| Theme |
Kampo Medicine for Gastrointestinal Diseases -- Theory and Practice |
| Title |
Efficacy of Japanese Herbal Medicine for Patients with GERD and Dysphagia |
| Author |
Noriyuki Kawami |
Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine |
| Author |
Katsuhiko Iwakiri |
Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine |
| [ Summary ] |
Proton pump inhibitors (PPIs) are recommended as first-line therapy per the 2015 clinical practice guideline for gastroesophageal reflux disease (GERD) of the Japanese Society of Gastroenterology; however, administration of PPI for 8 weeks shows absence of healing of mucosal breaks and no improvement of symptoms in PPI-resistant GERD patients. In such cases, additional administration of Japanese herbal medicine Rikkunshito, is an alternate treatment strategy. Rikkunshito has been reported to be effective for treatment of functional dyspepsia, and its treatment efficacy for GERD has been demonstrated through basic and clinical studies. Various mechanisms have been suggested to explain the ineffectiveness of PPIs in patients with PPI-resistant GERD. Additionally, detailed studies are needed to clarify the mechanisms that mediate the effectiveness of Rikkunshito's under each cause.
The efficacies of Hangekobokuto for globus sensation in the throat in patients without organic disease and Sha kuya ku kanzoto for patients with dysphagia caused by esophageal spasm or hyper contraction have also been reported. Further studies are needed to demonstrate the efficacies of these herbal medicines. |