Effects of Capsaicin on Older Patients with Oropharyngeal Dysphagia: A Double-Blind, Placebo-Controlled, Crossover Study.
OBJECTIVE
The standard of care for older patients with oropharyngeal dysphagia (OD) is poor. Stimulation of transient receptor potential vanilloid 1 might become a pharmacological strategy for these patients. This study aimed to compare the therapeutic effect of film food containing 0.75 µg of capsaicin in these patients.


METHODS
In a crossover, randomized trial, 49 patients with OD were provided capsaicin or identical placebo at least 7 days apart. Patients' reported symptoms during repeated swallowing, the volume, pH and substance P (SP) concentrations in saliva, and cervical esophageal wall motion evaluated by ultrasonographic tissue Doppler imaging were obtained before and after capsaicin or placebo administration.


RESULTS
Significantly more patients with OD who took capsaicin experienced improvement in symptoms than those who took placebo. Salivary SP levels were significantly increased after capsaicin administration compared with placebo in the effective group. The duration of cervical esophageal wall opening was significantly shorter in capsaicin administration in the effective group. Furthermore, a significant negative correlation was found between the duration of cervical esophageal wall opening and salivary SP levels.


CONCLUSIONS
Elevated salivary SP concentrations stimulated by capsaicin greatly improve the safety and efficacy of swallowing, and shorten the swallow response in older patients with OD.
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Kurashiki, Japan.
Rui
R
Nakato
Noriaki
N
Manabe
Sayako
S
Shimizu
Kozo
K
Hanayama
Akiko
A
Shiotani
Jiro
J
Hata
Ken
K
Haruma
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002211:Capsaicin / Q000494:pharmacology* / Q000627:therapeutic use; D018592:Cross-Over Studies; D003679:Deglutition / Q000187:drug effects*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy*; D019587:Dietary Supplements; D004311:Double-Blind Method; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059039:Standard of Care; D013373:Substance P / Q000032:analysis; D050916:TRPV Cation Channels / Q000819:agonists* / Q000378:metabolism; D013997:Time Factors; D018608:Ultrasonography, Doppler
D050916:TRPV Cation Channels; C494482:TRPV1 protein, human; D013373:Substance P; D002211:Capsaicin
Capsaicin; Oropharyngeal dysphagia; Saliva; Substance P; Ultrasonographic tissue Doppler imaging