Rikkunshito improves globus sensation in patients with proton-pump inhibitor-refractory laryngopharyngeal reflux

World J Gastroenterol. 2013 Aug 21;19(31):5118-24. doi: 10.3748/wjg.v19.i31.5118.


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: Gastric emptying; Gastroesophageal reflux disease; Globus sensation; Laryngopharyngeal reflux; Rikkunshito.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Drug Resistance
  • Drugs, Chinese Herbal / adverse effects
  • Drugs, Chinese Herbal / therapeutic use*
  • Female
  • Gastric Emptying / drug effects
  • Gastrointestinal Agents / adverse effects
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Japan
  • Laryngopharyngeal Reflux / diagnosis
  • Laryngopharyngeal Reflux / drug therapy*
  • Laryngopharyngeal Reflux / physiopathology
  • Male
  • Middle Aged
  • Pharynx / innervation*
  • Proton Pump Inhibitors / therapeutic use*
  • Sensation / drug effects*
  • Time Factors
  • Treatment Failure


  • Drugs, Chinese Herbal
  • Gastrointestinal Agents
  • Proton Pump Inhibitors
  • liu-jun-zi-tang