L-Menthol for Reducing Bowel Spasm During Colonoscopy

Bowel spasm during colonoscopy can slow down examinations and might prevent the identification of lesions. Outside the U.S., hyoscine is often given intravenously to counter bowel spasm. Now, researchers in Japan have conducted a randomized, single-blind, placebo-controlled trial of L-menthol spray, another antispasmodic agent, in 226 patients undergoing colonoscopy.

After the cecum was intubated, 20 mL of 1.6% L-menthol or placebo was sprayed onto the cecal mucosa. Within the L-menthol group only, an additional 20 mL dose could be given if significant peristalsis persisted. Few patients received sedation (2% in the L-menthol group and 3% in the placebo group).

The adenoma detection rate was significantly greater in the L-menthol group than i…