 Irritable bowel syndrome is a chronic, episodic, intestinal disorder characterized by abdominal pain and altered bowel habits, affecting one in seven Americans, though most go undiagnosed. It can have substantial impact on well-being and health, and doctors underestimate the impact the disease can have, particularly the pain, the discomfort. Using some measures, the health-related quality of life of irritable bowel sufferers can rival those of much more serious disorders such as diabetes, kidney failure, and inflammatory bowel disease. So the first step towards successful treatment is for doctors to acknowledge the condition and not dismiss the patient as just hysterical or something. Another reason sufferers often don't seek medical care may be the lack of effectiveness of available treatments. There is a huge unmet therapeutic need. Since there's no cure for IBS, treatment is targeted to alleviate the symptoms. The typical anti-spasmodic drugs can cause side effects such as dry mouth, dizziness, blurred vision, confusion, and fall risk. But there are new drugs on the market now like lube per stone, which can cost $2,000 a year, and cause, as side effects, many of the symptoms you're trying to treat. Lanacletide is one of the newest $3,000 a year, and again can cause the very problems it's designed to help. And the depressants are commonly given, but may take 4 to 6 weeks to help for a Prozac or Cilex, up to 12 weeks for Paxil, and have their own array of side effects, including sexual dysfunction caused by these three drugs in over 70% of the people who take them. There's got to be a better way. Acupuncture works, but no better than placebo. What's placebo acupuncture? It's where you poke people with a fake needle away from any known acupuncture points, yet that worked just as well as real acupuncture, showing the power of the placebo effect. I've talked about the ethics of so many doctors effectively passing off sugar pills as effective drugs who argue the ends justify the means. There's actually a way to harness the placebo effect without lying to patients, though. You tell them it's a sugar pill. Patients with irritable bowel syndrome were randomized to either get nothing or a prescription medicine bottle of placebo pills with a label clearly marked placebo pills. Take two pills twice a day. I kid you not. And, lo and behold, it worked! That's how powerful the placebo effect can be for irritable bowel. They conclude that for some disorders, it may be appropriate for clinicians to recommend that patients try an inexpensive and safe placebo. Indeed, sugar pills probably won't cost $3,000 a year, but is there a safe alternative that actually works, works? Nine randomized placebo-controlled studies have found peppermint oil. To be a safe and effective treatment for irritable bowel syndrome. A few adverse events were reported, but were mild and transient in nature, such as a peppermint taste, peppermint smell, and a cooling sensation around one's bottom. Whereas in some of the head-to-head peppermint versus drug studies, some of the drug side effects were so unbearable they had to drop out of the study. This suggests that it might be a reasonable approach for clinicians to treat IBS patients with peppermint oil as a first-line therapy before trying anything else. Now the longest trial only lasted 12 weeks, so we don't know about long-term efficacy, though the benefits may last at least a month after stopping. Thought, perhaps, to be due to lasting changes in our gut flora. The studies used peppermint oil capsules so they could match them with placebo pills. What about peppermint tea? It's never been tested, but one might assume it wouldn't be concentrated enough. But a quarter cup of fresh peppermint leaves has as much peppermint oil as some of the capsule doses they used in the studies, which one could easily blend into a smoothie or with frozen berries to make something like my pink juice recipe. You can grow mint right on your window cell. We doctors need effective treatments that are cheap, safe, and available. This is particularly relevant now as newer and more expensive drugs have either failed the work or have been withdrawn from the market owing to concerns about serious adverse events. And just like it might be a good idea to only eat foods with ingredients you can pronounce, it may be better to try some mint before novel pharmacological approaches, such as the new dual mu-opioid agonist delta antagonist drug with a name like J&J 27018966.