Educational information, not medical advice — ask your doctor or midwife.
Keishikashakuyakudaiogato is a Japanese Kampo herbal formula. It is a fixed blend of six herbs. It was used for constipation with a bloated, cramping belly.
The name describes the recipe: cinnamon twig and peony, with rhubarb root added. Rhubarb root is the laxative part. Licorice root is also in the blend, and it is the main source of risk.
In Japan it is one of the Kampo extracts covered by national health insurance. Doctors there prescribe it as a granule powder.
Here is the honest verdict on evidence. There are no good human trials of this exact formula. Long use in Kampo practice is not proof that it works, and it is not proof that it is safe.
The laxative part is well understood. The rest is mostly tradition and lab work.
Rhubarb root holds anthraquinones, plant compounds that act on the lining of the gut. The body changes them into active forms in the colon. Stimulant laxatives of this type do speed up bowel movements in people.
Peony root is said in Kampo to ease cramping. In animal and cell studies, its compounds appear to relax gut muscle. Whether this happens at the amounts found in the formula is not established.
Cinnamon twig, ginger and jujube were used to warm the belly and settle the stomach. That is a traditional idea, not a tested one.
Licorice was added to blend the herbs. It also drives the safety warnings on this page.
Most products are dried extract granules in single-dose sachets. This is the standard Kampo form in Japan.
Other forms include:
Fine powder or tablets made from the same extract.
Raw herb packs, boiled at home into a tea by a practitioner's direction.
Imported capsules sold online outside Japan.
Quality differs between countries. Outside Japan the product may not be checked to the same standard.
This formula comes from the Kampo tradition, Japan's own form of Chinese herbal medicine. Its base recipe traces to Chinese texts from about the third century.
Japanese doctors reshaped these recipes from the Edo period onward. They matched formulas to the pattern of the whole body, not to a single disease name.
It was given for constipation in people who also had a tight, sore, swollen belly. In the twentieth century it was listed among the Kampo extracts covered by Japanese health insurance.
That listing reflects long use and regulation. It does not mean the formula has been tested in modern trials.
Stop taking it and speak to a doctor if you notice:
Puffy ankles, face or hands, or fast weight gain from fluid.
Muscle weakness, cramps, or a heartbeat that feels fast or irregular.
Blood pressure readings that climb above your usual.
Diarrhoea that will not stop, or belly pain that gets worse.
Get urgent care for severe belly pain with vomiting and no bowel movement, for black or bloody stools, or for yellowing of the skin or eyes.
Also tell your doctor if constipation keeps returning. That needs a cause found, not a repeat course.
In Japan it is a regulated Kampo extract covered by national health insurance, and it is usually prescribed by a doctor. In the United States, the United Kingdom and the European Union it is not an approved medicine, and any import is sold as a food supplement.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
What it is typically used for, usual dose, cautions, and the study behind it where real trial data exists.
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