Peppermint oil effects on the gut microbiome in children with functional abdominal pain

Authors: THAPA, SANTOSH - Texas Children'S Hospital; LUNA, RUTH ANN - Texas Children'S Hospital; CHUMPITAZI, BRUNO - Children'S Nutrition Research Center (CNRC); OEZGUEN, NUMAN - Baylor College Of Medicine; ABDEL-RAHMAN, SUSAN - University Of Missouri; GARG, UTTAM - Children'S Mercy Hospital; MUSAAD, SALMA - Children'S Nutrition Research Center (CNRC); VERSALOVIC, JAMES - Baylor College Of Medicine; KEARNS, GREGORY - Texas Christian University; SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)

Submitted to: Clinical and Translational science
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/20/2021
Publication Date: 4/15/2022
Citation: Thapa, S., Luna, R., Chumpitazi, B.P., Oezguen, N., Abdel-Rahman, S.M., Garg, U., Musaad, S., Versalovic, J., Kearns, G.L., Shulman, R.J. 2022. Peppermint oil effects on the gut microbiome in children with functional abdominal pain. Clinical and Translational science. 15:1036-1049. https://doi.org/10.1111/cts.13224.
DOI: https://doi.org/10.1111/cts.13224

Interpretive Summary: Peppermint oil has been used for thousands of years to treat digestive problems. Despite this, how peppermint oil works is unclear. In this study, we found that peppermint oil can modestly change the composition of the bacteria in the gut. Given that an abnormal gut bacteria population is associated with many digestive problems, changing the bacterial composition may be one way peppermint oil relieves digestive problems.

Technical Abstract: Peppermint oil (PMO) is effective in the treatment of functional abdominal pain disorders, but its mechanism of action is unclear. Evidence suggests PMO has microbicidal activity. We investigated the effect of three different doses of PMO on gut microbiome composition. Thirty children (7–12 years of age) with functional abdominal pain provided a baseline stool sample prior to randomization to 180, 360, or 540 mg of enteric coated PMO (10 participants per dose). They took their respective dose of PMO (180 mg once, 180 mg twice, or 180 mg thrice daily) for 1 week, after which the stool collection was repeated. Baseline and post- PMO stools were analyzed for microbiome composition. There was no difference in alpha diversity of the gut microbiome between the baseline and post-PMO treatment. Principal coordinate analysis revealed no significant difference in overall bacterial composition between baseline and post-PMO samples, as well as between the PMO dose groups. However, the very low abundant Collinsella genus and three operational taxonomic units (one belonging to Collinsella) were significantly different in samples before and after PMO treatment. The Firmicutes/Bacteroidetes ratio was lower in children who received 540 mg of PMO compared to the 180 mg and 360 mg dose groups (p = 0.04). Network analysis revealed separation between pre- and post-PMO fecal samples with the genus Collinsella driving the post-PMO clusters. PMO administration appeared to impact only low abundance bacteria. The 540 mg PMO dose differentially impacted the Firmicutes/Bacteroidetes ratio. A higher dose and/or longer duration of treatment might yield different results.