L-menthol improves adenoma detection rate during colonoscopy: a randomized trial

Area of Science:

• Gastroenterology
• Endoscopy
• Pharmacology

Background:

• Colonoscopy is crucial for detecting colorectal neoplasms but can be hindered by colonic peristalsis.
• Antispasmodic agents are often used but may cause adverse reactions.
• L-menthol is explored as a topical antiperistaltic agent.

Purpose of the Study:

• To evaluate L-menthol spray's efficacy in suppressing colonic peristalsis.
• To assess the impact of L-menthol on adenoma detection rate (ADR) during colonoscopy.

Main Methods:

• Prospective, randomized, single-blind, placebo-controlled trial.
• 226 patients randomized to receive L-menthol spray or placebo.
• Adenoma detection rate (ADR) and absence of peristalsis were primary/secondary outcomes.

Main Results:

• Significantly higher ADR in the L-menthol group (60.2%) vs. placebo (42.6%).
• Significantly greater proportion of patients with no peristalsis in the L-menthol group (71.2%) vs. placebo (30.9%).
• No adverse effects reported in either group.

Conclusions:

• L-menthol spray effectively suppresses colonic peristalsis.
• Direct topical application of L-menthol improves adenoma detection rates during colonoscopy.