By preventing colon spasms, peppermint oil can both reduce the pain and discomfort of colonoscopies for the patient, as well as make insertion and withdrawal of scope easier for the doctor.
What to Take Before a Colonoscopy
Peppermint was not officially described—by a white guy—until 1696, but we’ve probably been using it for at least a few thousand years. After-dinner mints are used to reduce the gastrocolic reflex, the urge to defecate following a meal. The stretching of nerves in the stomach triggers spasms in the colon, which makes sense—our body’s making way for more food coming down the pipe. What peppermint does is relax the muscles of the colon.
If you take circular strips of human colons removed during surgery and just lay them on a table, they spontaneously contract on their own about three times a minute. Isn’t that kind of creepy? But then if you drop more and more menthol from peppermint on them, the contractions still happen, but they’re not as strong. Well, if peppermint can relax the colon and reduce spasms, might it be useful during a colonoscopy, as first suggested over 30 years ago. See, colon spasm can hinder the progress of the scope and cause the patient discomfort. So, they tried spraying some peppermint oil out the tip, and in every case, the spasm was relieved within 30 seconds. 30 seconds is a long time, though, when you have this snaking inside of you; so, the next innovation would be to just use a hand pump to flood the whole colon with a peppermint oil solution before the colonoscopy. Simple, safe, and convenient alternative to injecting an anti-spasm drug, which can have an array of side effects, whereas instilling some peppermint solution, dyed blue in the picture here, and within 20 seconds, the spasming colon opens right up.
Similar results were attained with upper endoscopy, working better, quicker, safer than the drug, and also when mixed into barium enemas. But wouldn’t it be easier to just swallow some peppermint oil instead of squirting it up the rectum? Premedication with peppermint oil in colonoscopy. Just popping a few peppermint oil capsules four hours before the procedure sped up the entire process, and increased both doctor and patient satisfaction, because reducing colon spasm reduces pain and discomfort, and makes the scope easier to insert and withdraw.
Pain and discomfort are not the only barriers to signing people up for colonoscopies, though. Even if peppermint oil makes it go seamlessly, there’s still the dreaded bowel prep, where you have to drink quarts of a powerful liquid laxative before the procedure to completely clean you out. And, aside from the pain, a fear of complications and feelings of embarrassment and vulnerability.
Serious complications occur in about 1 in every 350 colonoscopies: everything from perforations and bleeding to death. Perforations occur when the tip of the scope punches through wall of the colon, or because they inflated the colon too much—they have to pump in air so they can look around, or when they’re trying to cauterize some bleeding caused by like a biopsy, which, in extremely rare instances, can ignite some residual gas and cause the colon to explode.
Death from colonoscopy is rare, occurring only in about 1 in every thousand procedures, but with about 15 million colonoscopies performed annually in the United States, colonoscopies kill about 15,000 Americans every year, raising the question: do the benefits outweigh the risks? I’ll cover that next.
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.
- A Shavakhi, S K Ardestani, M Tak, M Goli, A H Keshteli. Premedication with peppermint oil capsules in colonoscopy: a double blind placebo-controlled randomized trial study. Acta Gastroenterol Belg. 2012 Sep;75(3):349-53.
- L I Spirling, I R Daniels. Botanical perspectives on health peppermint: more than just an after-dinner mint. J R Soc Promot Health. 2001 Mar;121(1):62-3.
- T Asao, H Kuwano, M Ide, I Hirayama, J I Nakamura, K I Fujita, R Horiuti. Spasmolytic effect of peppermint oil in barium during double-contrast barium enema compared with Buscopan. Clin Radiol. 2003 Apr;58(4):301-5.
- R J Leicester, R H Hunt. Peppermint oil to reduce colonic spasm during endoscopy. Lancet. 1982 Oct 30;2(8305):989.
- T Asao, E Mochiki, H Suzuki, J Nakamura, I Hirayama, N Morinaga, H Shoj, Y Shitara, H Kuwano. An easy method for the intraluminal administration of peppermint oil before colonoscopy and its effectiveness in reducing colonic spasm. Gastrointest Endosc. 2001 Feb;53(2):172-7.
- N Hik, H Kurosaka, Y Tatsutomi, S Shimoyama, E Tsuji, J Kojima, N Shimizu, H Ono, T Hirooka, C Noguchi, K Mafune, M Kaminishi. Peppermint oil reduces gastric spasm during upper endoscopy: a randomized, double-blind, double-dummy controlled trial. Gastrointest Endosc. 2003 Apr;57(4):475-82.
- H Manner, N Plum, O Pech, C Ell, M D Enderle. Colon explosion during argon plasma coagulation. Gastrointest Endosc. 2008 Jun;67(7):1123-7.
- S A McLachlan, A Clements, J Austoker. Patients' experiences and reported barriers to colonoscopy in the screening context--a systematic review of the literature. Patient Educ Couns. 2012 Feb;86(2):137-46.
- C W Ko, J A Dominitz. Complications of colonoscopy: magnitude and management. Gastrointest Endosc Clin N Am. 2010 Oct;20(4):659-71.
- T H Lüning, M E Keemers-Gels, W B Barendregt, A C Tan, C Rosman. Colonoscopic perforations: a review of 30,366 patients. Surg Endosc. 2007 Jun;21(6):994-7.
- A Amato, R Liotta, F Mulè. Effects of menthol on circular smooth muscle of human colon: analysis of the mechanism of action. Eur J Pharmacol. 2014 Oct 5;740:295-301.
- E P Whitlock, J S Lin, E Liles, T L Beil, R Fu. Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2008 Nov 4;149(9):638-58.
- S J deRoux, A Sgarlato. Upper and lower gastrointestinal endoscopy mortality: the medical examiner's perspective. Forensic Sci Med Pathol. 2012 Mar;8(1):4-12.
Images thanks to darwin Bell via Flickr.
Peppermint was not officially described—by a white guy—until 1696, but we’ve probably been using it for at least a few thousand years. After-dinner mints are used to reduce the gastrocolic reflex, the urge to defecate following a meal. The stretching of nerves in the stomach triggers spasms in the colon, which makes sense—our body’s making way for more food coming down the pipe. What peppermint does is relax the muscles of the colon.
If you take circular strips of human colons removed during surgery and just lay them on a table, they spontaneously contract on their own about three times a minute. Isn’t that kind of creepy? But then if you drop more and more menthol from peppermint on them, the contractions still happen, but they’re not as strong. Well, if peppermint can relax the colon and reduce spasms, might it be useful during a colonoscopy, as first suggested over 30 years ago. See, colon spasm can hinder the progress of the scope and cause the patient discomfort. So, they tried spraying some peppermint oil out the tip, and in every case, the spasm was relieved within 30 seconds. 30 seconds is a long time, though, when you have this snaking inside of you; so, the next innovation would be to just use a hand pump to flood the whole colon with a peppermint oil solution before the colonoscopy. Simple, safe, and convenient alternative to injecting an anti-spasm drug, which can have an array of side effects, whereas instilling some peppermint solution, dyed blue in the picture here, and within 20 seconds, the spasming colon opens right up.
Similar results were attained with upper endoscopy, working better, quicker, safer than the drug, and also when mixed into barium enemas. But wouldn’t it be easier to just swallow some peppermint oil instead of squirting it up the rectum? Premedication with peppermint oil in colonoscopy. Just popping a few peppermint oil capsules four hours before the procedure sped up the entire process, and increased both doctor and patient satisfaction, because reducing colon spasm reduces pain and discomfort, and makes the scope easier to insert and withdraw.
Pain and discomfort are not the only barriers to signing people up for colonoscopies, though. Even if peppermint oil makes it go seamlessly, there’s still the dreaded bowel prep, where you have to drink quarts of a powerful liquid laxative before the procedure to completely clean you out. And, aside from the pain, a fear of complications and feelings of embarrassment and vulnerability.
Serious complications occur in about 1 in every 350 colonoscopies: everything from perforations and bleeding to death. Perforations occur when the tip of the scope punches through wall of the colon, or because they inflated the colon too much—they have to pump in air so they can look around, or when they’re trying to cauterize some bleeding caused by like a biopsy, which, in extremely rare instances, can ignite some residual gas and cause the colon to explode.
Death from colonoscopy is rare, occurring only in about 1 in every thousand procedures, but with about 15 million colonoscopies performed annually in the United States, colonoscopies kill about 15,000 Americans every year, raising the question: do the benefits outweigh the risks? I’ll cover that next.
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.
- A Shavakhi, S K Ardestani, M Tak, M Goli, A H Keshteli. Premedication with peppermint oil capsules in colonoscopy: a double blind placebo-controlled randomized trial study. Acta Gastroenterol Belg. 2012 Sep;75(3):349-53.
- L I Spirling, I R Daniels. Botanical perspectives on health peppermint: more than just an after-dinner mint. J R Soc Promot Health. 2001 Mar;121(1):62-3.
- T Asao, H Kuwano, M Ide, I Hirayama, J I Nakamura, K I Fujita, R Horiuti. Spasmolytic effect of peppermint oil in barium during double-contrast barium enema compared with Buscopan. Clin Radiol. 2003 Apr;58(4):301-5.
- R J Leicester, R H Hunt. Peppermint oil to reduce colonic spasm during endoscopy. Lancet. 1982 Oct 30;2(8305):989.
- T Asao, E Mochiki, H Suzuki, J Nakamura, I Hirayama, N Morinaga, H Shoj, Y Shitara, H Kuwano. An easy method for the intraluminal administration of peppermint oil before colonoscopy and its effectiveness in reducing colonic spasm. Gastrointest Endosc. 2001 Feb;53(2):172-7.
- N Hik, H Kurosaka, Y Tatsutomi, S Shimoyama, E Tsuji, J Kojima, N Shimizu, H Ono, T Hirooka, C Noguchi, K Mafune, M Kaminishi. Peppermint oil reduces gastric spasm during upper endoscopy: a randomized, double-blind, double-dummy controlled trial. Gastrointest Endosc. 2003 Apr;57(4):475-82.
- H Manner, N Plum, O Pech, C Ell, M D Enderle. Colon explosion during argon plasma coagulation. Gastrointest Endosc. 2008 Jun;67(7):1123-7.
- S A McLachlan, A Clements, J Austoker. Patients' experiences and reported barriers to colonoscopy in the screening context--a systematic review of the literature. Patient Educ Couns. 2012 Feb;86(2):137-46.
- C W Ko, J A Dominitz. Complications of colonoscopy: magnitude and management. Gastrointest Endosc Clin N Am. 2010 Oct;20(4):659-71.
- T H Lüning, M E Keemers-Gels, W B Barendregt, A C Tan, C Rosman. Colonoscopic perforations: a review of 30,366 patients. Surg Endosc. 2007 Jun;21(6):994-7.
- A Amato, R Liotta, F Mulè. Effects of menthol on circular smooth muscle of human colon: analysis of the mechanism of action. Eur J Pharmacol. 2014 Oct 5;740:295-301.
- E P Whitlock, J S Lin, E Liles, T L Beil, R Fu. Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2008 Nov 4;149(9):638-58.
- S J deRoux, A Sgarlato. Upper and lower gastrointestinal endoscopy mortality: the medical examiner's perspective. Forensic Sci Med Pathol. 2012 Mar;8(1):4-12.
Images thanks to darwin Bell via Flickr.
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What to Take Before a Colonoscopy
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Content URLDoctor's Note
I was shocked to find out how risky colonoscopies are, but dying from colon cancer is no walk in the park either. There’s got to be a better way, and I cover that topic in my video, Should We All Get Colonoscopies Starting at Age 50?
For more on iatrogenic (doctor-induced) risks of various medical procedures, see:
- Cancer Risk From CT Scan Radiation
- Do Dental X-Rays Cause Brain Tumors?
- Why Prevention is Worth a Ton of Cure
- How Doctors Responded to Being Named a Leading Killer
You can also learn more about the benefits of all kinds of mint in:
- Antioxidants in a Pinch
- Reducing Radiation Damage with Ginger and Lemon Balm
- Enhancing Athletic Performance with Peppermint
- Peppermint Aromatherapy for Nausea
- Peppermint Oil for Irritable Bowel Syndrome
And what about preventing colon cancer in the first place? See:
- Starving Cancer with Methionine Restriction
- Turmeric Curcumin and Colon Cancer
- Phytates for the Prevention of Cancer
- Stool pH and Colon Cancer
- Solving a Colon Cancer Mystery
- Putrefying Protein and “Toxifying” Enzymes
- Resistant Starch and Colon Cancer
- Gut Dysbiosis: Starving Our Microbial Self
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