title: Influence of capsaicin infusion on secondary peristalsis in patients with gastroesophageal reflux disease.
abstract: OBJECTIVE
  To determine whether capsaicin infusion could influence heartburn perception and secondary peristalsis in patients with gastroesophageal reflux disease (GERD).
  
  
  METHODS
  Secondary peristalsis was performed with slow and rapid mid-esophageal injections of air in 10 patients with GERD. In a first protocol, saline and capsaicin-containing red pepper sauce infusions were randomly performed, whereas 2 consecutive sessions of capsaicin-containing red pepper sauce infusions were performed in a second protocol. Tested solutions including 5 mL of red pepper sauce diluted with 15 mL of saline and 20 mL of 0.9% saline were infused into the mid-esophagusviathe manometric catheter at a rate of 10 mL/min with a randomized and double-blind fashion. During each study protocol, perception of heartburn, threshold volumes and peristaltic parameters for secondary peristalsis were analyzed and compared between different stimuli.
  
  
  RESULTS
  Infusion of capsaicin significantly increased heartburn perception in patients with GERD (P< 0.001), whereas repeated capsaicin infusion significantly reduced heartburn perception (P= 0.003). Acute capsaicin infusion decreased threshold volume of secondary peristalsis (P= 0.001) and increased its frequency (P= 0.01) during rapid air injection. The prevalence of GERD patients with successive secondary peristalsis during slow air injection significantly increased after capsaicin infusion (P= 0.001). Repeated capsaicin infusion increased threshold volume of secondary peristalsis (P= 0.002) and reduced the frequency of secondary peristalsis (P= 0.02) during rapid air injection.
  
  
  CONCLUSIONS
  Acute esophageal exposure to capsaicin enhances heartburn sensation and promotes secondary peristalsis in gastroesophageal reflux disease, but repetitive capsaicin infusion reverses these effects.
authors.affiliation: Chih-Hsun Yi, Wei-Yi Lei, Jui-Sheng Hung, Tso-Tsai Liu, Chien-Lin Chen, Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97002, Taiwan.
authors.forename: Chih-Hsun
authors.initials: CH
authors.lastname: Yi
authors.affiliation: Chih-Hsun Yi, Wei-Yi Lei, Jui-Sheng Hung, Tso-Tsai Liu, Chien-Lin Chen, Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97002, Taiwan.
authors.forename: Wei-Yi
authors.initials: WY
authors.lastname: Lei
authors.affiliation: Chih-Hsun Yi, Wei-Yi Lei, Jui-Sheng Hung, Tso-Tsai Liu, Chien-Lin Chen, Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97002, Taiwan.
authors.forename: Jui-Sheng
authors.initials: JS
authors.lastname: Hung
authors.affiliation: Chih-Hsun Yi, Wei-Yi Lei, Jui-Sheng Hung, Tso-Tsai Liu, Chien-Lin Chen, Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97002, Taiwan.
authors.forename: Tso-Tsai
authors.initials: TT
authors.lastname: Liu
authors.affiliation: Chih-Hsun Yi, Wei-Yi Lei, Jui-Sheng Hung, Tso-Tsai Liu, Chien-Lin Chen, Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97002, Taiwan.
authors.forename: Chien-Lin
authors.initials: CL
authors.lastname: Chen
authors.affiliation: Chih-Hsun Yi, Wei-Yi Lei, Jui-Sheng Hung, Tso-Tsai Liu, Chien-Lin Chen, Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97002, Taiwan.
authors.forename: Fabio
authors.initials: F
authors.lastname: Pace
mesh_terms: D000328:Adult; D002211:Capsaicin / Q000494:pharmacology*; D004311:Double-Blind Method; D004947:Esophagus / Q000187:drug effects*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006356:Heartburn / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis / Q000187:drug effects*; D018689:Sensory System Agents / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D018689:Sensory System Agents; D002211:Capsaicin
keywords: Capsaicin; Esophageal manometry; Esophageal motility; Gastroesophageal reflux disease; Secondary peristalsis