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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"We can judge the heart of a man by his treatment of animals." ~Immanual Kant~