Rhei radix

Medicinal preparation of the roots and rhizomes of Rheum officinale (syn.: Rheum palmatum)

HMPC monograph: Well-established use: Internally: short-term treatment for occasional constipation
ESCOP monograph: short-term treatment for occasional constipation.
Commission e-monograph: forconstipation.

Proven and approved by clinical data: externally as a brushing for inflammation of the gums and oral mucosa.

Empirical medicine: to soften the stool, e.g. in anal fissures, before rectal-anal operations, also in low doses for gastrointestinal catarrh.

Active ingredients with a laxative effect are anthracene derivatives (3-12%), especially anthraquinone glycosides and dianthrone glycosides (e.g. sennoside A-F) as well as their aglycans: Rhine with its prodrug diacerein, rheumatism emodin, aloe emodin (see Emodine below). Furthermore catechin tanning agents (see below tanning agents), pectins and flavonoids.

Laxative, secretagogue, hydragogue, antiresorptive, inhibition of propulsive contractions, astringent.

According to Commission E: for short-term treatment of constipation.

Ready-to-use preparations are to be preferred; the application period should be limited to a maximum of 1-2 weeks.

Higher dosage may cause colicky abdominal pain, long-term use may cause albuminuria, electrolyte disturbances, hypokalemia, muscle weakness, pigment deposits in the intestinal mucosa.

Cave: Digitalis sensitivity increased!!!

(see information on commercial products); ileus of any kind, inflammatory gastrointestinal diseases. Children < 12 years, pregnancy and lactation (lack of sufficient toxicological and clinical data)

Enhancement of the effect of digitalis with prolonged use. Increased potassium loss with simultaneous administration of diuretics, adrenocortical hormones or licorice root!

1. Ammon HTP (2014) Hunnius pharmaceutical dictionary. Walter de Gruyter GmbH Berlin,Boston pp.1546-1547.
2. Schilcher H (2016) Guide to phytotherapy. Urban & Fischer Munich p.264-266
3. Zhou Z (1989) Application and mechanism of radix et rhizoma rhei in treating diseases of the digestive system. Zhongguo Zhong Yao Za Zhi 14:501-503
4. https://arzneipflanzenlexikon.info/rhabarber.php
5. https://www.ema.europa.eu/en/medicines/herbal/rhei-radix#overview-section
6. Wenigmann M. (2017) Phytotherapy medicinal drugs, phytopharmaceuticals, application. Urban & Fischer, pp. 178-179