BackgroundDaikenchuto (DKT), a traditional Japanese herbal medicine, is widely used for treatment of gastrointestinal disorders. We evaluated the efficacy and safety of DKT for abdominal bloating in patients with chronic constipation.ObjectiveTo evaluate the efficacy and safety of DKT for the treatment of abdominal bloating.MethodsAfter discontinuing as-needed use of laxatives, 10 patients received oral DKT for 14 days (15 g/d). To evaluate small intestinal bacteria overgrowth (SIBO), a glucose breath test was performed before and after treatment with DKT. Before beginning the treatment, 4 patients (40%) had a diagnosis of SIBO based on a positive glucose breath test result. In both the SIBO and non-SIBO groups, bowel movement frequency and stool form remained unchanged after DKT treatment.ResultsFor all patients, median total Gastrointestinal Symptoms Rating Scale score and the median Gastrointestinal Symptoms Rating Scale indigestion and constipation subscales were significantly decreased, whereas the median visual analog score for decreased abdominal bloating was significantly increased. Improvements of those symptoms were the same in both the SIBO and non-SIBO groups, indicating that DKT does not have effects on small intestine bacteria. No serious side effects were reported.ConclusionsDKT treatment improved quality of life for patients with chronic constipation regardless of the presence of SIBO and showed no effects on small intestine bacteria. UMIN Clinical Trial Registry identifier: UMIN000008070.

A decrease in aortic compliance can modify the loading sequence to the left ventricular ejection in the elderly. To determine whether a decreased aortic compliance influences the left ventricular relaxation in man, 83 healthy volunteers, aged 34-87 years, were studied. The left ventricular relaxation was characterized by the isovolumic relaxation period (IRP) of the left ventricle. The aortic compliance was characterized by the aortic pulse wave velocity (AoPWV). The loading sequence to left ventricular ejection was classified into three groups by carotid pulse contour; type A, dominant tidal wave; type B, percussion wave almost equal to the tidal wave; type C, dominant percussion wave. IRP and AoPWV increased with age. The mean arterial pressure was unrelated to age. IRP was significantly related to AoPWV and mean arterial pressures. Multiple regression analysis, correlating IRP with AoPWV and mean arterial pressure, demonstrated that only AoPWV was an independent factor to explain IRP. IRP was longer in type A than in type C, and AoPWV was faster in type A than in type C volunteers. The prominent tidal wave in type A may reflect a more rapid transmission of arterial wave reflection which can result in a change of the loading sequence to the left ventricular ejection. These results reveal that a decrease in aortic compliance with aging can affect left ventricular relaxation through the change of the loading sequence in man.

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