2018 Volume 60 Issue 2 Pages 145-151
Case 1 is a 74-year-old male who had undergone total gastrectomy and Roux-en-Y reconstruction for gastric cancer one year and three months previously. He presented with repeated reflux symptoms and aspiration pneumonia infections. Upper endoscopic examination showed the accumulation of a large volume of bile juice in the esophagus and severe reflux esophagitis. Treatments with a pancreatic enzyme inhibitor and peristaltic stimulant were ineffective, but he improved and could be discharged after the addition of Rikkunshito, a traditional Japanese medicine. Case 2 is a 75-year-old male who had undergone distal gastrectomy and B-I reconstruction for gastric cancer. He presented with vomiting, hiccups, appetite loss and body weight loss, and visited our department five years after the surgery. We also diagnosed this patient as having severe reflux esophagitis and his symptoms were improved by administration of Rikkunshito. As to the effects of Rikkunshito, absorption of bile has been reported in addition to improvement of gastrointestinal motility and appetite promotion. Rikkunshito may be suitable for the treatment of postoperative reflux esophagitis and should contribute to improvement of various symptoms.
