Digestive System

  • Volker Schulz
  • Rudolf Hänsel
  • Mark Blumenthal
  • Varro E. Tyler


This chapter deals with phytomedicines that are used in the treatment of poor appetite, functional dyspepsia (irritable stomach syndrome), irritable bowel syndrome (irritable colon), gastritis and ulcer disease, acute diarrhea, constipation, and chronic liver disease. These diseases and ailments are based only partly on underlying organic pathology; most are “functional” disturbances of the gastrointestinal tract and bile ducts. The remedies that are used for these indications are not always covered by health insurance in Germany, and certain groups, such as laxatives, have been largely excluded from coverage. The result has been an increase in the self-prescribing of these products by patients with digestive complaints. But functional dyspepsia and irritable bowel syndrome are examples of conditions in which it is imperative that the family doctor continue to provide appropriate counseling and guidance.


Irritable Bowel Syndrome Functional Dyspepsia Crude Drug Acute Diarrhea Saccharomyces Boulardii 
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  1. Adler M (1979) Physiologische Psychologie, Teil II: Spezielle Funktionssysteme, Enke Stuttgart, 177–185.Google Scholar
  2. Ammon HPT, Wahl MA (1990) Pharmacology of Curcuma longa. Planta Med 57: 1–7.CrossRefGoogle Scholar
  3. Anonymus (1999) Schöllkraut — rezeptfrei und lebertoxisch. Arzneitelegramm 6 /99: 65.Google Scholar
  4. Baumann J (1975) Über die Wirkung von Chelidonium, Curcuma, Absinth und Carduus marianus auf die Galle-und Pankreassekr tion bei Hepatopathien. Med Mschr 29: 173.PubMedGoogle Scholar
  5. Bellomo A (1939) Ricerche cliniche. Giorn cad Med Torino 52: 181.Google Scholar
  6. Bielenberg J (1998) Die Süßholzwurzel. Wirkungen und Anwendungen unter dem Aspekt neuer pharmakologischer Erkenntnisse. Zeitschrift für Phytotherapie 19: 197–208.Google Scholar
  7. Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, Rister RS (eds.). Klein S, Rister RS (trans). (1998) The Complete German Commission E Monographs — Therapeutic Guide to Herbal Medicines. American Botanical Council, Austin.Google Scholar
  8. Böhm K (1959) Untersuchungen über choleretische Wirkungen einiger Arzneipflanzen. Arzneim Forsch/Drug Res 9: 376.Google Scholar
  9. Bowen IH, Cubbin IJ (1993) Mentha piperita and Mentha spicata. In: De Smet PAGM, Keller K, Hänsel R, Chandler RF (eds) Adverse Effects of Herbal Drugs 1. Springer Verlag, Berlin Heidelberg New York: 171–178.Google Scholar
  10. Brandt W (1988) Spasmolytische Wirkung ätherischer Ole. In: Phytotherapie, Hippokrates Stuttgart 77–89.Google Scholar
  11. Brandt W (1988) Spasmolytische Wirkung ätherischer Öle. In: Phytotherapie, Hippokrates Stuttgart, 77–89.Google Scholar
  12. Braun JE, Rice-Evans CA (1998) Luteolin-rich artichoke extract protects low-density lipoprotein from oxidation in vitro. Free Radical Research 29: 247–255.CrossRefGoogle Scholar
  13. Camilleri M (1999) Therapeutic approach to the patient with irritable bowel syndrome. Am J Med 107: 27S–32S.Google Scholar
  14. Camilleri M, Choi MG (1997) Review article: irritable bowel syndrome. Aliment Pharmacol Ther 11: 3–15.PubMedCrossRefGoogle Scholar
  15. Carling I, Svedberg LE, Hulten S (1989) Short term treatment of the irritable bowel syndrome: a placebo-controlled trial of peppermint oil against hyoscyamine. OPMEAR 34: 55–57.Google Scholar
  16. Coon JT, Ernst E (2002) Systematic review: herbal medicinal products for non-ulcer dyspepsia. Alment Pharmacol Ther 16: 1689–99.CrossRefGoogle Scholar
  17. Dew MJ, Evans BK, Rhodes J (1984) Peppermint oil for the irritable bowel syndrome: a multicentre trial. Br J Clin Pract 38: 394–395.Google Scholar
  18. Dobrilla G, Comberlato M, Steele A, Vallaperta P (1989) Drug treatment of functional dyspepsia. A meta-analysis of randomized controlled clinical trials. J Clin Gastroenterol ii: 169–77.Google Scholar
  19. Dresser GK, Wacher V, Ramtoola Z, Cumming K, Bailey D (2002) Peppermint oil increases the oral bioavailability of felopidine and simvastatin. Clin Pharmacol Ther 71: P67.CrossRefGoogle Scholar
  20. Duke JA (1985) CRC Handbook of medicinal Herbs. CRC Press, Boca Raton (USA): 358–359.Google Scholar
  21. Englisch W, Beckers C, Unkauf M, Ruepp M, Zinserling V (2000) Efficacy of artichoke dry extract in patients hyperlipoproteinemia. Arzneim-Forsch/Drug Res 50: 260–5.Google Scholar
  22. Ernst E, Pittler MH (2000) Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials. Br J Anaesth 84: 367–71.PubMedCrossRefGoogle Scholar
  23. Fiegel G (1971) Die amphocholeretische Wirkung der Fumaria officinalis. Z Allg Med 34: 1819.Google Scholar
  24. Fintelmann V (1996) Klinische Bedeutung der lipidsenkenden und antioxidativen Wirkung von Cynara scolymus (Artischocke). In: Loew D, Rietbrock N (eds) Phytopharmaka II: Forschung und klinische Anwendung. Steinkopff Verlag, Darmstadt: 145–159.Google Scholar
  25. Fintelmann V, Menßen HG, Siegers CP (1993) Phytotherapie Manual. Pharmazeutischer, pharmakologischer und therapeutischer Standard. 2nd Ed. Hippokrates Verlag Stuttgart.Google Scholar
  26. Fintelmann V, Petrowicz O (1998) Langzeitanwendung von Hepar-SL forte bei dyspeptischem Symptomenkomplex: Ergebnisse einer Beobachtungsstudie. Natura med 13: 17–26.Google Scholar
  27. Fintelmann V, Wegener T (2001) Curcuma longa —eine unterschätzte Heilpflanze. Deutsche Apotheker Zeitung 141: 3735–43.Google Scholar
  28. Forster H (1983) Spasmolytische Wirkung pflanzlicher Carminativa. Allgemeinmedizin 59: 1327–1333.Google Scholar
  29. Forster HB, Niklas H, Lutz S (1980) Antispasmodic effects of some medicinal plants. Planta med 40: 309–319.PubMedCrossRefGoogle Scholar
  30. Friedman G (1991) Treatment of the irritable bowel syndrome. Gastroenterology Clinics of North America 20: 325–333.Google Scholar
  31. Gebhardt R (1997 a) Stimulation of acid secretion by extracts of Gentiana lutea L. in cultured cells from rat gastric mucosa. Pharm Pharmacol Lett 7: 106–108.Google Scholar
  32. Gebhardt R (1997 b) Antioxidative and protective properties of extracts from leaves of the artichoke (Cynara scolymus L.) against hydroperoxide-induced oxidative stress in cultured rat hepatocytes. Toxicol Appl Pharmacol 144: 270–286.Google Scholar
  33. Gebhardt R (1998) Inhibition of cholesterol biosynthesis in primary cultured rat hepatocytes by artichoke (Cynara scolymus L.) extracts. J Pharmacol Exp Ther 286: 1122–1128.PubMedGoogle Scholar
  34. Gebhardt R, Fausel M (1997) Antioxidant and hepatoprotective effects of artichoke extracts and constituents in cultured rat hepatocytes. Toxicology in Vitro 11: 669–672.PubMedCrossRefGoogle Scholar
  35. Glatzel H (1968) Die Gewürze. Ihre Wirkungen auf den Menschen. Nicolaische Verlagsbuchhandlung, Herford: 170.Google Scholar
  36. Glatzel H, Hackenberg K (1967) Röntgenuntersuchungen der Wirkungen von Bittermitteln auf die Verdauungsorgane. Planta Med 15: 223–232.PubMedCrossRefGoogle Scholar
  37. Gunn JWC (1920) The carminative action of volatile oils. J Pharmacol Exp Ther 6: 93–143.Google Scholar
  38. Gunn JWC (1920) The carminative action of volatile oils. J Pharmacol Exp Ther 16: 93–143.Google Scholar
  39. Guttenberg A (1926) Das Cholagogum Curcumen. Klin Wschr 5: 1998–1999.CrossRefGoogle Scholar
  40. Hänsel W (1997) Die Gelbwurzel — Curcuma domestica Val., Curcuma xanthorrhiza Roxb. Portrait zweier Arzneipflanzen. Zeitschrift für Phytotherapie 18: 297–306. 6.Google Scholar
  41. Hawthorn M, Ferrante J, Luchowski E, Rutledge A, Wei XY, Triggle DJ (1988) The actions of peppermint oil and menthol on calcium channel-dependent processes in intestinal, neuronal and cardiac preparations. Aliment Pharmacol Therap 2: loi-118.Google Scholar
  42. Hills JM, Aaronson PI (1991) The mechanism of action of peppermint oil on gastrointestinal smooth muscle. Gastroenterology loi: 55–65.Google Scholar
  43. Hills JM, Aaronson PI (1991) The mechanisms of action of peppermint oil on gastrointestinal smooth muscle. Gastroenterol 101: 55–65.Google Scholar
  44. Holtmann G, Gschossmann JM, Buenge L, Wieland V, Heydenreich CJ (2003) Effects of a fixed combination of peppermint oil and caraway oil on symptoms and quality of life in patients suffering from functional dyspepsia. Phytomedicine 10 Suppl IV: 56–57Google Scholar
  45. Inoue H, Saito K, Koshihara Y, Murota S (1986) Inhibitory effect of glyzyrrhetinic acid derivatives of lipoxygenase and prostaglandin synthetase. Chem Pharm Bull 34: 897.PubMedCrossRefGoogle Scholar
  46. Isaac D (1980) Die Kamillentherapie — Erfolg and Bestätigung. Dtsch Apoth Ztg 120: 567–570.Google Scholar
  47. Jailwala J, Imperiale TF, Kroenke K (2000) Pharmacologic treatment of the irritable bowel syndrome: a systematic review of randomized, controlled trials. Ann Intern Med 133: 136–47.Google Scholar
  48. Jenss H (1985) Zur Problematik funktioneller Magen-Darm-Krankheiten am Beispiel des Colon irritabile. In: Oepen I (Hrsg) An den Grenzen der Schulmedizin, eine Analyse umstrittener Methoden. Deutscher Ärzte-Verlag Cologne: 197–212.Google Scholar
  49. Kammerer E, Fintelmann V (2001) Curcuma-Wurzelstock bei dyspeptischen Beschwerden–Ergebnisse einer Anwendungsbeobachtung an 44o Patienten. NaturaMed 16: 18–24.Google Scholar
  50. Kassir ZA. Endoscopic controlled trial of four drug regimens in the treatment of chronic duodenal ulceration. Irish Med J. 1985; 78: 153–156.Google Scholar
  51. Kirchhoff R, Beckers CH, Kirchhoff GM, Trinczek-Gärtner H, Petrowicz O, Reimann HJ (1994)Google Scholar
  52. Increase in choleresis by means of artichoke extract. Phytomedicine 1: 107–115.Google Scholar
  53. Kohlstaedt E (1947) Choleretika, Cholekinetika and Cholagoga. Pharmazie 2: 529–536.PubMedGoogle Scholar
  54. Kraft K (1997) Artichoke leaf extract — recent findings reflecting effects on lipid metabolism, liver and gastrointestinal tracts. Phytomedicine 4: 369–378.Google Scholar
  55. Kupke D, Sanden H, Trinczek-Gärtner H, Lewin J, Blümel G, Reimann HJ (1991) Prüfung der choleretischen Aktivität eines pflanzlichen Cholagogums. Z Allg Med 67: 1046–1058.Google Scholar
  56. Lawson MJ, Knight RE, Tran K, Walker G, Roberts-Thomson IC (1988) Failure of enteric-coated peppermint oil in the irritable bowel syndrome: a randomized, double-blind crossover study. J Gastroenterol Hepatol 3: 235–238.CrossRefGoogle Scholar
  57. Lech AY, Olesen KM, Hey H et al. (1988) Behandling of colon irritable med pebermynteolie. Ugeskr Laeger 150: 2388–2389.PubMedGoogle Scholar
  58. Leicester RJ, Hunt RH (1982) Peppermint oil to reduce colonic spasm during endoscopy. Lancet: 989.Google Scholar
  59. Liu JH, Chen GH, Yeh HZ, Huang CK, Poon SK (1997) Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: A prospective, randomized trial. J Gastroenterol 32: 765–768.Google Scholar
  60. Madisch A, Heydenreich CJ, Wieland V, Hufnagel R, Hutz J (1999) Treatment of functional dyspepsia with a fixed peppermint oil and caraway oil combination preparation as compared to cisapride. Arzneim-Forsch/Drug Res 49: 925–32.Google Scholar
  61. Madisch A, Hotz J (2000) Therapie von Reizmagen- und Reizdarmsyndrom aus klinischer Sicht. In: Rietbrock N (ed) Phytopharmaka VI–Foerschung und Praxis. Steinkopff, Darmstadt, pp. 193–200.CrossRefGoogle Scholar
  62. Madisch A, Melderis H, Mayr G, Sassin I, Hotz J (2001) Ein Phytotherapeuticum und seine modifizierte Rezeptur bei funktioneller Dyspepsie. Ergebnisse einer doppelblinden placebokontrollierten Vergleichsstudie. Z Gastroenterol 39: 511–7.Google Scholar
  63. Madisch A, Plein K, Mayr G, Burchert D, Hotz J (2000) Benefit of a herbal preparation in patients with irritable bowel syndrome: results of a blind, randomized, placebo-controlled multicenter trial. Gastroenterology 118: A4440.Google Scholar
  64. Maiwald L, Schwantes PA (1991) Curcuma xanthorrhiza Roxb., eine Heilpflanze tritt aus dem Schattendasein. Z Phytother 12: 35–445.Google Scholar
  65. Manning AP, Thompson WG, Heaton KW, Morris AF (1978) Towards positive diagnosis of the irritable bowel. BMJ 2: 653–654.PubMedCrossRefGoogle Scholar
  66. Maxwell PR, Mendall MA, Kumar D (1997) Irritable bowel syndrome. The Lancet 35o: 1691–1695.CrossRefGoogle Scholar
  67. May B, Köhler S, Schneider B (moo) Efficacy and tolerability of a fixed combination of peppermint oil and caraway oil in patients suffering from functional dyspepsia. Aliment Pharmacol Ther 14: 1671–7.Google Scholar
  68. May B, Kuntz HD, Kieser M, Köhler S (1996) Efficacy of a fixed peppermint oil/caraway oil combination in non-ulcer dyspepsia. Arzneim-Forsch/Drug Res 46: 1449–53.Google Scholar
  69. May B, Kuntz HD, Kieser M, Köhler S (1996) Efficacy of a fixed peppermint oil/caraway oil combination in non-ulcer dyspepsia. Arzneim-Forsch/Drug Res 46: 1149–1153.Google Scholar
  70. Micklefield GH (moo) Fixe Kombination aus Pfefferminzöl und Kümmelöl: Übersicht zur Pharmakologie und Klinik. In: In: Rietbrock N (Hrsg.) Phytopharmaka VI–Foerschung und Praxis. Steinkopff, Darmstadt, S. 209–217Google Scholar
  71. Micklefield GH, Greying I, May B (2000) Effects of peppermint oil and caraway oil on gastroduodemal motility. Phytother Res 14: 20–23.PubMedCrossRefGoogle Scholar
  72. Möller K (1947) Pharmakologie, Benno Schwabe + Co Verlag Basel, 133–136.Google Scholar
  73. Nachmann M, Cole LP (1971) Role of taste in specific hungers. In: Beidler LM (ed) Handbook of Sensory Physiology, Vol IV, Chemical Senses 2, Taste, Springer. Berlin Heidelberg New York: 337–362.Google Scholar
  74. Nash P, Gould SR, Barnardo DE (1986) Peppermint oil does not relieve the pain of irritable bowel syndrome. Br J Clin Pract 4o: 292–293.Google Scholar
  75. Nicolaidis S (1969) Early systemic responses in the regulation of food and water balance: functional and electrophysiological data. In: Neurol regulation of food and water intake. Ann NY Acad Sci 157: 1176–1203.Google Scholar
  76. Nolen HW, Friend DR (1994) Menthol-ß-Glucuronide: A potential prodrug for treatment of the irritable bowel syndrome. Pharmaceutical Research u: 1707–1711.Google Scholar
  77. Pirtkien R, Surhe E, Seybold G (1960) Vergleichende Untersuchungen über die choleretischen Wirkungen verschiedener Arzneimittel bei der Ratte. Med Welt 1: 1417.Google Scholar
  78. Pittler MH, Ernst E (1998) Artichoke leaf extract for serum cholesterol reduction. Perfusion u: 338–40.Google Scholar
  79. Pittler MH, Ernst E (1998) Peppermint oil for irritable bowel syndrome: a critical review and meta-analysis. The American Journal of Gastroenterology 93: 1131–1135.PubMedCrossRefGoogle Scholar
  80. Rees WDW, Evans BK, Rhodes J (1979) Treating irritable bowel syndrome with peppermint oil. Brit med J II: 835–838.Google Scholar
  81. Reiter M, Brandt W (1985) Erschlaffende Wirkungen auf die glatte Muskulatur von Trachea und Ileum des Meerschweinchens. Arzneim-Forsch/Drug Res 35: 408–415.Google Scholar
  82. Ritter U (1984) Therapie mit Choleretika und Cholekinetika. Med Mo Pharm 7: 99–104.Google Scholar
  83. Rösch W (2000) Stellenwert von Iberogast® beim Reizmagen-und Reizdarmsyndrom. In: Rietbrock N (Hrsg.) Phytopharmaka VI–Foerschung und Praxis. Steinkopff, Darmstadt, pp. 201–207.Google Scholar
  84. Schilcher H (1987) Die Kamille Handbuch für Ärzte, Apotheker und andere Naturwissenschaftler. Wissenschaftliche Verlagsgesellschaft, Stuttgart.Google Scholar
  85. Schilcher H (1997) Schöllkraut — Chelidonium majus L. Portrait einer Arzneipflanze. Zeitschrift für Phytotherapie 18: 356–366.Google Scholar
  86. Schneider MME, Otten MH (1990) Efficacy of Colpermin in the treatment of patients with irritable bowel syndrome. Gastroenterology 98: A389.Google Scholar
  87. Schwenk HU, Horbach L (1978) Vergleichende klinische Untersuchung über die Wirksamkeit von Carminativum-Hetterich bei Kindern mittels wiederholter Sonographie des Abdomens. Therapiewoche 28: 2610–2615.Google Scholar
  88. Shaw G, Scrivastava ED, Sadlier M et al. (1991) Stress management for irritable bowel syndrome: a controlled trial. Digestion 5o: 36–42.CrossRefGoogle Scholar
  89. Sigmund ChJ, McNally EF (1969) The action of a carminative on the lower esophageal sphincter. Gastroenterol 56: 13–188Google Scholar
  90. Sommerville KW, Richmond CR, Bell GD (1984) Delayed-release peppermint oil capsules (Colpermin) for the spastic colon syndrome: a pharmacokinetic study. Br J Clin Pharmac 18: 638–640.CrossRefGoogle Scholar
  91. Talley NJ, Stanghellini V, Heading RC et al. (1999) Functional gastroduodenal disorders. Gut 45 (Suppl II) 1I37–II42.Google Scholar
  92. Tamura Y, Nishikawa T, Yamada K, Yamamoto M, Kumagai A (1979) Effects of glyzyrrhetinic acid and its derivatives on A4–5a-and 543-reductase in rat liver. Arzneimittel Forsch/Drug Res 29: 647.Google Scholar
  93. Tan RX, Zheng WF, Tan HQ (1998) Biologically active substances from the genus Artemisia. Planta Med 64: 295–302.PubMedCrossRefGoogle Scholar
  94. Taylor BA, Luscombe DK, Duthie HL (1983) Inhibitory effect of peppermint on gastrointestinal smooth muscle. Gut 24: A992 (Abstract).Google Scholar
  95. Thompson WG, Creed F, Drossman DA, Heaton KW, Mazzacca G (1992) Functional bowel disease and functional abdominal pain. Gastroenterology International 5: 75–91.Google Scholar
  96. Vutyavanich T, Kraisarin T, Ruangsri RA (2001) Ginger for nausea and vomiting in pregnancy: randomized, double-masked placebo-controlled trial. Obstet Gynecol 97: 577–82.PubMedCrossRefGoogle Scholar
  97. Weiß RF (1991) Lehrbuch der Phytotherapie. 7th Ed. Hippokrates Verlag Stuttgart.Google Scholar
  98. White DA, Thompson SP, Wilson CG, Bell GD (1987) A pharmacokinetic comparison of two delayed-release peppermint oil preparations, Colpermin and Mintec, for treatment of the irritable bowel syndrome. Int J Pharmaceutics 4o: 151–155.Google Scholar
  99. Wichtl M (ed) (1989) Teedrogen. Wissenschaftliche Verlagsgesellschaft mbH Stuttgart: 372–374.Google Scholar
  100. Anonymus (1994) Anwendung von Uzarabei unspezifischen Durchfallerkrankungen. Wissenschaftlicher Abschlußbericht, STADA Arzneimittel AG.Google Scholar
  101. Blumenthal M, Hall T, Goldberg A. (eds.) (2003) The ABC Clinical Guide to Herbs. Austin, Tex: American Botanical Council.Google Scholar
  102. Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, Rister RS (eds.). Klein S, Rister RS (trans). (1998) The Complete German Commission E Monographs — Therapeutic Guide to Herbal Medicines. American Botanical Council, Austin.Google Scholar
  103. Böckeler, W. Thomas G (1989) In-vitro-Studien zur destabilisierenden Wirkung Lyophilisierter Saccharomyces cereviseae Hansen CBS 5926-Zellen auf Enterobakterien. Läßt sich diese Eigenschaft biochemisch erklären? In: Müller J, Ottenhann R, Seifert J (eds) Ökosystem Darm. Springer Verlag, pp 142–253.CrossRefGoogle Scholar
  104. Czerucka D, Roux I, Rampal P (1994) Sacccharomyces boulardii inhibits secretagogue-mediated adenosine 3’,5’-cyclic monophosphate induction in intestinal cells. Gastroenterology 106: 65–72.PubMedGoogle Scholar
  105. Ewe K (1983) Obstipation — Pathophysiologie, Klinik, Therapie. Int Welt 6: 286–292.Google Scholar
  106. Gedek B, Hagenhoff G (1989) Orale Verabreichung von lebensfähigen Zellen des Hefestammes Saccharomyces cerevisiae Hansen CBS 5926 und deren Schicksal während der Magen-Darm-Passage. Therapiewoche 38 (special issue): 33–40.Google Scholar
  107. Höchter W, Chase D, Hagenhoff G (1990) Saccharomyces boulardii bei akuter Erwachsenendiarrhoe. Münch Med Wschr 132: 188–192.Google Scholar
  108. Hojgaard I, Arffmann S, Jorgenson M, Krag E (1981) Tea consumption: a cause of constipation. Br Med J 282: 864.CrossRefGoogle Scholar
  109. Jahn HU, Zeitz M (1991) Immunmodulatorische Wirkung von Saccharomyces boulardii beim Menschen. In: Seifert J, Ottenhann R, Zeitz M, Brockenmühl J (eds). Ökosystem Darm III. Springer Verlag, pp 159–164.CrossRefGoogle Scholar
  110. Kollaritsch HH, Tobüren D, Scheiner O, Wiedermann G (1988) Prophylaxe der Reisediarrhoe. Münch Med Wschr 130: 671–673.Google Scholar
  111. Ludewig R (1995) Schwarzer und Grüner Tee als Genuß-und Heilmittel. Dtsch Apoth Z 135: 2203–2218.Google Scholar
  112. Lund K, Rimpler H (1985) Tormentillwurzel. Dtsch Apoth Z 125: 1105–107.Google Scholar
  113. Reynolds JEF (ed) (1989) Martindale. The Extra Pharmacopoeia. 29th Ed. The Pharmaceutical Press, London, p 1535.Google Scholar
  114. Massot J, Desconclois M, Astoin J (1982) Protection par Saccharomyces boulardii de la diarrhée à Escherichia coli du souriceau. Ann Pharm Fr 40: 445–449.Google Scholar
  115. Plein K, Hotz J (1993) Therapeutic effect of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn’s disease with special reference to chronic diarrhea–a pilot study. Z. Gastroenterol 31: 129–134.PubMedGoogle Scholar
  116. Schmitz B, El Agamy R, Lindner K (1992) Uzarawurzel–seit 8o Jahren bewährt bei akuten Druchfallerkrankungen. Pharmazeutische Zeitung 137: 1697–1713.Google Scholar
  117. Scholz E, Bertram B (1995) Camelia sinensis (L.) O. Kuntze–Der Teestrauch. Z Phytother 17: 235–250.Google Scholar
  118. Schulte FJ, Spranger J (1988) Lehrbuch der Kinderheilkunde. Fischer, Stuttgart, p 320.Google Scholar
  119. Sollmann T (1948) A Manual of Pharmacology. 7th Ed. Saunders Company, Philadelphia London, p no.Google Scholar
  120. Surawicz C, Elmer GW, Speelman P, McFarland LV, Chinn J, van Belle G (1989) Die Prophylaxe Antibiotika-assoziierter Diarrhöen mit Saccharomyces boulardii. Eine prospektive Studie. Gastroenterol 96: 981–988.Google Scholar
  121. Tempé JD, Steidel AL, Blehaut H, Hasselmann M, Lutun P, Maurier F (1983) Prévention par Saccharomyces boulardii des diarrhées de l’alimentation entérale à débit continu. La Semaine des Hôpitaux de Paris 59: 1409–1412.Google Scholar
  122. Yajima T (1985) Contractile effect of short-chain fatty acids on the isolated colon of the rat. J Physiol 368: 667–678.PubMedGoogle Scholar
  123. Bayne HJ. FDA Issues Final Rule Banning Use of Aloe and Cascara Sagrada in OTC Drug Products. HerbalGram. 2002; 56: 56Google Scholar
  124. Brunswick D, Mengs K (1997) Assessment of the genotoxic risk from laxative senna products. Environmental and Molecular Mutagenesis 29: 1–9CrossRefGoogle Scholar
  125. Cummings JH, Southgate DAT, Branch W, Houston H, Jenkins DJA, James WPT (1978) Colonic response to dietary fiber from carrot, cabbage, apple, bran, and guar gum. Lancet I: 5.Google Scholar
  126. Curry CE (1982) laxative products. In: Handbook of Nonprescription Drugs. Am Pharmac Assoc, Washington, pp 69–92.Google Scholar
  127. Dufour P, Gendre P (1988) Long-term mucosal alterations by sennosides and related compounds. Pharmacology 36 (Suppl 1): 194–202.PubMedCrossRefGoogle Scholar
  128. Ewe K (1988) Schwer therapiebare Formen der Pbstipation. Verhandl dtsch Ges Inn Med 94: 473–480.Google Scholar
  129. Ewe K (1983) Obstipation–Pathophysiologie, Klinik, Therapie. Int Welt 6: 286–292.Google Scholar
  130. Fingl E (1980) Laxatives and cathartics. In: Goodman AF, Goodman L, Gilman A (eds) The Pharmacological Basis of Therapeutics. 6th Ed. Macmillan, New York Toronto London, p 1004.Google Scholar
  131. Gysling E (1976) Behandlung häufiger Symptome. Leitfaden zur Pharmakotherapie. Huber, Basel Bern Stuttgart Vienna.Google Scholar
  132. Huth K, Pötter C, Cremer CD (1980) Füll- und Quellstoffe als Zusatz industriell hergestellter Lebensmittel. In: Rottka H (ed) Pflanzenfasern-Ballaststoffe in der menschlichen Ernährung. Thieme, Stuttgart New York, pp 39–53.Google Scholar
  133. Hutz J, Rösch W (eds) (1987) Funktionelle Störungen des Verdauungstrakts. Springer-Verlag, Berlin Heidelberg New York, pp 200, 222.CrossRefGoogle Scholar
  134. Kasper H (1980) Der Einfluß von Gallastoffen auf die Ausnutzung von Nährstoffen und Pharmaka. In: Rottka H (ed) Pflanzenfasern-Ballastoffe in der menschlichen Ernährung. Thieme, Stuttgart New York, pp 93–112.Google Scholar
  135. Kasper H (1985) Ernährungsmedizin und Diätetik 5th Ed. Urban and Schwarzenberg. Munich Vienna.Google Scholar
  136. Leng-Peschlow E, Mengs U (1990) No renal pigmentation by Plantago ovata seeds or husks. Med Sci Res 18: 37–38.Google Scholar
  137. Loew D, Bergmann U, Dirschedl P, Schmidt M, Melching K, Hues B, Überla K (1996) Retro-und prospektive Fall-Kontroll-Studien zur Anthranoidlaxanzien. In: Loew D, Rietbrock N (Hrsg) Phytopharmaka II, Forschung und klinische Anwendung. Steinkopff, Stuttgart: 175–184.Google Scholar
  138. Mengs U (1996) Zur Sicherheit von Sennalaxanzien. In: Loew D, Rietbrock N (Hrsg) Phytopharmaka II, Forschung und klinische Anwendung. Steinkopff, Stuttgart: 161–166.Google Scholar
  139. Müller-Lissner S (1987) Chronische Obstipation. Dtsch Med Wschr 112: 1223–1229.PubMedCrossRefGoogle Scholar
  140. Nusko G, Schneider B, I, Wittekind CH, Hahn EG (1996) Prospektive klinische Studie zur Sicherheit von Anthranoidlaxanzien. In: Loew D, Rietbrock N (Hrsg) Phytopharmaka II, Forschung und klinische Anwendung. Steinkopff, Stuttgart: 167–174.Google Scholar
  141. Ruppin, H, Bar-Meir S, Soergel KH, Wood CM, Schmitt MG (1980) Absorption of short-chain fatty acids by the colon. Gastroenterol 78: 1500–1507.Google Scholar
  142. Schulz HU, Schürer M, Silber W (1998) Pharmakokinetische Untersuchungen eines Sennesfrüchte-Extraktes. Zeitschrift für Phytotherapie 19: 190–194.Google Scholar
  143. Schulz V, Löffler A, Gheeorghiu T (1983) Resorption von Blausäure aus Leinsamen. Leber Magen Darm 13: 10–14.PubMedGoogle Scholar
  144. Schulz V (1984) Clinical pharmacokinetics of nitroprusside, cyanide, thiosulphate, and thiocyanate. Clinical Pharmacokinetics 9: 239–251.PubMedCrossRefGoogle Scholar
  145. Sewing KFR (1986) Obstipation. In: Fülgraff G, Palm D (eds) Pharmakotherapie, Klinische Pharmakologie. 6th Ed. Fischer, Stuttgart, pp 162–168.Google Scholar
  146. Smith AN, Drummond E, Eastwood MA (1981) The effect of coarse and fine wheat bran on colonic motility in patients with diverticular disease. Am J Clin Nutr 34: 2460–2464.PubMedGoogle Scholar
  147. Stephen AM, Cummings JH (1980) The microbial contribution to human fecal mass. J Med Microbiol 13: 45–66.PubMedCrossRefGoogle Scholar
  148. USD (1967) The United States Dispensatory and Physicians’ Pharmacology. In: Osol R, Pratt R, Altschule MD (eds) Lippincott, Philadelphia Toronto, p 917.Google Scholar
  149. US Food and Drug Administration. 67 Federal Register 31125 (May 9, 2002).Google Scholar
  150. Weber E (1988) Taschenbuch der unerwünschten Arzneiwirkungen. Fischer, Stuttgart New York.Google Scholar
  151. Weinrich J (1980) Therapy of colon disease with a fiber-rich diet. In: Rottka H (ed) Pflanzenfasern-Ballaststoffe in der menschlichen Ernährung. Thieme, Stuttgart New York, pp 154–157.Google Scholar
  152. Yajima T (1985) Contractile effect of short-chain fatty acids on the isolated colon of the rat. J Physiol 368: 667–678.PubMedGoogle Scholar
  153. Arnone A, Merlini L, Zanarotti A (1979) Constituents of Silybum marianum. Structure of isosilybin and stereochemistry of isosilybin. J Chem Soc (Chem Commun): 696–697.Google Scholar
  154. Benda L, Dittrich H. Ferenzi P, Frank H, Wewalka F (1980) The influence of therapy with silymarin on the survival rate of patients with liver cirrhosis. Wien Klin Wschr 92 (19): 678–683.PubMedGoogle Scholar
  155. Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, Rister RS (eds.).Google Scholar
  156. Klein S, Rister RS (trans). (1998) The Complete German Commission E Monographs — Therapeutic Guide to Herbal Medicines. American Botanical Council, Austin.Google Scholar
  157. Bode JC (1986) Arzneimittel für die Indikation “Lebererkrankungen”. In: Dölle W, Müller-Oerlingshausen, B, Schwabe U (eds) Grundlagen der Arzneimitteltherapie. Entwicklung, Beurteilung und Anwendung von Arzneimitteln, B.I.-Wissenschaftsverlag, Mannheim Vienna Zurich, pp 202–211.Google Scholar
  158. Bode JC (1981) Die alkoholische Hepatitis, ein Krankheitsspektrum. Internist zzo: 536–545.Google Scholar
  159. Boigk G, Stroedter L, Herbst H, Waldschmidt J, Riecken EO, Schuppan D (1997) Silymarin retards collagen accumulation in early and advanced biliary fibrosis secondary to complete bile duct obliteration in rats. Hepatology 26: 643–649.PubMedCrossRefGoogle Scholar
  160. Dölle W, Schwabe U (1988) Leber- und Gallenwegstherapeutika. In: Schwabe U, Paffrath D (eds) Arzneiverordnungsreport 88. Gustav Fischer, Stuttgart New York, pp 242–253.Google Scholar
  161. Ernst E, Pittler MH, Stevinson C, White A (zoo1) The Desktop Guide to Complementary and Alternative Medicine - an evidence-based approach. Mosby, Edingurgh London New York, pp 134–5.Google Scholar
  162. Feher J, Deak G, Muezes G, Lang I, Niederland V, Nekam K, Karteszi M (1989) Hepatoprotective activity of silymarin Legalon therapy in patients with chronic alcoholic liver disease. Ory Hetil 130 (51): 2723–2727.Google Scholar
  163. Ferenci P, Dragosics B, Dittrich H, Frank H, Benda L, Lochs H, Meryn S, Base W, Schneider B (1989) Randomized controlled trial of silymarin treatment in patient with cirrhosis of the liver. J Hepatol 9 (1): 105–113.Google Scholar
  164. Fintelmann V, Albert A (1980) Nachweis der therapeutischen Wirksamkeit von Legalon bei toxischen Lebererkrankungen im Doppelblindversuch. Therapiewoche 30 (35): 5589–5594.Google Scholar
  165. Hahn G, Lehmann HD, Kürten M et al. (1968) Zur Pharmakologie und Toxikologie von Silymarin, des antihepatotoxischen Wirkprinzips aus Silybum marianum ( L.) Gaertn. Arzneim Forsch/ Drug Res 18: 696–704.Google Scholar
  166. Hruby K, Fuhrmann M, Csomos G, Thaler H (1983) Pharmakotherapie der Knollenblätterpilzvergiftung mit Silibinin. Wien Klin Wschr 95 (7): 225–231.Google Scholar
  167. Koch H (1980) Leberschutz-Therapeutika. Pharmazie in unserer Zeit 9: 33–44, 65–74.Google Scholar
  168. Leng-Peschlow E, Strenge-Hesse A (1991) Die Mariendistel ( Silybum marianum) und Silymarin als Lebertherapeutikum. Z Phytother 12: 162–174.Google Scholar
  169. Lorenz D, Mennicke WH, Behrendt W (1982) Untersuchungen zur Elimination von Silymarin bei cholecystektomierten Patienten. Planta Med 45: 216–233.CrossRefGoogle Scholar
  170. Martines G, Copponi V, Cagnetta G (1980) Aspetti del danno epatico dopo somministrazione sperimentale diarrhea alcuni farmaci. Arch Sci Med 137: 367–386.Google Scholar
  171. Martini GA (1988) Hepatocelluläre Erkrankungen, Leberkrankheiten. In: Riecker G (ed) Therapie innerer Krankheiten. Springer, Berlin Heidelberg New York, pp 638–652.Google Scholar
  172. Marugg D, Reutter FW (1985) Die Amanita-phalloides-Intoxikation. Moderne therapeutische Maßnahmen und klinischer Verlauf. Schweiz Rundschau Med (Praxis) 14 (37): 972–982.Google Scholar
  173. Mennicke WH (1975) Zur biologischen Verfügbarkeit und Verstoffwechselung von Silybin. Dtsch Apoth Z 115 (33): 1205–1206.Google Scholar
  174. Peeters H (ed) (1976) Phosphatidylcholine. Biochemical and Clinical Aspects of Essential Phospholipids. Springer-Verlag, Berlin Heidelberg New York.Google Scholar
  175. Pelter A, Hansel R (1969) The structure of silybin (Silybum substace E6), the first flavonolignan. Tetrahedron Letters 25: 2911–2916Google Scholar
  176. Rauen HM, Schriewer H (1971) Die antihepatotoxische Wirkung von Silymarin bei experimentellen Leberschäden der Ratte durch Tetrachlorkohlenstoff, D-Galaktosamin und Allylalkohol. Arzneim Forsch/Drug Res 21: 1194–1201.Google Scholar
  177. Reuter HD (1992) Spektrum Mariendistel und andere leber-und gallewirksame Phytopharmaka. In: Bundesverband Deutscher Ärzte für Naturheilverfahren (ed). Arzneimitteltherapie heute. Aesopus Verlag, Basel.Google Scholar
  178. Salmi HA, Sarna S (1982) Effect of silymarin on chemical, functional und morphological alter- ations of the liver. A double-blind controlled study. Scand J Gastroenterol 17 (4): 517–521.PubMedCrossRefGoogle Scholar
  179. Schulz HU, Schürer M, Krumbiegel G, Wächter W, Weyhenmeyer R, Seidel G (1995). Untersuchungen zum Freisetzungsverhalten und zur Bioäquivalenz von Silymarin-Präparaten. Arzneim Forsch/Drug Res 45: 61–64.Google Scholar
  180. Schuppan d, Lang T, Gerling G, Leng-Peschlow E, Krumbiegel G, Riecken EO, Waldschmidt J (1994) Antifibrotic effect of silymarin in rat secondary biliary fibrosis induced by bile duct obliteration with ethibloc. Z jGastroenterol 32: 45–46.Google Scholar
  181. Schuppan D, Strösser W, Burkard G, Walosek G (1998) Verminderung der Fibrosierungsaktivität durch Legalon bei chronischen Lebererkrankungen. Z Allg Med 74: 577–584.Google Scholar
  182. Sonnenbichler J, Zetl I (1984) Untersuchungen zum Wirkungsmechanismus von Silibinin, Einfluß von Silibinin auf die Synthese ribosomaler RNA, mRNA und tRNA in Rattenlebern in vivo. Hoppe-Syler’s Physiol Chem365: 555–566.Google Scholar
  183. Sonnenbichler J, Zetl I (1986) Biochemical effects of the flavonolignane silibinin in RNA, protein and DNA synthesis in rat livers. Prog Clin Biol Res 213: 319–331.PubMedGoogle Scholar
  184. Sonnenbichler J, Zetl I (1987) Stimulating influence of a flavonolignane on proliferation, RNA synthesis and protein synthesis in liver cells. In: Okoliczânyi L, Csomós G, Crepaldi G (eds) Assessment and Management of Hepatobiliary Disease. Springer, Berlin Heidelberg New York, pp 265–272.CrossRefGoogle Scholar
  185. Sonnenbichler J, Zetl I (1988) Specific binding of a flavonolignane to an estradiol receptor. In: Plant Flavonoids in Biology and Medicine II: Biochemical, Cellular, and Medicinal Properties. Alan R Liss, New York, pp 369–374.Google Scholar
  186. Varis K, Salmi HA, Siurala M (1978) Die Therapie der Lebererkrankung mit Legalon; eine kontrollierte Doppelblindstudie. In: Aktuelle Hepatologie, Third International Symposoium, Cologne, Nov.15–17,1978. Hanseatisches Verlagskontor. Lübeck, pp 42–43.Google Scholar
  187. Vogel G, Görler K (1981) Lebertherapeutika. In: Ullmanns Enzyklopädie der technischen Chemie. Vol.18, 4th Ed. Verlag Chemie, Weinheim New York, pp 132–136.Google Scholar
  188. Vogel G (1980) The anti-amanita effect of silymarin. In: Faulstich et al. (eds) Amanita toxins and poisoning. Witzstrock, Baden-Baden Cologne New York, pp 132–136.Google Scholar
  189. Vogel G (1980) The anti-amanita effect of silymarin. In: Faulstich et al. (eds) Amanita toxins and poisoning. Witzstrock, Baden-Baden Cologne New York, pp 180–187.Google Scholar
  190. Wagner H, Seligmann O, Seilz M, Abraham D, Sonnenbichler J (1976) Silydianin und Silychristin, zwei isomere Silymarine aus Silybum marianum L. Gaertn. ( Mariendistel ). Z Naturforsch 31b: 876–884.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • Volker Schulz
    • 1
  • Rudolf Hänsel
    • 2
    • 3
  • Mark Blumenthal
    • 4
  • Varro E. Tyler
  1. 1.BerlinGermany
  2. 2.Institut für Pharmakognosie und PhytochemieFreien Universität BerlinMünchenGermany
  3. 3.MünchenGermany
  4. 4.American Botanical CouncilAustinUSA

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