for postoperative nausea and vomiting—the smell of isopropyl alcohol, which is what’s found in those alcohol wipes, the little prep pads that nurses swab you with before shots. They found out that they could just effectively tear one open and wave it under someone’s nose, and relieve nausea and vomiting in more than 80% of folks after surgery. It’s been since shown to work as well as a leading anti-nausea drug, and may even work faster, cutting nausea in half within 10 to 15 minutes, rather than 20 or 25.

So was it the alcohol, the peppermint, or both? We didn’t know, until it was put to the test. Patients were instructed to take three slow, deep breaths, inhaling through the nose and exhaling through the mouth, smelling alcohol, peppermint, or nothing. The smell of peppermint cut nausea in half within 5 minutes. And so did the alcohol. But so did smelling nothing. So maybe it had nothing to do with the scent; maybe it was just the instruction to take slow, deep breaths. That would make it a really cost-effective intervention. Maybe it shouldn’t be so surprising, given the proximity of the vomiting and breathing centers within the brain.

And indeed, controlled breathing was effective with or without any scent. So next time you feel nauseous, inhale deeply through your nose to the count of three, hold your breath to the count of three, and exhale out the mouth to the count of three. And do that three times. Ironically, the researchers continued to advocate using that nasty smelling alcohol pad even though they showed it wasn’t any more effective than breathing alone. Why? Because since isopropyl alcohol has a readily detectable odor, patients are more likely to think that their post-operative nausea and vomiting are being actively treated when they inhale alcohol vapors rather than just engaging in breathing exercises.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to scribbletaylor via Flickr.

Doctor's Note

What do you think of alcohol pads still being used, even though they were shown to offer no additional benefit? I have a whole video on such questions: The Lie That Heals: Should Doctors Give Placebos?

Here’s a link to my Natural Nausea Remedy Recipe. Powdered ginger may be easier though (see Dangerous Advice From Health Food Store Employees).

More on aromatherapy here:

What about actually eating the peppermint? See:

Of course the best way to avoid postsurgical nausea is to try to avoid surgery in the first place. Those who eat healthy may be less likely to go under the knife. See: Say No to Drugs by Saying Yes to More Plants.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

47 responses to “Peppermint Aromatherapy for Nausea

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    1. Hey Holden. That’s a good question. To my knowledge I’m unaware of any specific post surgery advice. My guess is there are standard protocols, where doctors offer medications to curb the side effects of surgery rather than discuss breathing patterns and peppermint. Perhaps there is more information in methodology sections that discuss the breathing patterns? Do you mind checking the sources cited? I’ll pull any study for you from Dr Greger’s list if you are in need of learning more.

      Thanks,
      Joseph

        1. The fact you are asking these questions is a good thing! Let me know what you dig up and again happy to gather info for anyone that is interested in learning. I’m not an expert on nausea, as my comments suggest, but I too enjoy learning from these different studies. Thanks, Holden!

          Joseph

  1. Any alternative to the common drugs we use to treat nausea are welcome – the drugs can have some nasty side effects eg metoclopramide which can give you movement disorder – but dont worry – then you can get biperiden, which can give you anxiety, confusion and hallucinations – but dont worry……

      1. May I recommend a beta blocker for tachycardia, SSRI for anxiety and triazolam so you don’t lose any sleep worrying about side effects to beta blocker and SSRI…… ;-)

          1. I can appreciate the joke, and I appreciate he’s not a bad person. But that doesn’t safeguard someone maybe without insurance reading it, thinking hey I got the same thing and then order those drugs in Mexico.
            Playing online doctor is a very very bad idea.

      2. I had a laparoscopic hernia operation a couple of years ago at the age of 56. It was my first time being admitted to a hospital for anything. I was taken in early afternoon and out before dinner time. Never had any nausea. None. In fact, I had packed my good vegan breakfast and had it waiting for me as I came out of the anesthesia. Tasted like crap, bus hungry as heck. I’m very glad I had the surgery.

        I was discharged with some pretty heavy duty pain killers, which I never took. Never needed them. I wasn’t pain free, but it was never bad enough to require drugs.

        I had had the hernia, undiagnosed, for maybe 5 years ( I felt the tug but never asked about it and I guess they didn’t feel at my annual physicals). Once it was finally diagnosed, I scheduled the surgery as soon as they could fit me in. I was grateful to get it over with and feel better as a result.

        You can do this!

        1. Only bulges out a little bit when I cough, only very occasionally some sensitivity. I’m still in a too vulnerable state now, I went to a orientation talk Thursday of a cooperative living community just the new impressions, and 3 hours talking to nice new people has left me with an overloaded hyper-excited feeling in my head ever since. The operation can still wait, other things are far more pressing, like reconditioning myself to more frequent and intensive human contact, beyond just shopping for groceries.
          Thank you for your comforting reply, was very nice of you!

          1. It’s hard to remove the buttons that were installed when we were young. With work, it can be done. Mostly :-) Good luck and all the best. – Steve

  2. I’m wondering if the mechanism of action of deep breathing on nausea is known, and what about nausea caused by chemotherapy drugs?

    1. That would be good to know. I think nausea is nausea, but I might assume the level of nausea from chemotherapy drugs is more severe than other medications. I know many integrative medicine centers use all types of healing methods to help nausea, including aromatherapy, diet (like Dr. Greger mentioned, ginger could be a good thing), acupuncture, etc. Deep breathing would fit into that category of non-invasive therapies. If I stumble across more research I’ll let you know. Please do the same for us!

      Thanks, JohnL,
      Joseph

      1. Hi Joseph,
        Without being a nausea expert, I think that there are different types of nausea – the nausea induced from various drugs, nausea from irritation of the ventricle, hypotension, stress, raised intracranial pressure (which can be rather refractory to treatment and it can be severe) and the nausea of love! When I met my future wife, I couldn’t eat for weeks :-)
        So the more treatment options (especially those without side effects) the better.

          1. Not to my knowledge, unless you can treat the cause. I would prefer the “natural approach” to begin with and secondarily the antiemetic drugs

        1. Gotcha! Thanks for clarifying. I guess I only meant that I am unsure if they prescribe different drugs or therapies based on the “type” of nausea Coming back to the video; peppermint and deep breathing may be useful for dealing with nausea from surgery. Still, I don’t think there is any harm trying these non-invasive therapies for other types of nausea.

          1. The only thing I’ve tried for migraine nausea is ginger but it just made it worse but peppermint aroma or deep breathing is worth trying if I can remember it during that time. At that point thinking rationally isn’t easy.

            1. The problem could be that the ventricle is also paralyzed meaning that you wont absorb anything taken by mouth, meaning that pills or ginger ingested wont help. Often we use other routes – nasal, subcutaneously, rectally or i.v.

      2. I’ve been on chemo for nearly 4 years and I supplement my anti nausea pills with black licorice, ginger or peppermint. Some in tea form and some in candy or lozenge form. A little little bit can make the horrific 45 wait for the pills to work seem like 15 minutes when the black licorice soothes your soul and you realize you’ve survived until the pills kicked in. Always check with a doctor about these items causing a rise in blood pressure.

  3. Interesting… I suffer with nausea and can react to strong odors. I suffered with a bout of nausea and vomiting after abdominal surgery. They didn’t give me any meds for it that I recall. I’ve also hyperventilated from feeling nausea at a doctors office. I woke up in the recovery room at a clinic after an incident where I felt nauseous and like I was going to vomit. The doctor explained that I had hyperventilated. I experienced that very recently in a recovery room waiting for someone else and the moment I realized that feeling – I was breaking into a cold sweat and that familiar lightheaded faint feeling I bolted for the door to get outside. It was below 30°, but I knew that the cold bracing fresh air would help me, and so it did.

    1. Hi Karen. Thanks for sharing your story. Sounds like for you cold weather really helps!

      Best regards,
      Joseph

      1. I tend to wonder why that is. It also doesn’t always work as I’ve fainted several times, but I tend to feel that is dependent upon if I can get outside quick enough.

        1. I feel faint all too often – cancer in brain stem and cerebellum. For me, the solutions are:
          – to eat an apple if I’m feeling potentially dodgy

          – to keep my liquids up

          – to lie down before I fall down, yes even in public. :/

  4. A breathing technique that another internet MD mentioned recently as a simple form of meditation might apply. He (Dr. Al Sears) said to inhale as deeply as you can to the count of seven, hold your breath for seven seconds, and then exhale for a count of seven, emptying your lungs as completely as possible. For stress relief he said to do this ten times.

  5. Dr. Gonzáles, can you please tell me where I can get a lipid profile prescribed for myself without having to get an appointment with my personal provider? Is this something you can do? Thank you!

    1. Hi Nina. I am not a doctor, but I am a dietitian with research experience. I don’t know where to obtain a “lipid profile” other than standard tests on cholesterol and triglycerides ordered by your doctor. You could try contacting a lab directly? If other members have any ideas please jump in. NutritionFacts does not offer any of that testing. Sorry I can’t be of more help.

      Best regards,
      Joseph

    2. Nina: Life Extension Foundation (lef.org). I’m a member and have used them a couple of times. Non-members have to pay a little extra.

    3. I’ve used Walk-in Lab for yearly assessments, and donate blood bimonthly for more immediate feedback of how dietary changes are affecting iron levels and total cholesterol: my local blood center provides this as a courtesy to donors. The common blood chemistry & lipid profiles are inexpensive; its when one gets into other less common tests that may be of interest to plant based dieters (methylmalonic acid for B12, 25-OH-D, etc) that things get pricey. I have the fortune of a couple of physicians in my immediate family that can review my blood work (and endure my gloating). It’s no substitute for a provider’s expertise if one has an ailment, but I find having one’s own history of test results offers feedback and encourages both futher lifestyle improvements and learning about physiology.

  6. Very interesting information. I found a Cochrane review review entitled “Aromatherapy for treatment of postoperative nausea and
    vomiting” http://eprints.qut.edu.au/54475/4/54475b.pdf which indicates that isopropyl alcohol (IPA) may be more effective than placebo. While controlled breathing is helpful for many things, I’m skeptical of the dismissal that its benefits won’t be enhanced by aroma therapy. I could be a placebo effect, but if aromas have been shown to induce relaxation responses, and/or stimulate people to higher levels of alertness I wonder if parasympathetic/sympathetic stimulation could be a confounding variable.

    For my wife’s recent birth, we were told to bring a freshly sliced lemon to the hospital to smell for reducing symptoms of nausea and vomiting. I had too many other things to research at the time to verify what the hospital birthing educator told us. I think it was anecdotal from her nursing experience, but seeing significant levels of limonene in the mint and peppermint oils in one of these studies, I wonder if there could be something said of amount or enantiomer of limonene? So much to research. :-)

  7. Speaking of nausea, we can add “cheap wine” to the list of foods contaminated with arsenic. Brown rice, brussels sprouts, apple juice and now cheap wine.
    I tried to get drunk on cheap wine as a teenager, but before that happened I just threw-up. Mmm

    http://www.taintedwine.com/

  8. right at the 1:00 mark I was drinking coffee and you almost got me at that part. You almost made me ruin my monitor with coffee. But it was still worth it. I love analysts.

  9. Thanks for this video- actually dealing with nausea at the moment. I do have an unrelated question and wasn’t sure if it’s best to post on the newest video as you all are busy and not sure if you check older vids. I can’t seem to find anything on here for recommendation of caloric intake- how to calculate your caloric needs, nor a recommended calonutrient ration- ie. was percent of fat/protein/carbs to aim for. Any assistance with this would be greatly appreciated! I’ve done my best to search the site and can’t find these two specific issues. Many thanks!

  10. Thanks for this video- actually dealing with nausea at the moment. I do have an unrelated question and wasn’t sure if it’s best to post on the newest video as you all are busy and not sure if you check older vids. I can’t seem to find anything on here for recommendation of caloric intake- how to calculate your caloric needs, nor a recommended calonutrient ration- ie. was percent of fat/protein/carbs to aim for. Any assistance with this would be greatly appreciated! I’ve done my best to search the site and can’t find these two specific issues. Many thanks!

    1. The short answer is: if you’re eating a whole food, plant based diet it doesn’t matter. If you simply eat the foods that Dr. Greger, and science, recommend, it is virtually impossible to “go wrong.” Green leafies, berries, brassicas, onions, garlic, nuts, seeds, sprouts, legumes, whole/sprouted grains, melons, apples, citrus, spices, teas, cocoa, …..the list is endless. As has been stated on this site, this type of diet is nutrient dense and calorie dilute. It is virtually impossible to eat too overeat this type of food. Combine this with pushups, pullups and squats and you’re on the right track.

      1. thank you- still, is there a macronutrient ratio recommendation? I eat only whole plant foods, but within that can eat 90% carb and 5% protein/fat or 50%fat and 40% protein and 10% carbs all while eating those foods. Also, I can eat 1,000 calories a day or 6,000. There has to be some limit at some point and something to aim for ratio-wise and calorically.

  11. Some say, “Spirit is the healer” and the word spirit means breath, so yes, breathing is the key to many problems – mental, emotional and physical. And some scents encourage us to breathe more fully and freely and deeply. But don’t tell big pharma I told you guys this, ok? ;)

  12. Every time I get my goodbye message censored thus deleted I will delete a part of my own history here in return.
    Keep it up and in the end all of it will be gone and for what?

    The proliferation of mystery MD’s on NF is becoming intolerable, it invites damage by allowing a forum while at the same time masking the personal responsibilities of these individuals. This can have only one consequence, detriment to some random future readers and to NF itself,
    while none of the burden will be borne by the people using it as a cheap and easy status enhancement.

    The right to voice critical opinion is now also being tread upon, it is all a very much a turn for the worse and I’m worried for NF.
    As is I cannot in good conscience partake in this site anymore nor recommend it to anyone in my personal sphere anymore from this point forward.

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