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Physiological analysis of the effects of rikkunshito on acid and non-acid gastroesophageal reflux using pH-multichannel intraluminal impedance monitoring

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Abstract

Purpose

To clarify the effects of rikkunshito on acid reflux, non-acid reflux, and esophageal clearance in patients with gastroesophageal reflux disease (GERD).

Methods

We enrolled seven patients with vomiting and/or stridor (median 6 years; 1 month–17 years), with a percent total time of esophageal pH <4.0 (reflux index) over 4.0 %. Rikkunshito (TJ-43; Tsumura Co, Tokyo, Japan) was given in three divided doses before meals. We retrospectively investigated its efficacy using pH-multichannel intraluminal impedance before and 7 (6–10) days after starting treatment. Statistical analyses were conducted using Wilcoxon signed-rank test.

Results

In the pH analyses alone, the median number of acid reflux episodes >5 min (14 versus 10, p = 0.046) and median acid-clearance time (184 versus 134 s, p = 0.03) decreased significantly, although median decrease in reflux index did not reach significance (16.0 versus 17.9 %, p = 0.06). In the combined impedance and pH analyses, the median number (36 versus 36, p = 0.03) and median duration (1.9 versus 1.1 %, p = 0.046) of acid reflux decreased significantly; non-acid reflux and bolus clearance time did not change.

Conclusion

Rikkunshito effectively reduced acid reflux, but not esophageal clearance, in patients with GERD.

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Acknowledgements

The authors would like to thank Enago (www.enago.jp) for the English language review.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan

    Hisayoshi Kawahara

  2. Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan

    Yuko Tazuke, Hideki Soh, Akihiro Yoneda & Masahiro Fukuzawa

Authors
  1. Hisayoshi Kawahara
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  2. Yuko Tazuke
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  3. Hideki Soh
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  4. Akihiro Yoneda
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  5. Masahiro Fukuzawa
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Corresponding author

Correspondence to Hisayoshi Kawahara.

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Kawahara, H., Tazuke, Y., Soh, H. et al. Physiological analysis of the effects of rikkunshito on acid and non-acid gastroesophageal reflux using pH-multichannel intraluminal impedance monitoring. Pediatr Surg Int 30, 927–931 (2014). https://doi.org/10.1007/s00383-014-3565-z

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  • DOI: https://doi.org/10.1007/s00383-014-3565-z

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