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CC BY-NC-ND 4.0 · Endosc Int Open 2025; 13: a24656918
DOI: 10.1055/a-2465-6918
Original article

Orally peppermint oil in small bowel capsule endoscopy: Novel approach to improve completion rates in patients at risk of delayed gastric transit

Authors

  • Fintan John O'Hara

    1   Gastroenterology, Tallaght University Hospital, Dublin, Ireland (Ringgold ID: RIN57976)

  • Conor Costigan

    1   Gastroenterology, Tallaght University Hospital, Dublin, Ireland (Ringgold ID: RIN57976)
    2   Gastroenterology, Trinity College Dublin, Dublin, Ireland (Ringgold ID: RIN8809)

  • Deirdre Mc Namara

    1   Gastroenterology, Tallaght University Hospital, Dublin, Ireland (Ringgold ID: RIN57976)
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Abstract

Background and study aims

Small bowel capsule endoscopy (SBCE) is crucial in diagnosing small bowel diseases, yet incomplete examinations often result from prolonged gastric transit time. This study aimed to assess the efficacy of orally administered peppermint oil solution as a prokinetic agent to improve SBCE completion rates in patients with delayed gastric transit risk factors.

Patients and methods

Conducted as a single-center, prospective, open-label, non-inferiority trial, the study involved 132 patients identified as at risk for delayed gastric transit. Participants were divided into three groups: peppermint oil solution group (n = 57), real-time monitoring and intravenous prokinetics group (n = 75), and control group without risk factors (n = 193). Primary outcomes included SBCE completion rates, gastric transit time (GTT), small bowel transit time (SBTT), diagnostic yield, and bowel preparation quality.

Results

Completion rates were high and comparable among groups, with 94.7% in the peppermint group, 90.7% in the real-time monitoring group, and 95.3% in the control group. The peppermint group exhibited a significantly shorter mean GTT of 42.3 minutes compared with 57.0 minutes in the real-time monitoring group (P = 0.0423). However, SBTT was longer in the peppermint group at 246 minutes versus 193 minutes in the real-time monitoring group (P = 0.0081), although similar to the control group at 228.3 minutes (P = 0.2612). Diagnostic yield and bowel preparation quality were consistent across all groups.

Conclusions

Oral peppermint oil solution is a safe and effective alternative to traditional prokinetics, enhancing SBCE completion rates while reducing time and resource use in the endoscopy unit.

Keywords

Endoscopy Small Bowel - Capsule endoscopy - Endoscopy Upper GI Tract - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE)


Publikationsverlauf

Eingereicht: 14. Juni 2024

Angenommen nach Revision: 11. November 2024

Accepted Manuscript online:
13. November 2024

Artikel online veröffentlicht:
14. März 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Fintan John O'Hara, Conor Costigan, Deirdre Mc Namara. Orally peppermint oil in small bowel capsule endoscopy: Novel approach to improve completion rates in patients at risk of delayed gastric transit. Endosc Int Open 2025; 13: a24656918.
DOI: 10.1055/a-2465-6918
 

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