Impact of Peppermint Therapy on Dysphagia and Non-cardiac Chest Pain: A Pilot Study

Dig Dis Sci. 2019 Aug;64(8):2214-2218. doi: 10.1007/s10620-019-05523-8. Epub 2019 Feb 15.

Abstract

Background: Due to its smooth muscle relaxing properties, peppermint oil (PO) may relieve dysphagia and chest pain due to esophageal motility disorders.

Aim: To explore the impact of PO on dysphagia and/or chest pain in patients referred for motility testing.

Methods: Patients initiated on PO for dysphagia and/or chest pain from 2013 to 2016 were identified. We excluded patients with obstructing esophageal lesions, patients lost to follow-up, and those with preexisting cardiac conditions. Concentrated PO was given as commercially available dissolvable peppermint tablets; two tablets before meals were prescribed to patients with dysphagia and on an as-needed basis for patients with chest pain. Patient-reported symptom response was assessed using a modified five-point Likert scale.

Results: Thirty-eight patients were included. Twenty-four patients (63%) reported improvement; 12 were much better and 12 were slightly better. Fourteen experienced no change and none reported feeling worse. Based on pre-treatment HRM, patients with distal esophageal spasm (DES) (n = 10) and esophagogastric junction outflow obstruction (EGJOO) (n = 8) appeared to demonstrate the best subjective improvement (83% and 100%, respectively) (P < 0.05).

Conclusion: PO appears to provide symptomatic relief in some patients with dysphagia and CP. Presence of a well-defined manometric disorder, particularly DES or EGJOO, appeared to predict response.

Keywords: Chest pain; Dysphagia; Esophagus; Motility.

MeSH terms

  • Aged
  • Chest Pain / diagnosis
  • Chest Pain / drug therapy*
  • Chest Pain / physiopathology
  • Deglutition / drug effects*
  • Deglutition Disorders / diagnosis
  • Deglutition Disorders / drug therapy*
  • Deglutition Disorders / physiopathology
  • Esophagus / drug effects*
  • Esophagus / physiopathology
  • Female
  • Gastrointestinal Agents / administration & dosage*
  • Gastrointestinal Agents / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Plant Oils / administration & dosage*
  • Plant Oils / adverse effects
  • Recovery of Function
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Gastrointestinal Agents
  • Plant Oils
  • peppermint oil