Capsaicin combined with ice stimulation improves swallowing function in patients with dysphagia after stroke: A randomised controlled trial

Abstract

Background Dysphagia is a common condition after stroke, and it is associated with many complications. Early and effective treatments are essential to the prognosis of patients with dysphagia. We aimed to evaluate the effects and safety of capsaicin combined with ice stimulation in patients with dysphagia after stroke. Methods Patients with dysphagia admitted to our hospital from December 2017 to December 2019 were included. The control group received the ice stimulation, and the experimental group received the combined capsaicin and ice stimulation. The grade of water swallowing test (WST), standard swallowing assessment (SSA) scores and the serum substance P level was compared between control (ice only) and experimental group (capsaicin plus ice). Results No differences before treatment and significance following treatment in each group (before and after) and between groups (capsaicin plus ice vs ice only) were found (all P > .05); the SSA scores were significantly reduced after intervention for both groups (all P < .001), and after intervention, SSA score in experimental group was significantly less than that of control group (P < .001). After intervention, the number of patients graded as WST level I‐II in experimental group was significantly more than that of control group (P < .001); the serum substance P level was significantly increased after intervention for both groups (all P < .05), and after intervention, the serum substance P level in experimental group was significantly higher than that of control group (P = .007). Conclusions The combined use of capsaicin with ice stimulation is beneficial to the recovery of swallowing function of patients with dysphagia, which should be included into the clinical practice.

A Novel Balloon Catheter-based Dilation Intervention for Patients with Cricopharyngeus Achalasia After Stroke: A Randomized Study

“…First and most importantly is ice stimulation, which is an effective method to improve the motor and sensory activities of the tongue and soft palate through repeated mechanical, temperature, and pressure stimulation [16]. It increases the sensitivity of the swallowing reflex areas by stimulating the sensory input nerve fibers and eventually induces the swallowing reflex to improve the swallowing function [17,18]. Kawakami,M et al first reported the excitability of the human cortical swallowing motor pathway after oral ice stimulation and found that oral ice stimulation increases the excitability of the corticobulbar projection to the mylohyoid muscles, but ice stimulation to the superficial neck skin does not have any effects [19].…”

Inhalation Therapy with Nebulized Capsaicin in a Patient with Oropharyngeal Dysphagia Post Stroke: A Clinical Case Report

“…Of note, there is a related body of literature, in which capsaicin in different modes of administration is suggested to improve cough and/or swallowing function. This literature includes studies of capsaicin ointment which is applied to the external auditory canal, under the hypothesis that this could stimulate the auricular branch of the vagus nerve (Arnold’s nerve) and improve glottal closure and reflex cough via Arnold’s ear–cough reflex [ 49 ]; and studies in which capsaicin is added to ingested drinks or food [ 50 , 51 ] or administered to the oropharynx using a troche [ 52 ] or a frozen/cold swab containing capsaicin [ 53 , 54 ]. The latter studies are mainly based on the reasoning that capsaicin improves swallowing function by stimulating and enhancing oropharyngeal and laryngeal sensation [ 51 , 54 ].…”

Effect of Capsaicin Atomization–Induced Cough on Sputum Excretion in Tracheotomized Patients After Hemorrhagic Stroke: A Randomized Controlled Trial

“…Ebihara (2006) has used black pepper oil for olfactory stimulation in older adults with dysphagia to improve their reflexive swallowing movements. Recently, Cui et al (2020) found that the use of capsaicin combined with ice stimulation can promote recovery of swallowing function in stroke patients. Therefore, capsaicin nebulization may…”