Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 21, 2013; 19(31): 5118-5124
Published online Aug 21, 2013. doi: 10.3748/wjg.v19.i31.5118
Rikkunshito improves globus sensation in patients with proton-pump inhibitor-refractory laryngopharyngeal reflux
Ryoji Tokashiki, Isaku Okamoto, Nobutoshi Funato, Mamoru Suzuki
Ryoji Tokashiki, Isaku Okamoto, Nobutoshi Funato, Mamoru Suzuki, Department of Otolaryngology, Tokyo Medical University, Tokyo 160-0023, Japan
Author contributions: Tokashiki R and Suzuki M were the study supervisors; Tokashiki R designed the study; Tokashiki R, Okamoto I and Funato N performed the research; Tokashiki R analysed the data; Tokashiki R wrote the paper; all authors critically reviewsed the manuscript.
Supported by Tsumura & Co.
Correspondence to: Dr. Ryoji Tokashiki, Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinkjyukuku, Tokyo 160-0023, Japan.
Telephone: +81-3-33426111 Fax: +81-3-33469275
Received: January 17, 2013
Revised: February 20, 2013
Accepted: April 9, 2013
Published online: August 21, 2013

AIM: To investigate the effect of rikkunshito on laryngopharyngeal reflux (LPR) symptoms and gastric emptying in patients with proton-pump inhibitor (PPI)-refractory LPR.

METHODS: In total, 22 patients with LPR were enrolled. Following a 2-wk treatment with PPI monotherapy, PPI-refractory LPR patients were randomly divided into two treatment groups (rikkunshito alone or rikkunshito plus the PPI, lansoprazole). LPR symptoms were assessed using a visual analog scale (VAS) score, gastrointestinal symptoms were assessed using the gastrointestinal symptom rating scale (GSRS), and gastric emptying was assessed using the radio-opaque marker method prior to and 4 wk following treatments.

RESULTS: The 4-wk treatment with rikkunshito alone and with rikkunshito plus the PPI significantly decreased the globus sensation VAS scores. The VAS score for sore throat was significantly decreased following treatment with rikkunshito plus PPI but not by rikkunshito alone. Neither treatment significantly changed the GSRS scores. Rikkunshito improved delayed gastric emptying. We found a significant positive correlation between improvements in globus sensation and in gastric emptying (r2 = 0.4582, P < 0.05).

CONCLUSION: Rikkunshito improved globus sensation in patients with PPI-refractory LPR, in part, because of stimulation of gastric emptying. Thus, rikkunshito is an effective treatment for PPI-refractory LPR.

Keywords: Laryngopharyngeal reflux, Gastroesophageal reflux disease, Globus sensation, Gastric emptying, Rikkunshito

Core tip: Regarding the treatment of laryngopharyngeal reflux (LPR) symptoms such as globus sensation and a scratchy feeling, proton pump inhibitors (PPIs) are considered the mainstay. We investigated the effects of rikkunshito on globus sensation and gastric emptying in patients with PPI-refractory LPR.