Characteristics of gastrointestinal symptoms and function following endoscopic submucosal dissection and treatment of the gastrointestinal symptoms using rikkunshito

Uehara,Ryohei; Isomoto,Hajime; Minami,Hitomi; Yamaguchi,Naoyuki; Ohnita,Ken; Ichikawa,Tatsuki; Takeshima,Fuminao; Shikuwa,Saburo; Nakao,Kazuhiko

doi:10.3892/etm.2013.1299

Characteristics of gastrointestinal symptoms and function following endoscopic submucosal dissection and treatment of the gastrointestinal symptoms using rikkunshito

Authors:
- Ryohei Uehara
- Hajime Isomoto
- Hitomi Minami
- Naoyuki Yamaguchi
- Ken Ohnita
- Tatsuki Ichikawa
- Fuminao Takeshima
- Saburo Shikuwa
- Kazuhiko Nakao
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Affiliations: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
Published online on: September 13, 2013 https://doi.org/10.3892/etm.2013.1299
Pages: 1083-1088

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Abstract

The aim of the present study was to investigate the gastrointestinal (GI) symptoms and gastric emptying following endoscopic submucosal dissection (ESD), as well as to evaluate a novel treatment strategy using rikkunshito, a traditional Japanese herbal medicine. GI symptoms and gastric emptying were evaluated 6-8 days after ESD as part of the Step I study. In the Step 1 study, the Gastrointestinal Symptom Rating Scale (GSRS) scores of the two groups after 4 and 8 weeks of treatment with either a proton pump inhibitor (PPI; PPI monotreatment group, n=5) or a PPI plus rikkunshito (PPI + rikkunshito group, n=8) were compared against baseline values. Abdominal pain and constipation occurred in the majority of patients after ESD. The mean T-max 6-8 days after gastric emptying was 75.4±13.6 min, which was significantly longer compared with that reported in healthy subjects (43.9±10.3 min). In the Step 2 study, the total GSRS score was significantly improved only in the PPI + rikkunshito group after 8 weeks of treatment. In conclusion, ESD affects gastric emptying and is associated with an increased incidence of upper GI symptoms such as abdominal pain and indigestion. Rikkunshito may be useful as a novel supporting therapeutic drug for the treatment of GI symptoms in patients who have undergone ESD.

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