• The Journal of Internal Korean Medicine
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• v.37 no.3
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• pp.495-507
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• 2016

Objectives: This study was designed to investigate the effects of Jwa Kum-Whan (JKW) on reflux esophagitis in rats.Methods: Forty rats were divided into five groups: a sham group (with no medication and only treated with ventrotoby); a group with reflux esophagitis (RE); a pantoprazole group (treated with 30 mg/kg pantoprazole per day for two weeks); a JKW280 group (treated with 280 mg/kg JKW per day for two weeks); and a JKW560 group (treated with 560 mg/kg JKW per day for 2 weeks). All rats fasted for 24 hrs and then were induced with RE by the oral administration of indomethacin and by a pylorus and forestomach ligation operation. After 8 hrs, the rats were sacrificed. We measured body weight, gastric juice pH, gastric volume, antioxidant activity, and cytokine and made a histologic examination of the esophagus and the stomach.Results: The weights of the rats in each group were not significantly different. The gastric juice pH significantly increased in the JKW560 group and the pantoprazole group compared with the RE group. Gastric volume significantly decreased in the JKW560 group compared with the RE group and the pantoprazole group. SOD activities significantly increased in the JKW280 and JKW560 groups compared with the RE group. Catalase activities significantly increased in the pantoprazole group and the JKW560 group compared with the RE group. TNF-α significantly decreased in the JKW280 and JKW560 groups compared with the RE group. IL-6 significantly decreased in the pantoprazole group and the JKW280 and JKW560 groups compared with the RE group. Histologic examination of the esophagus and the stomach showed significant improvements in the pantoprazole, JKW280, and JKW560 groups compared with the RE group.Conclusion: Based on these results, it is concluded that JKW can prevent reflux esophagitis.

• The Korea Journal of Herbology
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• v.31 no.6
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• pp.37-44
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• 2016

Objective : This study aimed to evaluate the protective effect of Artemisiae Capillaris Herba (AC) in reflux esophagitis (RE) rats. Methods : The AC was measured antioxidant activity through in vitro experiments, such as total polyphenol and flavonoid contents, 1, 1-diphenyl-2-picrylhydrazyl (DPPH) and 2, 2'-azinobis-3-ethyl-benzothiazoline-6-sulfonic acid (ABTS) radical scavenging activity. Base on the results, we had conducted in vivo experiments. Rats were divided normal, control, AC treatment 50 mg/kg BW (AC50), and AC treatment 100 mg/kg BW (AC100) groups. AC were orally administered 2 h before the induction of RE. RE was induced by tie the pylorus and the transitional junction between the forestomach and the corpus in Sprague-Dawley rats. The rats were sacrificed 5 h after the surgery. We analyzed the expression of inflammatory related markers by western blot and observed the production of reactive oxygen species (ROS) and hematoxylin-eosin staining, Results : The $IC_{50}$ of AC for DPPH and ABTS were showed 12.60 and $33.32{\mu}g/m{\ell}$ respectively. In the RE rat, AC decreased inflammatory related markers, such as phosphorylated inhibitor of ${\kappa}B{\alpha}$, nuclear factor-kappa B, cyclooxygenase-2, inducible nitric oxide synthase, and tumor necrosis factor alpha. Also, AC reduced the increased reactive oxygen species in serum. The anti-inflammatory effect of AC appeared to be partially mediated through the inhibition of ROS. Also, AC markedly ameliorated esophageal mucosa damage via the inhibition of protein expression related to inflammation. Conclusions : Therefore, these results suggest that AC would be used as a therapeutic material in protection and/or treatment for reflux esophagitis.

• Korean Journal of Organic Agriculture
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• v.29 no.1
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• pp.85-96
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• 2021

Reflux esophagitis (RE) is a common gastrointestinal disease observed at all ages, which seriously affects the quality of life. In this study, we investigated the anti-inflammatory effects of Pomacea canaliculata extract (PCE) using the experimental RE rat model. RE was induced by a surgical procedure. The rats were randomly divided into 4 groups: normal group, RE group, PCE group (RE treated with PCE, 100 mg/kg), positive control group (RE treated with ranitidine, 40 mg/kg). We performed the histological examination and measured the expression of tight junction complex and inflammatory mediators using western blot analysis. The phenotypes of RE were attenuated by PCE treatment. PCE administration significantly reduced esophageal mucosal damage and protected tight junction confirmed by claudin-5. Furthermore, PCE treatment reduced inflammatory reaction by inhibiting the expression of COX-2 and TNF-α. PCE treatment, also, reduced translocation of NF-κB into nuclear and IκB-α phosphorylation at the same time. Our findings indicate that PCE has the potential as a novel therapeutic agent to inhibit RE by protecting mucosal damage and regulating inflammatory reactions mediated by NF-κB signaling.

• The Korea Journal of Herbology
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• v.34 no.2
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• pp.15-23
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• 2019

Objective : Reflux esophagitis (RE) is a disease that caused gastric acid reflux and inflammation due to unstable gastroesophageal sphincter, as increasing worldwide respectively. This study was conducted to evaluate the effect of Evodiae Fructus (EF) extract on chronic reflux esophagitis in rats. Methods : The EF was measured antioxidant activity, such as total polyphenol and total flavonoid contents, 1, 1-diphenyl-2-picrylhydrazyl (DPPH) and 2, 2'-azinobis-3-ethyl-enzothiazoline-6-sulfonic acid (ABTS) radical scavenging activity. Rats were divided into 3 groups; Nor (normal group), Con (chronic acid reflux esophagitis rats treatment with water), EF (chronic acid reflux esophagitis rat treatment with EF 200 mg/kg body weight group). A surgically-induced chronic acid reflux esophagitis (CARE) model was established in SD rats, and treated with water or EF 200 mg/kg body weight for 14 consecutive days. Results : Administration of EF to rats of induction of chronic acid reflux esophagitis was found to reduce esophagus tissues injury. Reactive oxygen species (ROS) and produces peroxynitrite ($ONOO^-$) levels of esophagus tissues were significantly decreased in EF compared to Con group. As results of esophagus protein analyses, EF effectively reduce inflammatory-related factors ($NF-{\kappa}Bp65$, $p-I{\kappa}B{\alpha}$, iNOS, $TNF-{\alpha}$, IL-6), and increase anti-oxidant enzyme (Nrf2, HO-1, SOD, catalase, GPx-1/2). Conclusions : These results suggest that EF administration comfirmed that decreased esophagus tissues injury, oxidantive stress, anti-inflammation effect, and increased anti-oxidant effect. Therefore, EF was the potential to be used as a natural therapeutic drug.

• The Journal of Internal Korean Medicine
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• v.34 no.2
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• pp.165-177
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• 2013

Objectives : The object of this study was to observe the protective effects of 8 types of individual herbal components of Yijintang-gamibang, on the reflux esophagitis (RE) in rats as compared with omeprazole. Methods : Each 100 mg/kg individual herbal component was orally pretreated, at 1 hr before and 6 hrs after pylorus and forestomach ligation, the changes on the esophageal lesion areas, gastric volumes, acid and pepsin outputs, antioxidant effects, esophageal total hexose and sialic acid contents were observed with changes on the esophageal histopathology. The results were compared with an omeprazole 10 mg/kg treated group. Results : Pylorus and forestomach ligation-induced RE were inhibited by treatment of all 8 herbal components and omeprazole except for Pinella Rhizoma and Massa Meicata Fermentata, in order of Atractylodis Rhizoma, Citri Pericarpium, omeprazole, Glycyrrhizae Radix, Hordei Fructus Germiniatus, Holelen and Citri Pericarpium, as compared with RE control. Pinella Rhizoma and Massa Meicata Fermentata did not show any favorable protective effects against RE nor antioxidant effects in the present study. Conclusions : The main active herbal components showing favorable protective effects on RE of Yijintang-gamibang mediated by antioxidant effects, were Atractylodis Rhizoma, Citri Pericarpium, Glycyrrhizae Radix, Hordei Fructus Germiniatus, Holelen and Citri Pericarpium. Furthermore Atractylodis Rhizoma and Citri Pericarpium showed more favorable protective effects as compared with omeprazole, therefore, it is expected that Atractylodis Rhizoma and Citri Pericarpium have potential as new alternatives or safe therapeutics against RE.

• The Journal of Korean Medicine
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• v.31 no.5
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• pp.64-81
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• 2010

Objectives: The object of this study was to observe the suppressive effects of Yijintang-gamibang (YJGMB), Yijintang being traditionally used in the Korean Medicine for treating various digestive diseases, on the rat reflux esophagitis (RE) as compared with omeprazole, a well-known proton pump inhibitor. Methods: Three different dosages of YJGMB, 50, 100 and 200 mg/kg, were orally pretreated once a day for 28 days before pylorus and forestomach ligation. Seven groups of 8 rats each were used in the study. Six hrs after pylorus and forestomach ligation, changes to the stomach and esophagus lesion areas, gastric volumes, acid and pepsin outputs, invasive lesion percentages, fundic mucosa, esophageal submucosa and total thicknesses were measured by histomorphometry. The results were compared with omeprazole 10 and 30 mg/kg treated groups in which the effects on RE were already confirmed. Results: As results of pylorus and forestomach ligation, marked increases of esophageal and gastric mucosa lesion areas, gastric volumes, acid outputs, pepsin outputs were observed with histopathological changes of RE, such as hemorrhages, ulcerative lesions and edematous changes on the esophageal and fundic mucosa. However, these pylorus and forestomach ligation induced RE were dose-dependently inhibited by treatment of 50, 100 and 200 mg/kg of YJGMB. YJGMB 50 mg/kg showed similar suppressive effects as 30 mg/kg of omeprazole, but more favorable effects were observed as compared with omeprazole 10 mg/kg. Conclusion: The results suggest that YJGMB showed favorable suppressive effects on the RE induced by pylorus and forestomach ligation. It is therefore expected that YJGMB will show favorable effects on RE as corresponds to the suggestion of traditional Korean medicine. However, more detailed mechanism studies should be conducted in future with the screening of the biological active chemical compounds in herbs.

• Journal of Acupuncture Research
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• v.30 no.2
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• pp.31-41
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• 2013

Objectives : This study was to evaluate inhibitory effects of Naegwan-acupuncture($PC_6$) on acute RE(reflux esophigitis) rat induced by pylorus and forestomach ligation operation. Methods : Twenty seven SD rats were divided three groups (intact normal rat; RE control rat; RE control rat respectively stimulated by Naegwan point($PC_6$)). All rats was fasted for 18 h but free water, we induced RE by pylorus and forestomach ligation operation. Six hour after the operation, rats were sacrified, collected bloods in the abdominal vein, dissected a esophagus and stomach. The stomach was washed a 1 ml PBS to research gastric volume, pH, acidity and mucin release of gastric juice, esophagus was cut longitudinally and pictured a innter mucosa area to research damages in esophagus. The proinflammatory cytokine and chemokine including IFN-${\gamma}$, TNF-${\alpha}$, IL-$1{\beta}$, IL-6 and MCP-1 were analyzed by ELISA kit. Results : 1. Significantly, death rate of $PC_6$ acupuncture rat group was decreased compared to that of RE control group. 2. Gastric Volume, gastric injury and esophageal mucosa demage were decreased significantly, too. 3. Compared with RE, all of the proinflammatory cytokine and chemokine analyzed in serum of $PC_6$ were decreased remarkably. Especially, there were significant meanings TNF-${\alpha}$, IL-6 and MCP-1 in serum of $PC_6$ were decreased. Conclusion : The results suggest that antiinflammatory and protecting effects of PC6 could attenuate the severity of reflux esophagitis and prevent the esophageal mucosal damage, and validate its therapeutic use in esophageal reflux disease.

• The Journal of Internal Korean Medicine
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• v.42 no.6
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• pp.1245-1254
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• 2021

Objectives: This study investigated the clinical characteristics and symptoms of patients with reflux esophagitis (RE) visiting a Korean medicine hospital. Methods: We retrospectively reviewed the medical records of patients with an RE diagnosis who visited a Korean medicine hospital from June 15, 2020, to April 15, 2021. We analyzed the clinical characteristics and the results of a symptoms questionnaire. Results: Our sample included 1,151 patients (711 females). The median age was 58 years; the most common age bracket was 60-69 years. A total of 837 patients (72.7%) presented with symptoms lasting more than one year, and 1,035 (89.9%) had been prescribed medications for more than three months before visiting a Korean medicine hospital. Belching (77.6%) and acid regurgitation (70.9%) were the most frequent symptoms, followed by epigastric pain (61.6%) and throat globus (58.5%). Throat globus was the most bothersome symptom, and 72.4% of the patients experienced the symptom on more than five days in the preceding two weeks. Patients with a longer symptom duration were older (p<0.01) and more likely to be overweight (p=0.03). Patients experiencing symptoms for more than five years were more likely to report throat globus (p=0.02), hoarseness (p<0.01), and coughing (p<0.01). Conclusions: Most RE patients visiting a Korean medicine hospital were females in their sixties with chronic and refractory RE. Atypical symptoms (belching, epigastric pain, and throat globus) were common. Throat globus was highly prevalent in severe cases, suggesting that it warrants attention when treating RE patients.

• The Korea Journal of Herbology
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• v.31 no.5
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• pp.85-92
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• 2016

Objectives： This study is experimental comparison of brown rice (BR) and germinated brown rice (GBR) on upper gastrointestinal diseases animal models.Methods： The ICR mice were divided randomly into four groups of six animals each (Normal mice, gastritis mice, gastritis mice treated with BR, gastritis mice treated with 48h GBR). Gastritis was induced by administration of 0.5 mL 150 mM HCl-60% ethanol. Six-week-old male Sprague-Dawley (SD) rats were randomly divided into 7 groups after 1 week adaptation. (Normal rat, reflux esophagitis (RE) rat, RE rat treated with BR, RE rat treated with 24,30,36,48h GBR). Reflux esophagitis was induced by ligation with a 2-0 silk thread both the pylorus and the transitional junction between the forestomach and the corpus in SD rats.Results： HCl/ethanol-induced gastric mucosal injury mice were ameliorated mucosal damage upon histological evaluation by treatment of 48h GBR than BR. Optical changes such as hyperemia and multiple erosions were observed in the rats with RE and damage to the normal rats was not apparent. The oral administration of GBR significantly diminished against gross mucosal damage in a germination time-dependent manner. Also, the administration of GBR suppressed the biomarker of oxidative stress, reactive oxygen species (ROS) and produces peroxynitrite (ONOO-) in serum. However, the administration of GBR could not affect to the pH level secreted from stomach when compared with Control group.Conclusions： These findings suggest that GBR could have improving effects on upper gastrointestinal diseases in a germination time-dependent manner.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.3
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• pp.160-166
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• 2017

Purpose: The prevalence of reflux esophagitis (RE) has increased recently in Korea. Little is known concerning the prevalence and characteristics of RE in pediatric patients. This study investigated the prevalence and influence of risk factors in endoscopically proven RE in Korea in pediatric patients over a period of 14 years. Methods: A retrospective chart review of all patients between the ages of 1 month and 20 years who underwent esophagogastroduodenoscopy at Samsung Medical Center between 2001 and 2014 was carried out. Univariate and multivariate analyses were conducted to identify independent risk factors for RE. Results: The prevalence rate of endoscopically proven RE in this study was 28.7% (978/3,413). The prevalence of RE increased from 11.8% from 2001 to 2007 to 37.7% from 2008 to 2014. Multivariate logistic regression analysis revealed that residency in the Greater Gangnam area (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.02-1.44) and age (OR, 1.13; 95% CI, 1.11-1.15) were significant predictive factors for the presence of RE. Conclusion: The prevalence rate of endoscopically proven pediatric RE has increased over the past 14 years. Residency and older age are more important independent risk factors for pediatric RE in Korea.