Effects of Rikkunshito (TJ-43) on Esophageal Motor Function and Gastroesophageal Reflux

Abstract

Background/Aims Rikkunshito (TJ-43), an herbal medicine, has been demonstrated to relieve gastroesophageal reflux symptoms. However, the effects of TJ-43 on esophageal motor functions have not been fully determined. This double-blind crossover study was performed to investigate the effects of TJ-43 on esophageal motor functions and gastroesophageal reflux. Methods The subjects were 10 normal male volunteers. Lower esophageal sphincter pressure and esophageal body peristaltic contractions with and without 1-week administration of TJ-43 were examined in a crossover fashion. Post-prandial gastroesophageal reflux was also determined using a multi-channel impedance pH dual monitor. Results TJ-43 at a standard dose of 7.5 g/day did not significantly augment esophageal peristaltic contraction pressure measured in the proximal, middle and distal segments of the esophagus, whereas increment of resting lower esophageal sphincter pressure was observed in a supine position. In addition, TJ-43 administration did not decrease post-prandial gastroesophageal acid, non-acid reflux events or accelerate esophageal clearance time. Conclusions TJ-43 at a standard dose did not have a significant effect on esophageal motor activity or gastroesophageal reflux in healthy adults.

Preventive effect of rikkunshito on gastric motor function inhibited by l-dopa in rats

“…Stable ghrelin agonists have been reported to improve delayed gastric emptying in various experimental and clinical conditions associated with diabetes, postoperative and morphine-induced ileus and immune challenge [4,7,33,48,56,58]. Likewise, rikkunshito, a Japanese Kampo medicine acting as a ghrelin enhancer [50], alleviates gastroparesis [1,52], dyspepsia [1,25,52,54,61], post-operative gastric ileus [27,62], and gastroesophageal reflux disease [31,34,54] in experimental or clinical studies. A recent pilot clinical study also indicates that rikkunshito can ameliorate gastroparesis in PD patients [14].…”

Esophageal Motility and Rikkunshito Treatment for Proton Pump Inhibitor-Refractory Nonerosive Reflux Disease: A Prospective, Uncontrolled, Open-Label Pilot Study Trial

“…On the other hand, Morita et al 22 reported that RKT at a standard dose did not have a significant effect on esophageal motor activity in healthy adults. This difference might be due to varying esophageal motor function between healthy adults and patients with PPI-refractory NERD.…”

Complementary and Alternative Medicine for Gastroparesis

“…49 It was reported to promote gastric adaptive relaxation in patients with functional dyspepsia. 50 Simotang Simotang (decoction of 4 powered drugs), one of the most commonly used Chinese herbal formulas, was administrated to chronically stressed mice daily for 7 days for the assessment of its effect on gastrointestinal motility.…”