Impact of rikkunshito, an herbal medicine, on delayed gastric emptying in profoundly handicapped patients

Rikkunshito is used to treat functional dyspepsia in adults. This study investigated the effects of rikkunshito on delayed gastric emptying in handicapped patients. A retrospective review was performed in nine profoundly handicapped patients (aged 1-19 years). All were diagnosed with delayed gastric emptying based on their half gastric emptying time (T (1/2)) over 90 min. Gastric emptying was evaluated after the ingestion of liquid meals using the (13)C-acetate breath test and the BreathID (TM) system. Participants were given rikkunshito [0.3 g/(kg day)] with the aim of accelerating gastric emptying. Parameters related to gastric emptying before and during rikkunshito administration were compared using the Wilcoxon signed-rank test. Data were expressed as the median (range). Emesis and hematemesis were relieved with rikkunshito administration in four symptomatic patients. The T (1/2) and T (lag) decreased significantly during rikkunshito administration from 115 min (94-167 min) to 107 min (64-66 min; p = 0.02), and from 60 min (42-90 min) to 47 min (29-59 min; p = 0.03), respectively. The gastric emptying coefficient did not show a significant change [3.1 (2.8-3.8) vs. 3.2 (2.6-4.0), p = 0.15)] with rikkunshito treatment. The administration of rikkunshito resulted in symptomatic relief and improved gastric emptying in profoundly handicapped patients with delayed gastric emptying.