Impact of rikkunshito, an herbal medicine, on delayed gastric emptying in profoundly handicapped patients

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Abstract
Purpose Rikkunshito is used to treat functional dyspepsia in adults. This study investigated the effects of rikkunshito on delayed gastric emptying in handicapped patients. Methods A retrospective review was performed in nine profoundly handicapped patients (aged 1–19 years). All were diagnosed with delayed gastric emptying based on their half gastric emptying time (T 1/2) over 90 min. Gastric emptying was evaluated after the ingestion of liquid meals using the 13C-acetate breath test and the BreathID™ system. Participants were given rikkunshito [0.3 g/(kg day)] with the aim of accelerating gastric emptying. Parameters related to gastric emptying before and during rikkunshito administration were compared using the Wilcoxon signed-rank test. Data were expressed as the median (range). Results Emesis and hematemesis were relieved with rikkunshito administration in four symptomatic patients. The T 1/2 and T lag decreased significantly during rikkunshito administration from 115 min (94–167 min) to 107 min (64–66 min; p = 0.02), and from 60 min (42–90 min) to 47 min (29–59 min; p = 0.03), respectively. The gastric emptying coefficient did not show a significant change [3.1 (2.8–3.8) vs. 3.2 (2.6–4.0), p = 0.15)] with rikkunshito treatment. Conclusion The administration of rikkunshito resulted in symptomatic relief and improved gastric emptying in profoundly handicapped patients with delayed gastric emptying.

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