L-Menthol for Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis

Qin, You; Li, Lan; Chen, Zhidong; Chen, Lin; Chen, Xia; Liu, Youping

doi:10.14309/ctg.0000000000000252

Cited by 9 publications

(10 citation statements)

References 62 publications

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“…In addition, a few studies have described the efficacy and safety of menthol in clinical practice (Alammar et al, 2019;Ford et al, 2008;Pittler and Ernst, 1998;Li et al, 2019; National Collaborating Centre for Nursing and Supportive Care (UK), 2008). Moreover, accumulating evidence from clinical trials has shown that directly spraying L-menthol onto the gastrointestinal mucosa significantly improves spasms; it also improves the adenoma detection rate (ADR) during an endoscopic procedure (You et al, 2020). In 2011, a study proposed that during upper gastrointestinal endoscopy, direct endoscopic spraying of L-menthol inhibits gastric peristalsis with almost no adverse reactions (Hiki et al, 2011a;Hiki et al, 2011b).…”

Section: Clinical Applicationmentioning

confidence: 99%

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Menthol: An underestimated anticancer agent

et al. 2023

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Menthol, a widely used natural, active compound, has recently been shown to have anticancer activity. Moreover, it has been found to have a promising future in the treatment of various solid tumors. Therefore, using literature from PubMed, EMBASE, Web of Science, Ovid, ScienceDirect, and China National Knowledge Infrastructure databases, the present study reviewed the anticancer activity of menthol and the underlying mechanism. Menthol has a good safety profile and exerts its anticancer activity via multiple pathways and targets. As a result, it has gained popularity for significantly inhibiting different types of cancer cells by various mechanisms such as induction of apoptosis, cell cycle arrest, disruption of tubulin polymerization, and inhibition of tumor angiogenesis. Owing to the excellent anticancer activity menthol has demonstrated, further research is warranted for developing it as a novel anticancer agent. However, there are limitations and gaps in the current research on menthol, and its antitumor mechanism has not been completely elucidated. It is expected that more basic experimental and clinical studies focusing on menthol and its derivatives will eventually help in its clinical application as a novel anticancer agent.

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Section: Clinical Applicationmentioning

confidence: 99%

“…However, other researchers have pointed out that L-menthol could indeed alleviate adverse reactions such as gastrointestinal peristalsis and even spasm during endoscopy. Thus, the correlation between L-menthol and ADR requires further investigation (Shah et al, 2019;Aziz et al, 2020;You et al, 2020).…”

Section: Clinical Applicationmentioning

confidence: 99%

Menthol: An underestimated anticancer agent

et al. 2023

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“…< 1 on a 0-10 scale, with zero indicating ‘none at all’) and were not different between gels. Menthol is known to alleviate symptoms related to irritable bowel syndrome and functional dyspepsia, and help relax the smooth muscle of the GI tract [ 35 ]. Energy gels are specifically formulated for consumption during exercise, and are commonly provided by race directors for competitors during organized endurance events.…”

Section: Discussionmentioning

confidence: 99%

Athlete perceptions of flavored, menthol-enhanced energy gels ingested prior to endurance exercise in the heat

Vogel

Ross

Swann

et al. 2022

Journal of the International Society of Sports Nutrition

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Background L-menthol evokes a cooling sensation by activating cold sensing cation channels. Menthol-enhanced fluids can be ergogenic during exercise in the heat by improving thermal perception; hence, the addition of menthol to energy gels may benefit athletes. Previously, unflavored menthol gels were deemed acceptable at 0.1% concentration, but no research has been undertaken on menthol gels with additional flavoring. Therefore, we determined athlete perceptions of flavored energy gels with different menthol concentrations. Methods With a randomized, crossover, double-blind, placebo-controlled design, 27 athletes (34.8 ± 6.7 y, 9 females) ingested an energy gel with either 0.1%, 0.3%, 0.5%, or 0.7% menthol concentration, or a non-menthol, flavor-matched placebo (CON), on separate occasions before outdoor exercise. Gels were rated for cooling sensation, irritation, flavor, and overall experience on 100-point sensory and hedonic labeled magnitude scales. The duration of any cooling sensation was also reported. Results All menthol gels delivered a greater cooling sensation compared to CON (7.4 ± 8.1 AU) with a significantly greater response for 0.7% (59.9 ± 20.5 AU) and 0.5% (57.7 ± 21.8 AU), compared to all others. Irritation was higher for all menthol gels compared to CON (3.4 ± 7.2 AU) and for 0.7% compared to 0.1% (31.1 ± 31.0 vs. 16.3 ± 21.0 AU, p = 0.041), with none rated above a ‘mild-moderate’ intensity. The menthol gels delivered a significantly longer cooling sensation duration (12.3-19.6 min) versus CON (2.2 ± 4.8 min) with no difference between menthol gels. Conclusion A flavored menthol energy gel at 0.1–0.7% concentration provides a cooling sensation for athletes when ingested before exercise. The 0.5% concentration is recommended to maximize the cooling sensation whilst minimizing irritation.

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“…l -Menthol has been shown to effectively suppress gastric peristalsis with few AEs while intraluminally administered during EGD in the general population 22 , 23 , 28 – 30 . Although its application in elderly patients was mentioned in some studies, no well-designed RCT was conducted until now.…”

Section: Discussionmentioning

confidence: 99%

Antiperistaltic effect and safety of l-menthol for esophagogastroduodenoscopy in the elderly with contraindication to hyoscine-N-butylbromide

Yang

Chen

Hou

et al. 2022

Sci Rep

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Hyoscine-N-butylbromide (HBB) is the most used antiperistaltic agent during esophagogastroduodenoscopy (EGD). However, almost half of the elderly have a contraindication to HBB. We aimed to evaluate l-menthol’s antiperistaltic effect and safety for EGD in the elderly with contraindication to HBB. This prospective, randomized, double-blind, placebo-controlled study screened 86 elderly patients (≥ 65 years old) scheduled to undergo EGD, and 52 of them with contraindication to HBB were enrolled. The participants were randomized to receive l-menthol (n = 26) or a placebo (n = 26), which was locally sprayed on the gastric antrum endoscopically. The proportion of patients with no or mild peristalsis after medication and at the end of EGD was significantly higher in the l-menthol group (76.9%) than in the placebo group (11.5%, p < 0.001). l-Menthol administration significantly reduced peristaltic grade, improved contraction parameters, and eased intragastric examination relative to the placebo (p < 0.001, respectively). Hemodynamic changes, adverse events, and discomfort levels of patients were similar between the two groups. l-Menthol is an effective and safe alternative antiperistaltic medication for EGD in elderly patients with contraindication to HBB. Further large, randomized trials are required to clarify whether l-menthol can lead to better detection yield in the elderly.Clinical trial registration: The study was registered at ClinicalTrials.gov (NCT04593836).

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L-Menthol for Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis

Cited by 9 publications

References 62 publications

Menthol: An underestimated anticancer agent

Menthol: An underestimated anticancer agent

Athlete perceptions of flavored, menthol-enhanced energy gels ingested prior to endurance exercise in the heat

Antiperistaltic effect and safety of l-menthol for esophagogastroduodenoscopy in the elderly with contraindication to hyoscine-N-butylbromide

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