Gastrointestinal complaints can be very unpleasant and stressful for those affected. In particular, pain and cramping colic significantly impair functioning and quality of life. High-dose peppermint and caraway oil in capsule form has been shown to be an effective and well-tolerated treatment option in patients of various age groups. Painful abdominal cramps are relieved quickly and effectively.
If no organ pathological cause can be identified for gastrointestinal complaints such as flatulence, abdominal pain or cramps, bloating, diarrhea or constipation, and if these symptoms occur over a period of at least 6 months, they are referred to as functional complaints. In many patients, there is an overlap of symptoms of the upper and lower gastrointestinal tract, the former being classified as functional dyspepsia and irritable stomach and the latter as irritable bowel syndrome [1].
Gut-brain axis: multifactorial interaction structure
Abdominal cramps are caused by spasmodic contraction of certain muscles in the digestive tract, which is associated with impaired transport of the food pulp. Dense innervation in the stomach and intestines transmits pain signals and can cause colic. The parasympathetic nerve fibers originating from the vagus nerve promote the digestive process, while the sympathetic nerve cords inhibit the activity of the stomach and intestines. The interplay of autonomic and central nervous processes is described in the explanatory concept of the gut-brain axis (“brain-gut axis”) [2]. Motility disorders and visceral hypersensitivity act as key mechanisms [3,4]. As a result, visceral allodynia can lead to the subjective perception of flatulence even with only a slight increase in gas formation. In addition to trigger factors such as stress and nutrition, changes in the intestinal microbiome also play a role in this multifactorial interaction.
Peppermint and caraway oil have a relaxing and analgesic effect
There are various methods which can help relieve functionally induced abdominal cramps, such as heat applications, abstaining from alcohol and nicotine, sufficient fluid intake, stomach-friendly diet, stress reduction. As a medicinal measure, antispasmodic substances can provide relief. For functionally induced abdominal cramps, the essential oils of the two medicinal plants peppermint and caraway have proven to be very effective. Peppermint oil causes relaxation of gastrointestinal tract muscles via inhibition of voltage-dependent calcium influx [5]. In addition to these antispasmodic properties, the analgesic effects have also been proven. Binding of menthol to the cold receptor TRPM8 elicits a cold signal and has an inhibitory effect on pain transmitting nerves. Caraway oil has carminative properties, which leads to a decrease in surface tension and inhibition of gas and foam formation in the intestine. In addition, caraway oil has a selective effect on the growth of pathogenic germs without, however, leading to negative effects on desirable intestinal bacteria [10].
| Multiple mechanisms of action Caraway oil and peppermint oil have analgesic and carminative effects. Peppermint oil activates the cold sensors of the intestinal nerves, which leads to the calming of neighboring pain sensors, inducing a massive reduction in their sensitivity. Caraway oil has an activity-inhibiting effect on gas-forming bacteria, so that flatulence is reduced [10]. Moreover, the intestinal microbiome is positively influenced by a selective effect on pathogenic bacteria. |
In combination, the two essential oils, on the one hand, reduce unpleasant intestinal stimuli and dull the perception of pain. The active ingredient combination menthacarin (Carmenthin®) [6] contains peppermint oil and caraway oil in high dosage and has been shown to relieve functional digestive disorders such as pain, cramps, flatulence, and feelings of pressure and fullness [7], with the symptom-relieving effect occurring rapidly and many patients experiencing relief from symptoms after just one week [8]. The ingredients are contained in an enteric-coated soft capsule that only dissolves in the intestine, where it can exert its targeted effect. The tolerability of this herbal preparation is good even with frequent use [9]. In Switzerland, this phytotherapeutic drug is approved for use by health insurers for patients aged 12 years and older, provided the indication is appropriate [6].
Literature:
- Madisch A: Journal of Phytotherapy 2013; 34(06): 270-273.
- Matricon J, et al: Aliment Pharmacol Ther 2012; 36(11-12): 1009-1031.
- Madisch A, et al: Dtsch Arztebl Int 2018; 115: 222-232.
- Mari A, et al: Adv Ther 2019; 36(5): 1075-1084.
- Deutsche Apothekerzeitung (DAZ): DAZ 2018 (9): 73, 01.03.2018.
- Carmenthin®: www.compendium.ch
- Holtmann G, Stracke B: Gastroenterol 2016; 54 (8).
- Noe S, et al: Internist 2016; 57 (Suppl. 1), S42-S42.
- Madisch A, et al: Internist 2015(56) (Suppl 1), 28.
- Pharmaceutical Newspaper, 18.05.2016, www.pharmazeutische-zeitung.de
- Krueger D, et al: J Physiol 2016; 594: 357-372.
- Chumpitazi BP, Kearns GL, Shulman RJ: AP&T 2018; 47(6): 738-752.
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