Abstract
Background. Treating functional gastrointestinal disorders is extremely difficult. We herein report the effect of the oral administration of Ninjinto (NJT, ginseng decoction), a traditional Japanese Kampo medicine, on chronic intestinal failure. Patients and Methods. Seven patients with chronic intestinal failure treated with NJT were evaluated in this study. The primary diseases included chronic intestinal pseudoobstruction (CIPO: n = 4), short bowel syndrome (SBS: n = 2), and intestinal atresia (n = 1). All patients orally received NJT extract granules at a dose of 0.3 g/kg BW per day. The treatment outcomes were then assessed according to the patients' symptoms and consecutive abdominal X-ray findings. Results. The targeted symptoms were abdominal distension in four patients, diarrhea in three patients, and frequent hospitalization due to infections in two patients. An improvement in the symptoms was observed in six of the seven patients, whereas one patient with SBS did not show any improvement. An improvement in an abdominal roentgenogram was observed in the four patients with remarkably dilated bowel loops due to CIPO. Conclusions. NJT may be effective in controlling functional gastrointestinal disorders associated with chronic intestinal failure. The use of Kampo medicine in the field of pediatric surgery may help to improve the quality of life in children suffering from such conditions.
Highlights
Pediatric intestinal failure is a complex clinical problem associated with high patient morbidity and mortality
Intestinal failure due to short bowel syndrome (SBS) and/or intestinal dysmotility caused by chronic intestinal pseudoobstruction (CIPO) or a postoperative state of intestinal atresia result in inadequate nutritional absorption to support normal growth and development
A previous study demonstrated that treatment with Ninjinto significantly improves gastrointestinal motility, and exhibits stronger effects than that observed for various prokinetic drugs, such as cisapride and metoclopramide, in a rat model of postoperative ileus [4]
Summary
Pediatric intestinal failure is a complex clinical problem associated with high patient morbidity and mortality. Intestinal failure due to short bowel syndrome (SBS) and/or intestinal dysmotility caused by chronic intestinal pseudoobstruction (CIPO) or a postoperative state of intestinal atresia result in inadequate nutritional absorption to support normal growth and development. Ninjinto (NJT), a traditional Japanese Kampo medicine, is prepared from four different Chinese crude drugs. This medicine is a major prescription in Japan and most frequently used for the treatment of gastroenteritis, esogastritis, gastric atony, gastrectasis, vomiting, and anorexia [3]. We report the effect of the oral administration of Ninjinto (NJT, ginseng decoction), a traditional Japanese Kampo medicine, on chronic intestinal failure. Seven patients with chronic intestinal failure treated with NJT were evaluated in this study. NJT may be effective in controlling functional gastrointestinal disorders associated with chronic intestinal failure. The use of Kampo medicine in the field of pediatric surgery may help to improve the quality of life in children suffering from such conditions
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