A spoonful of peppermint helps the meal go down

Imagine that by eating a delicious meal in your favorite restaurant, your joy is reduced to nothing because of the difficulty in swallowing your food, followed by a chest pain.

If you consult a doctor about these symptoms and there is no evidence that the chest pain is of cardiac origin, you could be diagnosed with some kind of esophageal disorder.

Peppermint can help relieve swallowing difficulty and non-cardiac chest pain experienced by some patients with esophageal disorders, reported researchers at the Medical University of South Carolina (MUSC) in Science and digestive diseases. Of the 38 patients included in the MUSC pilot study, 63 percent overall reported improvement in symptoms. Patients were recruited from the Esophageal Disorders Clinic of the MUSC Health Digestive Disease Center.

"Peppermint oil is a recognized agent in the treatment of irritable bowel syndrome. We have tried to examine its effect on patients with swallowing problems and chest pain without apparent cause," states Mohamed Khalaf, MD, researcher in Esophageal Disorders at the MUSC Health Digestive Disease Center and first author of the article.

"Our findings suggest that peppermint can help prevent these symptoms by releasing the smooth muscle from the bottom of the esophagus," says Donald O. Castell, MD, Professor Emeritus at MUSC College of Medicine, renowned gastroenterologist national, and the main author of the article.

Peppermint oil is known to have therapeutic effects in many disorders because of its relaxing properties for the muscles. However, only two previous studies have studied its role in the upper digestive tract.

The MUSC study found that patients who took peppermint oil tablets before eating felt better after meals than those who did not take them. Those with both non-cardiac chest pain and unobstructed difficulty in swallowing were the most advantaged: 73% reported feeling better. Among patients with only one of the symptoms, those with noncardiac chest pain exhibited a more positive response of peppermint oil (63%) than those with difficulty swallowing (53%). %).

The results were even better in patients with spastic disorders of the esophagus: 83% reported feeling better or slightly better. Although less known than esophageal disorders such as acid reflux, spastic disorders of the esophagus can also disrupt the patient's life. In these conditions, the esophagus suffers painful spasms that can affect the diet. Because spasms occur only occasionally, these disorders are difficult to diagnose and treat.

The current standard of care for these disorders involves testing several drugs, including tricyclic antidepressants and calcium channel blockers, and hope that it works.

Peppermint is an attractive first line of defense for these patients with intermittent symptoms as they can take it freely as symptoms develop.

"In this study, patients who had difficulty swallowing had taken two pieces of commercially available peppermint just before meals, and those with chest pain took the peppermint tablets as needed," Khalaf explains.

This study highlights the effects of the so-called Charleston method, which advocates a treatment strategy of "starting slowly and slowly". The Charleston approach differs from the current standard of care in that it uses peppermint oil as a first attempt to relieve symptoms.

Castell and Khalaf warn patients that patients must first be examined by a doctor to rule out heart disease and that they undergo a procedure called endoscopy in order to eliminate any obstruction before being offered a first-line treatment with peppermint. Endoscopy involves inserting a flexible tube with a light and a camera into the esophagus.

One of the drawbacks of the study was that the researchers did not know the exact dosage of peppermint, as it was a commercial candy (of which only one type was effective) with an exclusive recipe. Another study was that the study relied on self-reporting by patients to determine if symptoms were improving.

Although the preliminary results of this study are promising, they must be confirmed by a trial comparing the results in patients receiving a specific dose of peppermint oil and those receiving only one placebo.

Meanwhile, however, patients who have been diagnosed with spastic disorders of the esophagus and who do not suffer from heart disease or obstruction may try to use peppermint to see if it relieves their symptoms.

"Given the safety profile, low cost and widespread availability, the empirical use of peppermint oil poses no risk," says Khalaf.

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Founded in 1824 in Charleston, MUSC is the oldest medical school in the South, as well as the only integrated academic health sciences center, with a unique mandate to serve the state through education, research and patient care. Each year, MUSC trains and trains more than 3,000 students and 700 residents from six colleges: dentistry, graduate studies, health professions, medicine, nursing and pharmacy. As the state's leader in obtaining biomedical research funds, MUSC reached a new peak in 2018, bringing in more than $ 276.5 million. For more information on academic programs, visit http: // musc.Edu.

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