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Cascara Sagrada Use May Lead to Laxative Dependence

Q. I have had severe constipation for years, just like my mother before me. I’ve been using cascara sagrada for a daily bowel movement. If I don’t take it, I get bloated and very uncomfortable.

I read that this herb was banned in 2002 because FDA was not sure it is safe. Is this herb safe or not? I have been taking it daily for several years.

I have tried fiber, stool softeners, you name it. Cascara sagrada is the only thing that works for me. My doctor thinks I should take something different. She had me try Colace, but of course it did not work. I took 4 pills every morning and did not have a BM for several days. Please let me know what you recommend.

A. Stimulant laxatives like cascara sagrada can lead to dependence. After daily use for years, your digestive tract doesn’t function normally.

In 2002 the FDA reclassified cascara sagrada along with aloe as not generally recognized as safe and effective. As a result, it can’t be sold as an over-the-counter laxative. There was concern about liver toxicity, colorectal cancer (Gut, Aug., 1993) and loss of electrolytes such as potassium.

We suggest you work with your doctor to overcome this laxative addiction. It will take patience and persistence. We are sending you our Guide to Constipation to help you. It provides recipes for Power Pudding and dynamite pumpkin-bran muffins as well as our 10 tips to combat constipation. 

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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