Advertisement

Peppermint oil reduces gastric spasm during upper endoscopy: a randomized, double-blind, double-dummy controlled trial

      This paper is only available as a PDF. To read, Please Download here.
      Background: Gl endoscopy without general anesthesia causes a hyperperistaltic state in the stomach, which frequently necessitates the use of antispasmodic agents, such as hyoscine-N-butylbromide, but these drugs have side effects. Peppermint oil is harmless and acts locally to inhibit Gl smooth muscle contraction.
      Methods: A randomized double-blind, double-dummy, controlled trial was conducted in 100 patients to compare the antispasmodic effects of hyoscine-N-butylbromide administered intramuscularly and a placebo solution administered intraluminally by means of the endoscope, and also the effects of a placebo solution administered intramuscularly with those of a peppermint oil solution administered intraluminally. The percent change in diameter of the pyloric ring before and after the administrations was defined as the opening ratio, and the percent change in diameter between the maximally and minimally opened pyloric ring states was defined as the contraction ratio. Time until disappearance of the contraction ring(s) in the gastric antrum and side effects of the drugs were also determined.
      Results: The opening ratio was significantly higher in the peppermint oil administration group than in the hyoscine-N-butylbromide injection group. The contraction ratio after peppermint oil administration was significantly lower than that after hyoscine-N-butylbromide injection. The time required for disappearance of the antral contraction ring(s) was shorter in the peppermint oil group (97.1±11.4) than in the hyoscine-N-butylbromide group (185.9±10.1 s; p<0.0001). No significant side effects were associated with peppermint oil, whereas hyoscine-N-butylbromide injection produced side effects such as dry mouth, blurred vision, and urinary retention.
      Conclusions: Peppermint oil solution administered intraluminally can be used as an antispasmodic agent with superior efficacy and fewer side effects than hyoscine-N-butylbromide administered by intramuscular injection during upper endoscopy.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Gastrointestinal Endoscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Sparks MJ
        • O'Sullivan P
        • Herrington AA
        • Morcos SK
        Does peppermint oil relieve spasm during barium enema?.
        Br J Radiol. 1995; 68: 841-843
        • Treweeke P
        • Barrett NK
        Allergic reaction to Buscopan.
        Br J Radiol. 1987; 60: 417-418
        • Goei R
        • Nix M
        • Kessels AH
        • Ten Tusscher MP
        Use of antispasmodic drugs in double contrast barium enema examination: glucagon or buscopan?.
        Clin Radiol. 1995; 50: 553-557
        • Micklefield GH
        • Greving I
        • May B
        Effects of peppermint oil and caraway oil on gastroduodenal motility.
        Phytother Res. 2000; 14: 20-23
        • Sigmund CJ
        • McNally EF
        The action of a carminative on the lower esophageal sphincter.
        Gastroenterology. 1969; 56: 13-18
        • Somerville KW
        • Richmond CR
        • Bell GD
        Delayed release peppermint oil capsules (Colpermin) for the spastic colon syndrome: a pharmacokinetic study.
        Br J Clin Pharmacol. 1984; 18: 638-640
        • Nolen III, HW
        • Friend DR
        Menthol-beta-D-glucuronide: a potential prodrug for treatment of the irritable bowel syndrome.
        Pharm Res. 1994; 11: 1707-1711
        • Pittler MH
        • Ernst E
        Peppermint oil for irritable bowel syndrome: a critical review and metaanalysis.
        Am J Gastroenterol. 1998; 93: 1131-1135
        • Leicester RJ
        • Hunt RH
        Peppermint oil to reduce colonic spasm during endoscopy [letter].
        Lancet. 1982; II: 989
        • Kingham JG
        Peppermint oil and colon spasm [letter].
        Lancet. 1995; 346: 986
        • Asao T
        • Mochiki E
        • Suzuki H
        • Nakamura J
        • Hirayama I
        • Morinaga N
        • et al.
        An easy method for the intraluminal administration of peppermint oil before colonoscopy and its effectiveness in reducing colonic spasm.
        Gastrointest Endosc. 2001; 53: 172-177
        • Fink AM
        • Aylward GW
        Buscopan and glaucoma: a survey of current practice.
        Clin Radiol. 1995; 50: 160-164
        • Skucas J
        The use of antispasmodic drugs during barium enemas.
        AJR Am J Roentgenol. 1994; 162: 1323-1325
        • Hills JM
        • Aaronson PI
        The mechanism of action of peppermint oil on gastrointestinal smooth muscle. An analysis using patch clamp electrophysiology and isolated tissue pharmacology in rabbit and guinea pig.
        Gastroenterology. 1991; 101: 55-65
        • Beesley A
        • Hardcastle J
        • Hardcastle PT
        • Taylor CJ
        Influence of peppermint oil on absorptive and secretory processes in rat small intestine.
        Gut. 1996; 39: 214-219
        • Hawthorn M
        • Ferrante J
        • Luchowski E
        • Rutledge A
        • Wei XY
        • Triggle DJ
        The actions of peppermint oil and menthol on calcium channel dependent processes in intestinal neuronal and cardiac preparations.
        Aliment Pharmacol Ther. 1988; 2: 101-118
        • Chen JD
        • Zou X
        • Lin X
        • Ouyang S
        • Liang J
        Detection of gastric slow wave propagation from the cutaneous electrogastrogram.
        Am J Physiol. 1992; 277: G424-G430