Influence of Menthol Infusion on Esophageal Peristalsis in Patients With Ineffective Esophageal Motility.

Background/aims: Activation of the cold receptor, transient receptor potential melastatin 8 (TRPM8) by menthol inhibits esophageal secondary peristalsis in healthy adults. Ineffective esophageal motility (IEM) is common. This study is to evaluate the effects of acute infusion of menthol on esophageal peristalsis in patients with IEM.

Methods: Twenty patients with IEM (males 11, mean age 36) were studied for esophageal peristalsis using high-resolution manometry. All participant had primary peristalsis performed with 10 water swallows and secondary peristalsis generated with 10 rapid air injections of 20 mL via mid-esophageal infusion port. Two different sessions by randomly performing acute administration of placebo or menthol (3 mM) were used for testing their effects on esophageal peristalsis.

Results: Menthol infusion had no effects on distal contractile integral ( = 0.471), distal latency ( = 0.58), or complete peristalsis ( = 0.251). Menthol infusion did not change basal lower esophageal sphincter pressure ( = 0.321), esophagogastric junction contractile integral ( = 0.758), or integrated relaxation pressure ( = 0.375) of primary peristalsis, but reduced upper esophageal sphincter pressure ( = 0.037). Infusion of menthol significantly reduced the frequency of secondary peristalsis for air injects of 20 mL ( = 0.002), but did not affect distal contractile integral of secondary peristalsis for air injections of 20 mL.

Conclusion: This work has suggested that activation of TRPM8 by menthol can attenuate mechanosensitivity of secondary peristalsis in response to rapid air distension regardless of the presence of IEM.