Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 12, Number 3, June 2019, pages 141-147

Peppermint Oil to Improve Visualization in Screening Colonoscopy: A Randomized Controlled Clinical Trial

**Table 1.** Classification of Severity of Colonic Peristalsis as Subjectively Graded by Endoscopists in Our Study
Grade	Severity of peristalsis	Subjective endoscopic description
Grade 0	No peristalsis	No movement observed, with colon dilated
Grade 1	Mild peristalsis	Colon movement not observed, but haustral septae with mild spasm remained
Grade 2	Moderate peristalsis	Colon movement
Grade 3	Severe peristalsis	Severe spasm

Table 1. Classification of Severity of Colonic Peristalsis as Subjectively Graded by Endoscopists in Our Study

Grade

Severity of peristalsis

Subjective endoscopic description

Grade 0

No peristalsis

No movement observed, with colon dilated

Grade 1

Mild peristalsis

Colon movement not observed, but haustral septae with mild spasm remained

Grade 2

Moderate peristalsis

Colon movement

Grade 3

Severe peristalsis

Severe spasm

**Table 2.** Extent of the Total Bowel Wall Visualized, as Subjectively Graded by Endoscopists in Our Study
Grade	Extent of total bowel wall visualized (%)
Grade 0	≥ 75%
Grade 1	50-75%
Grade 2	25-49%
Grade 3	≤ 25%

Table 2. Extent of the Total Bowel Wall Visualized, as Subjectively Graded by Endoscopists in Our Study

Grade

Extent of total bowel wall visualized (%)

Grade 0

≥ 75%

Grade 1

50-75%

Grade 2

25-49%

Grade 3

≤ 25%

**Table 3.** Degree of Colonic Wall Spasticity, as Subjectively Graded by Endoscopists in Our Study
Grade	Degree of colonic wall spasticity
Grade 0	≥ 75%
Grade 1	50-75%
Grade 2	25-49%
Grade 3	≤ 25%
Grade 4	No spasticity observed

Table 3. Degree of Colonic Wall Spasticity, as Subjectively Graded by Endoscopists in Our Study

Grade

Degree of colonic wall spasticity

Grade 0

≥ 75%

Grade 1

50-75%

Grade 2

25-49%

Grade 3

≤ 25%

Grade 4

No spasticity observed

**Table 4.** Comparison of Baseline Patient Characteristics Between Peppermint Oil and Placebo Groups
Patient characteristics	Peppermint oil group (N = 24)	Placebo group (N = 24)	P-value
Mean age (years)	53.8 ± 3.9	54.8 ± 4.9	0.41
BMI (kg/m²)	29.6 ± 5.3	26.3 ± 5.8	0.02
Gender, n (%)			0.07
Male	13 (54.2%)	5 (20.8%)
Female	11 (45.8%)	19 (79.2%)
Diabetes mellitus, n (%)	2 (8.3%)	2 (8.3%)	1
Chronic narcotic use, n (%)	0 (0%)	2 (8.3%)	0.15

Table 4. Comparison of Baseline Patient Characteristics Between Peppermint Oil and Placebo Groups

Patient characteristics

Peppermint oil group (N = 24)

Placebo group (N = 24)

P-value

Mean age (years)

53.8 ± 3.9

54.8 ± 4.9

0.41

BMI (kg/m²)

29.6 ± 5.3

26.3 ± 5.8

0.02

Gender, n (%)

0.07

Male

13 (54.2%)

5 (20.8%)

Female

11 (45.8%)

19 (79.2%)

Diabetes mellitus, n (%)

2 (8.3%)

Chronic narcotic use, n (%)

0 (0%)

2 (8.3%)

0.15

**Table 5.** Comparison of Procedural Details and Visual Parameters Between Peppermint Oil and Placebo Groups
Procedural details	Peppermint oil (N = 24)	Placebo (N = 24)	P-value
Bowel preparation product used, n (%)			1
MoviPrep	16 (66.7%)	16 (66.7%)
GoLytely	8 (33.3%)	8 (33.3%)
Mean Boston bowel preparation score (BBPS)	8 ± 1	7.9 ± 1.2	0.98
Severity of peristalsis, n			0.08
Grade 0 (no peristalsis)	8	5
Grade 1 (mild peristalsis)	11	18
Grade 2 (moderate peristalsis)	5	1
Grade 3 (severe peristalsis)	0	0
Extent of bowel wall visualized, n			0.56
≥ 75%	20	20
50-75%	4	3
25-49%	0	1
≤ 25%	0	0
Degree of colonic spasticity, n			0.05
Grade 0 (≥ 75%)	1	0
Grade 1 (50-75%)	0	1
Grade 2 (25-49%)	4	0
Grade 3 (≤ 25%)	5	12
Grade 4 (no spasticity observed)	14	11
Mean cecal intubation time (min)	7.2 ± 3.6	10.3 ± 6.2	0.04
Mean colonoscopic withdrawal time (min)	10.6 ± 3.4	11.6 ± 5.2	0.43
Mean total colonoscopy time (min)	17.8 ± 4.6	21.9 ± 9.6	0.07
Total polyps removed, n	18	15	0.64
Right colon	12	7
Left colon	6	8
Adenomas removed during colonoscopy, n (%)	11 (45.8%)	9 (37.5%)	0.56
Perception of pain (≥ 1 on scale = yes), n (%)	8 (33.3%)	8 (34.8%)	0.92
Willingness to repeat colonoscopy, n (%)			0.30
Very likely	15 (62.5%)	10 (43.5%)
Likely	9 (37.5%)	12 (41.7%)
Not very likely	0 (0%)	1 (4.2%)

Table 5. Comparison of Procedural Details and Visual Parameters Between Peppermint Oil and Placebo Groups

Procedural details

Peppermint oil (N = 24)

Placebo (N = 24)

P-value

Bowel preparation product used, n (%)

MoviPrep

16 (66.7%)

GoLytely

8 (33.3%)

Mean Boston bowel preparation score (BBPS)

8 ± 1

7.9 ± 1.2

0.98

Severity of peristalsis, n

0.08

Grade 0 (no peristalsis)

Grade 1 (mild peristalsis)

Grade 2 (moderate peristalsis)

Grade 3 (severe peristalsis)

Extent of bowel wall visualized, n

0.56

≥ 75%

50-75%

25-49%

≤ 25%

Degree of colonic spasticity, n

0.05

Grade 0 (≥ 75%)

Grade 1 (50-75%)

Grade 2 (25-49%)

Grade 3 (≤ 25%)

Grade 4 (no spasticity observed)

Mean cecal intubation time (min)

7.2 ± 3.6

10.3 ± 6.2

0.04

Mean colonoscopic withdrawal time (min)

10.6 ± 3.4

11.6 ± 5.2

0.43

Mean total colonoscopy time (min)

17.8 ± 4.6

21.9 ± 9.6

0.07

Total polyps removed, n

0.64

Right colon

Left colon

Adenomas removed during colonoscopy, n (%)

11 (45.8%)

9 (37.5%)

0.56

Perception of pain (≥ 1 on scale = yes), n (%)

8 (33.3%)

8 (34.8%)

0.92

Willingness to repeat colonoscopy, n (%)

0.30

Very likely

15 (62.5%)

10 (43.5%)

Likely

9 (37.5%)

12 (41.7%)

Not very likely

0 (0%)

1 (4.2%)