title: Effects of herbal medicine Dai-Kenchu-to on anorectal function in children with severe constipation.
abstract: OBJECTIVE
  We administered the herbal medicine Dai-Kenchu-To (DKT) to children with severe chronic constipation or with severe constipation after surgery for anorectal malformations. We then objectively assessed the effect of DKT on anorectal function by manometric study in addition to using a clinical scoring system.
  
  
  METHODS
  Ten children with severe chronic constipation and 5 children with severe constipation after surgery for anorectal malformations were assessed. These 15 children received 0.3 g/kg/day of DKT for periods ranging from 3 months to 1 year. We objectively assessed their bowel function, sphincter function and rectal reservoir function by anorectal manometry and clinical scoring.
  
  
  RESULTS
  In 10 children with severe chronic constipation, the clinical score after administration of DKT (7.2 +/- 0.8) improved significantly compared with that before administration of DKT (4.6 +/- 2.9) (p < 0.02). The threshold sensation volume and the maximum tolerable volume after administration of DKT significantly (p < 0.05; p < 0.01) decreased (128 +/- 63 ml vs. 69 +/- 18 ml; 229 +/- 99 ml vs. 144 +/- 47 ml), and rectal compliance after administration of DKT also significantly (p < 0.05) decreased (12.4 +/- 10.9 ml/cmH(2)O vs. 4.7 +/- 3.9 ml/cmH(2)O).
  
  
  CONCLUSIONS
  The present study demonstrated that DKT had a favorable clinical effect on severe constipation in children, and anorectal manometry showed an improvement in their rectal reservoir functions. It appears that the results were secondary to DKT-stimulated peristalsis of the intestine, which promoted regular bowel habits.
authors.affiliation: Division of Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan. n-iwai@koto.kpu-m.ac.jp
authors.forename: N
authors.initials: N
authors.lastname: Iwai
authors.forename: Y
authors.initials: Y
authors.lastname: Kume
authors.forename: O
authors.initials: O
authors.lastname: Kimura
authors.forename: S
authors.initials: S
authors.lastname: Ono
authors.forename: S
authors.initials: S
authors.lastname: Aoi
authors.forename: T
authors.initials: T
authors.lastname: Tsuda
mesh_terms: D000293:Adolescent; D002648:Child; D003248:Constipation / Q000188:drug therapy*; D013505:Digestive System Surgical Procedures; D006801:Humans; D008365:Manometry; D005894:Panax; D010528:Peristalsis / Q000187:drug effects*; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D016896:Treatment Outcome; D032106:Zanthoxylum; D030521:Zingiberaceae
chemical_list: D010936:Plant Extracts; C121414:dai-kenchu-to