Daikenchuto significantly improves stool consistency and lower gastrointestinal symptoms in patients with chronic constipation

Abstract

Background and Aim: A number of basic and clinical studies have confirmed that the traditional Japanese herbal medicine, Daikenchutou (DKT) has a pharmacological effect on cholinergic and serotonergic mechanisms with a favorable safety profile and an improving effect on lower gastrointestinal (GI) symptoms including abdominal pain or bloating. The purpose of this study is to evaluate the efficacy and safety of DKT on chronic constipation. Methods: This multicenter, randomized, placebo-controlled, double-blinded clinical trial enrolled 67 patients with chronic constipation fulfilling Rome III criteria. After a 2-week observation period, 63 patients with persistent symptoms were finally randomized to a 4-week course of treatment with DKT or placebo. The primary endpoint consisted of a global assessment of overall treatment effect (OTE), while the secondary endpoints consisted of improvements in stool consistency, spontaneous bowel movements, lower GI symptoms related to constipation, and quality of life. Factors associated with OTE were also investigated. Results: After 4 weeks administration of DKT, OTE was significantly higher than placebo. No side effects were observed. Significant improvement in stool consistency and lower GI symptoms was observed in the DKT group. The improvements in lower GI symptoms as well as stool consistency were associated with OTE. OTE was higher in patients with greater improvement in lower GI symptoms with mental component summary scores close to normal before treatment. Conclusion: DKT was effective and safe in treating chronic constipation, especially in patients having symptoms related to constipation with no impaired mental component summary score.

Management of Chronic Constipation: A Comprehensive Review

“…Although Kampo medicines are used in clinical practice, there are few reports with a high level of evidence, such as RCTs, to prove their effectiveness. Recently, Manabe et al randomized 63 patients with chronic constipation (including constipated IBS) who met the ROME III criteria to receive Daikenchuto or placebo and treated them for four weeks (74). They reported that the overall improvement was significantly higher in the Daikenchuto group than in the placebo group, and Daikenchuto also significantly improved stool consistency and abdominal distension compared with the placebo group.…”

Quality markers of Dajianzhong decoction based on multicomponent qualitative and quantitative analysis combined with network pharmacology and chemometric analysis

“…3 It was included by the State in the "Catalogue of Ancient Classical Prescriptions (First Batch)" and has been extensively compiled in medical texts throughout the ages. 4 For the treatment of digestive system illnesses such as postoperative ileus (POI), [5][6][7] small intestinal mucositis, 8 chronic constipation, 9 and colitis, 2 DJZD is frequently used as a basic formula and has a long history of clinical application. Modern pharmacological studies have verified that DJZD possesses anti-inflammatory 2 and analgesic, 10 as well as promotes the motor function of the gastrointestinal tract 11 and anti-gastrointestinal tumours.…”