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Study: Red Pepper and Irritable Bowel Syndrome
Authors: Bortolotti M, Porta S.
Reference: Effect of red pepper on symptoms of irritable bowel syndrome: preliminary study. Dig Dis Sci 2001; 56:3288-3295.
Design: Random double-blind placebo controlled trial
Participants: Twenty women and thirty men, 18-65 y.o. with irritable bowel syndrome (IBS), per Rome II criteria.
Study Medication and Dosage: After a 20-week washout period, 23 patients received four pills/day for six weeks and 27 patients received placebo. Each active pill was coated to dissolve in the colon and contained 150 mg of red pepper powder. Eight patients dropped out from the study, six in the red pepper group, due to abdominal pain and two in the placebo group. In eight patients, the pills were reduced to two per day due to abdominal pain at the onset of treatment.
Primary Outcome Measures: The primary outcome was the intensity of abdominal pain and bloating following the 5-point Likert scale. Weekly symptom mean scores and patient subjective evaluation were used to evaluate treatment.
Key Findings: In patients taking red pepper, the mean score values of the last two weeks of treatment showed significantly improved abdominal pain compared to pre-treatment values. Those taking placebo showed transient improvement during the first four weeks which then disappeared during the last two weeks. In the final patient subjective evaluation, the red pepper group scored significantly better than placebo.
Practice Implications: This preliminary study indicates that chronic enteric coated red pepper powder has the potential to help patients with IBS symptoms and reduce the intensity of abdominal pain and bloating. Clinicians need to be aware that some individuals may experience an increase in abdominal pain in the first few days of red pepper administration. This is thought to be due to the phase of sensitization due to capsaicin on the nociceptive fibers that precedes the densensitization and analgesic phase. The low dose of two capsules per day seemed equal to the four caps per day in effectiveness and may offer an advantage in avoiding or decreasing the potential of the initial abdominal pain.
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