title: CLINICAL APPLICATION OF L-MENTHOL IN THE UPPER GASTROINTESTINAL ENDOSCOPIC PROCEDURE.
abstract: OBJECTIVE
  Peppermint oil, which suppresses gastric peristalsis during esophagogastroduodenoscopy (EGD), is effective for determining the margin of a gastric tumor. This study was conducted to evaluate the utility of an L-menthol preparation for suppressing gastric peristalsis and for diagnosing gastric tumors.
  
  
  METHODS
  The study examined 124 patients who underwent EGD between January and April 2012. After 20 mL of 0.8% L-menthol was sprayed directly onto the mucosal surface of the gastric antrum, the degree of peristalsis suppression in the antrum was evaluated. The effectiveness of L-menthol for identifying new gastric tumors and determining tumor margins was also evaluated.
  
  
  RESULTS
  Gastric peristalsis was suppressed in 88.5% (69/78) of patients, with complete suppression of peristalsis achieved in 78.2%. L-menthol exerted a higher peristalsis-suppressive effect in patients with endoscopic gastric mucosal atrophy (93.3%, 56/60) than in patients without atrophy (72.2%, 13/18) (p = .014). L-menthol application caused the detection of new gastric tumors in 1.6% (2/124) of patients and clarification of the margin of three lesions (in 3 patients) identified as having an unclear margin before L-menthol application.
  
  
  CONCLUSIONS
  These results suggest that L-menthol is effective for suppressing gastric peristalsis during EGD and suggest that it is useful for identifying gastric tumors and for determining tumor margins.
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Takuto
authors.initials: T
authors.lastname: Hikichi
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Takagi
authors.forename: Rei
authors.initials: R
authors.lastname: Suzuki
authors.forename: K O
authors.initials: KO
authors.lastname: Watanabe
authors.forename: Jun
authors.initials: J
authors.lastname: Nakamura
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Waragai
authors.forename: Naoki
authors.initials: N
authors.lastname: Konno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Asama
authors.forename: Mika
authors.initials: M
authors.lastname: Takasumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Obara
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
mesh_terms: D000368:Aged; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008610:Menthol; D013274:Stomach Neoplasms / Q000175:diagnosis
chemical_list: D008610:Menthol