Effects of capsaicin on esophageal peristalsis in humans using high resolution manometry.

Publisher: Blackwell Scientific Publications Country of Publication: England NLM ID: 9432572 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2982 (Electronic) Linking ISSN: 13501925 NLM ISO Abbreviation: Neurogastroenterol Motil Subsets: MEDLINE

Original Publication: Osney Mead, Oxford, UK : Blackwell Scientific Publications, c1994-

Peristalsis*/drug effects ; Peristalsis*/physiology ; Capsaicin*/pharmacology ; Capsaicin*/administration & dosage ; Manometry*/methods ; Esophagus*/drug effects ; Esophagus*/physiology; Humans ; Male ; Adult ; Female ; Sensory System Agents/pharmacology ; Middle Aged ; Young Adult ; Muscle, Smooth/drug effects ; Muscle, Smooth/physiology

Background: Capsaicin-containing red pepper sauce suspension augments esophageal contraction amplitude on conventional manometry. This study used high-resolution manometry (HRM) to investigate if capsaicin infusion modulates segmental esophageal smooth muscle peristalsis in healthy adults.
Methods: Sixteen healthy volunteers (mean age 37 years, 14 male) underwent HRM for the evaluation of primary peristalsis and secondary peristalsis using slow and rapid air distensions. Both primary and secondary peristalsis were assessed following infusions of capsaicin-containing red pepper sauce and saline.
Key Results: Capsaicin infusion significantly increased heartburn symptoms compared to saline infusion (p < 0.001), and significantly decreased threshold volumes of secondary peristalsis during rapid air distensions (p = 0.02). The frequency of secondary peristalsis during rapid air distensions was significantly increased by capsaicin infusion (p = 0.03). Neither capsaicin infusion (p = 0.06) nor saline infusion (p = 0.27) altered threshold volume during slow air distensions. Capsaicin infusion significantly increased distal contractile integral (DCI) of primary peristalsis (p = 0.04), particularly in the proximal smooth muscle segment (p = 0.048). It enhanced secondary peristalsis during rapid air distensions (p = 0.003) but not during slow air distension (p = 0.23). Saline infusion significantly increased DCI of secondary peristalsis during rapid air distension (p = 0.01).
Conclusions and Inferences: Augmentation of distension-induced secondary peristalsis can be modulated by activation of capsaicin-sensitive afferents similar to mechanosensitive afferents. Capsaicin-induced augmentation of primary peristalsis isolates to the cholinergic-mediated proximal smooth muscle segment, which warrants study in ineffective esophageal motility to determine therapeutic potential.
(© 2024 John Wiley & Sons Ltd.)

Helm JF, Dodds WJ, Pelc LR, Palmer DW, Hogan WJ, Teeter BC. Effect of esophageal emptying and saliva on clearance of acid from the esophagus. N Engl J Med. 1984;310:284‐288.
Kravitz JJ, Snape WJ Jr, Cohen S. Effect of thoracic vagotomy and vagal stimulation on esophageal function. Am J Phys. 1978;234:E359‐E364.
Lang IM, Medda BK, Shaker R. Mechanisms of reflexes induced by esophageal distension. Am J Physiol Gastrointest Liver Physiol. 2001;281:G1246‐G1263.
Fox MR, Bredenoord AJ. Oesophageal high‐resolution manometry: moving from research into clinical practice. Gut. 2008;57:405‐423.
Clouse RE, Prakash C. Topographic esophageal manometry: an emerging clinical and investigative approach. Dig Dis. 2000;18:64‐74.
Staiano A, Clouse RE. The effects of cisapride on the topography of oesophageal peristalsis. Aliment Pharmacol Ther. 1996;10:875‐882.
Wong MW, Yi CH, Liu TT, et al. Effects of phosphodiesterase‐5 inhibitor sildenafil on esophageal secondary peristalsis: studies with high‐resolution manometry. J Gastroenterol Hepatol. 2021;36:430‐435.
Lei WY, Liang SW, Hung JS, et al. Effects of menthol on esophageal motility in humans: studies using high‐resolution manometry. Neurogastroenterol Motil. 2022;34:e14267.
Chen CL, Wong MW, Hung JS, et al. Effects of codeine on esophageal peristalsis in humans using high resolution manometry. J Gastroenterol Hepatol. 2021;36:3381‐3386.
Page AJ, Brierley SM, Martin CM, et al. Different contributions of ASIC channels 1a, 2, and 3 in gastrointestinal mechanosensory function. Gut. 2005;54:1408‐1415.
Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science. 2000;288:1765‐1769.
Matthews PJ, Aziz Q, Facer P, Davis JB, Thompson DG, Anand P. Increased capsaicin receptor TRPV1 nerve fibres in the inflamed human oesophagus. Eur J Gastroenterol Hepatol. 2004;16:897‐902.
Banerjee B, Medda BK, Lazarova Z, Bansal N, Shaker R, Sengupta JN. Effect of reflux‐induced inflammation on transient receptor potential vanilloid one (TRPV1) expression in primary sensory neurons innervating the oesophagus of rats. Neurogastroenterol Motil. 2007;19:681‐691.
Shieh KR, Yi CH, Liu TT, et al. Evidence for neurotrophic factors associating with TRPV1 gene expression in the inflamed human esophagus. Neurogastroenterol Motil. 2010;22(971–7):e252.
Kindt S, Vos R, Blondeau K, Tack J. Influence of intra‐oesophageal capsaicin instillation on heartburn induction and oesophageal sensitivity in man. Neurogastroenterol Motil. 2009;21:1032‐e82.
Yadlapati R, Kahrilas PJ, Fox MR, et al. Esophageal motility disorders on high‐resolution manometry: Chicago classification version 4.0(©). Neurogastroenterol Motil. 2021;33:e14058.
Tolone S, De Bortoli N, Marabotto E, et al. Esophagogastric junction contractility for clinical assessment in patients with GERD: a real added value? Neurogastroenterol Motil. 2015;27:1423‐1431.
Lee H, Lee SK, Park JC, Shin SK, Lee YC. Effect of acid swallowing on esophageal contraction in patients with heartburn related to hypersensitivity. J Gastroenterol Hepatol. 2013;28:84‐89.
Kushnir VM, Prakash GC. High resolution manometry patterns distinguish acid sensitivity in non‐cardiac chest pain. Neurogastroenterol Motil. 2011;23:1066‐1072.
Rogers BD, Rengarajan A, Mauro A, et al. Fragmented and failed swallows on esophageal high‐resolution manometry associate with abnormal reflux burden better than weak swallows. Neurogastroenterol Motil. 2019;32:e13736.
Gonzalez R, Dunkel R, Koletzko B, Schusdziarra V, Allescher HD. Effect of capsaicin‐containing red pepper sauce suspension on upper gastrointestinal motility in healthy volunteers. Dig Dis Sci. 1998;43:1165‐1171.
Bass BL, Trad KS, Harmon JW, Hakki FZ. Capsaicin‐sensitive nerves mediate esophageal mucosal protection. Surgery. 1991;110:419‐425. discussion 425–6.
Mantyh PW, Hunt SP. Hot peppers and pain. Neuron. 1998;21:644‐645.
Woodland P, Aktar R, Mthunzi E, et al. Distinct afferent innervation patterns within the human proximal and distal esophageal mucosa. Am J Physiol Gastrointest Liver Physiol. 2015;308:G525‐G531.
Sekizawa S, Ishikawa T, Sant'Ambrogio FB, et al. Vagal esophageal receptors in anesthetized dogs: mechanical and chemical responsiveness. J Appl Physiol. 1985;1999(86):1231‐1235.
Berthoud HR, Patterson LM, Willing AE, Mueller K, Neuhuber WL. Capsaicin‐resistant vagal afferent fibers in the rat gastrointestinal tract: anatomical identification and functional integrity. Brain Res. 1997;746:195‐206.
Grossi L, Cappello G, Marzio L. Effect of an acute intraluminal administration of capsaicin on oesophageal motor pattern in GORD patients with ineffective oesophageal motility. Neurogastroenterol Motil. 2006;18:632‐636.
Lee H, Park JC, Shin SK, Lee SK, Lee YC. Segmental changes in smooth muscle contraction as a predictive factor of the response to high‐dose proton pump inhibitor treatment in patients with functional chest pain. J Gastroenterol Hepatol. 2012;27:1192‐1199.
Chen CL, Szczesniak MM, Cook IJ. Oesophageal bolus transit and clearance by secondary peristalsis in normal individuals. Eur J Gastroenterol Hepatol. 2008;20:1129‐1135.

Ministry of Science and Technology, Taiwan

Keywords: capsaicin; esophageal motility; high‐resolution manometry; secondary peristalsis

S07O44R1ZM (Capsaicin)
0 (Sensory System Agents)

Date Created: 20241010 Date Completed: 20241113 Latest Revision: 20241113

20250114

10.1111/nmo.14942

39385495