Department of Internal Medicine and Gastroenterology, University of Bologna, Via Massarenti 48, 40138 Bologna, Italy.
Dig Dis Sci. 2011 Nov;56(11):3288-95. doi: 10.1007/s10620-011-1740-9. Epub 2011 May 15.
Abdominal pain, that characterizes irritable bowel syndrome (IBS) together with bloating and disordered defecation, is mainly related to a visceral hypersensitivity due to an increase of TRPV(1) nociceptive nerve fiber activity.
As capsaicin contained in red pepper is able to desensitize the TRPV(1) fibres, we evaluated whether the red pepper oral administration can decrease the symptoms of visceral hypersensitivity in IBS patients.
The study was performed on 50 patients with IBS diagnosed following Rome II criteria. After a 2-week washout period, 23 patients were planned to receive 4 pills/day, for 6 weeks randomly and in a double blind manner, each containing 150 mg of red pepper powder with a coat that dissolves in the colon, and 27 patients placebo. The patients scored each day in a diary the abdominal pain and bloating intensities following the 5-point Likert scale. The weekly symptom mean scores and the final patient subjective evaluation on treatment effectiveness were statistically compared among groups and intra-groups with appropriate tests.
Eight patients dropped from the study: 6 in the red pepper group for abdominal pain and 2 in the placebo group. In 8 patients, the pills were reduced to 2/day, because of the abdominal pain at the onset of treatment. The intra-group comparisons showed that in patients taking red pepper the abdominal pain and bloating mean score values of the last weeks of treatment were significantly improved with respect to pre-treatment values, unlike patients taking placebo. The final patient subjective evaluation on the treatment effectiveness showed that red pepper group scored significantly better than placebo.
The results of this preliminary study indicate that the chronic administration of red pepper powder in IBS patients with enteric-coated pills was significantly more effective than placebo in decreasing the intensity of abdominal pain and bloating and was considered by the patients more effective than placebo.
腹痛是肠易激综合征(IBS)的特征之一,常伴有腹胀和排便紊乱,主要与内脏敏感性增加有关,这是由于 TRPV(1)伤害性神经纤维活性增加所致。
由于红辣椒中的辣椒素能够使 TRPV(1)纤维脱敏,我们评估了口服红辣椒是否可以降低 IBS 患者内脏敏感性症状。
该研究纳入了 50 名符合 Rome II 标准诊断的 IBS 患者。经过 2 周的洗脱期后,23 名患者随机分为两组,每组 150mg 辣椒粉末包衣肠溶胶囊,每日 4 粒,分 2 次服用,共 6 周,另一组服用安慰剂。患者每天根据 5 分制 Likert 量表记录腹痛和腹胀强度。采用适当的检验对组间和组内的每周症状平均评分和最终患者对治疗效果的主观评价进行统计学比较。
8 名患者退出研究:红辣椒组 6 名因腹痛,安慰剂组 2 名。由于治疗开始时出现腹痛,有 8 名患者将剂量减少至每日 2 粒。组内比较显示,与安慰剂组相比,服用红辣椒的患者在治疗最后几周的腹痛和腹胀平均评分值明显改善。最终患者对治疗效果的主观评价显示,红辣椒组的评分明显优于安慰剂组。
这项初步研究的结果表明,与安慰剂相比,肠溶包衣胶囊形式的慢性给予红辣椒粉在降低 IBS 患者腹痛和腹胀强度方面更有效,且患者认为其比安慰剂更有效。