Pediatric Surgery International

, Volume 23, Issue 10, pp 1001–1005

Effects of rikkunshito on the clinical symptoms and esophageal acid exposure in children with symptomatic gastroesophageal reflux

  • Hisayoshi Kawahara
  • Akio Kubota
  • Toshimichi Hasegawa
  • Hiroomi Okuyama
  • Takehisa Ueno
  • Shinobu Ida
  • Masahiro Fukuzawa
Original Article

DOI: 10.1007/s00383-007-1986-7

Cite this article as:
Kawahara, H., Kubota, A., Hasegawa, T. et al. Pediatr Surg Int (2007) 23: 1001. doi:10.1007/s00383-007-1986-7

Abstract

Rikkunshito (TJ-43), a herbal medicine consisting of eight herbs, is used to treat chronic dyspepsia. Studies have shown that TJ-43 improves human gastric emptying. This study investigated the effects of TJ-43 on the clinical symptoms and esophageal acid exposure in children with symptomatic gastroesophageal reflux (GER). Eight children, aged from 2 months to 15 years (median age 4 years), were studied. Six of them had neurological impairment. TJ-43 (0.3 g/kg/day) was given orally or via nasogastric tubes in three divided doses before meals for 7 days. Their symptoms were frequent emesis in four, nausea in two, and hematemesis and stridor in one each. Twenty-four-hour esophageal pH monitoring was conducted using multichannel pH electrodes located at the distal esophagus (P1) and 10 cm proximal to P1 (P2). The clinical symptoms and esophageal pH were compared before and after TJ-43 therapy for 1 week. The frequency of emesis decreased in three patients. Other symptoms, including nausea, hematemesis, and stridor, were relieved in the remaining patients. Measured at the distal pH electrode, the percentage time of esophageal pH < 4.0 and the mean duration of reflux decreased significantly (P < 0.05). However, the number of acid reflux per hour did not change significantly, and no pH parameters measured at the proximal electrode differed significantly. The short-term administration of TJ-43 relieved symptoms and reduced the distal esophageal acid exposure through improved esophageal acid clearance.

Keywords

Rikkunshito Gastroesophageal reflux (GER) Emesis Esophageal clearance 24-h esophageal pH monitoring 

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Hisayoshi Kawahara
    • 1
  • Akio Kubota
    • 1
  • Toshimichi Hasegawa
    • 1
  • Hiroomi Okuyama
    • 1
  • Takehisa Ueno
    • 1
  • Shinobu Ida
    • 2
  • Masahiro Fukuzawa
    • 3
  1. 1.Department of Pediatric SurgeryOsaka Medical Center and Research Institute for Maternal and Child HealthOsakaJapan
  2. 2.Department of Pediatric Gastroenterology and NutritionOsaka Medical Center and Research Institute for Maternal and Child HealthOsakaJapan
  3. 3.Department of Pediatric SurgeryOsaka University Graduate School of MedicineOsakaJapan

Personalised recommendations