CLINICAL APPLICATION OF L-MENTHOL IN THE UPPER GASTROINTESTINAL ENDOSCOPIC PROCEDURE.

Abstract

Peppermint oil, which suppresses gastric peristalsis during esophagogastroduodenoscopy (EGD), is effective for determining the margin of a gastric tumor. This study was conducted to evaluate the utility of an L-menthol preparation for suppressing gastric peristalsis and for diagnosing gastric tumors. The study examined 124 patients who underwent EGD between January and April 2012. After 20 mL of 0.8% L-menthol was sprayed directly onto the mucosal surface of the gastric antrum, the degree of peristalsis suppression in the antrum was evaluated. The effectiveness of L-menthol for identifying new gastric tumors and determining tumor margins was also evaluated. Gastric peristalsis was suppressed in 88.5% (69/78) of patients, with complete suppression of peristalsis achieved in 78.2%. L-menthol exerted a higher peristalsis-suppressive effect in patients with endoscopic gastric mucosal atrophy (93.3%, 56/60) than in patients without atrophy (72.2%, 13/18) (p = .014). L-menthol application caused the detection of new gastric tumors in 1.6% (2/124) of patients and clarification of the margin of three lesions (in 3 patients) identified as having an unclear margin before L-menthol application. These results suggest that L-menthol is effective for suppressing gastric peristalsis during EGD and suggest that it is useful for identifying gastric tumors and for determining tumor margins.