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. 

Join Over 55,000 Subscribers at The People's Pharmacy

Each week we send two free email newsletters with breaking health news, prescription drug information, home remedies and a preview of our award-winning radio show. Join our mailing list and get the information you need to make confident choices about your health.

  1. cv
    Reply

    I had the same problems. My body got used to taking all the laxatives (dylcolax, senna, stool softener, miralax, lactulose etc…) and those seemed to work but only for a little bit. l’ve also taken fiber which really upset my stomach. I was using enemas every week. Until i started eating flax seeds by taking a few tablespoons with my cereal or yogurt. I usually eat it at night time and when I get up I am good to go. :) If you do try this make sure to get enough water! Hope you feel better.

  2. LD
    Reply

    Hi GB,
    Just curious if you ever got off of the Cascara Sagrada. I’ve been taking it for appx. 14 years in the form of Super Cleanse by Nature’s Secret. I started taking it due to constipation after a gall bladder surgery and have never been able to get off it. I started taking 1 pill daily for maintenance and then as time went on, 2 pregnancies (prenatal vitamins,high in iron, very constipating), I was up to 5 pills nightly.
    I started to get nervous and spoke with my primary care to ask for advice. She has since got me down to 4 pills nightly by weaning 1 pill per 1 day/per week. Then 1 pill less X 2 days per week. I did this for 7 weeks and am now down to 4 pills nightly, as I previously said, but I’m having trouble getting down from here. I also suffer from a fissure and hemorrhoids, so I really need to keep my stool soft on order to not affect these other problems.
    I am getting nervous of the side effects as I am soon to turn 49.
    I had a colonoscopy in 2005, and it showed stained colon and my gastro tried to out me on Miralax, which didn’t help. I moved my bowel once in 8-10 days and had such abdominal pain that I went right back on the CS pills.
    I would welcome any advice at this point.
    Thx,
    LD

  3. Russ1a
    Reply

    Hi Akt,
    Here is an update on my current status regarding constipation. Since my last post, my constipation had come and gone without me being able to discern why. About 3 months ago a friend suggested that sucralose might have a bearing on my constipation as sucralose is known to kill certain good bacteria in the gut. When I replaced sucralose with stevia, my constipation was greatly reduced. Now I’m working on drinking more water, which is reported to be very important in treating constipation.
    Regarding my Elixir, I’ve replaced the 1 t of ground cloves with 1/2 t cinnamon because ground cloves are so expensive right now. In a small bowl, I add 2 t molecularly distilled fish oil plus about 1 t of extra virgin olive oil to the cinnamon plus 1 T turmeric and 1 t ground black pepper, to make a thin slurry. I then take a teaspoon of the slurry in my mouth, take a sip of water, swish a little, and swallow. I repeat this until the slurry is all gone. The secret to all this is that oil magically reduces the hotness of the spices by about 95%!
    Hope this helps. Russ

  4. Akt
    Reply

    Russ- how are you taking the clove, pepper, turmeric mix? Do you make a tea, or add that amount to food? All at once or spread thru day?
    I would think it burns?

  5. A.C.
    Reply

    I would recommend taking prunes, which can be bought ready to eat. Two or three are sufficient for me, better to take less initially than too many. Eat as they are. Sip some water afterwards. They are simply dried plums which are a good idea when fresh but not enough when there is a problem.
    Good luck

  6. GB
    Reply

    Seems I am not alone on the “CS island”. I too am addicted to it and can’t have a normal bowel movement without it. I consulted a GI doctor last month for my “problem” and he recommended a colonoscopy which was normal except for a little staining of the colon and some mild internal hemorrhoids. He advised me to stop taking the cascara COLD TURKEY and follow his regimen which consisted an new EXPENSIVE medication called Amitiza, plus 1 tsp citrucel daily, 2 colace, a high fiber diet and 64 oz of water daily.
    The result of his recommended treatment was this: I went without a bowel movement for 7 DAYS. I urinated all night and all day because of the increased fluid intake and developed such a severe impaction from all the fiber that I had to go to the ER to have the impaction removed! Extremely painful.
    The next day, I resorted back to taking my CS again just so I could “go”. My GI doc was upset with me for taking the CS again and said I wasn’t being patient enough with my treatment. If an impaction is his idea of patience, then I need a new doc. I don’t know what to do.
    I hope I don’t get cancer from taking the CS but nothing else helps once your colon gets used to it. Apparently, it damages the nerves in your colon so that it can not contract on it’s own. This is why, when you take fiber and stool softeners, they just SIT THERE because your colon has lost its ability to contract and push things through. Any way you look at it, it is NOT a good situation to be in.

  7. TS
    Reply

    I tried to get off cascara sagrada but had a lot of trouble. Still working on it. Any tips or ideas would be very helpful. I’m a little worried how to get off it. Nothing else seems to work.

  8. J. G
    Reply

    Could you e mail me. This is exactly my situation and I do not know how to get off the laxatives…how did you?

  9. SB
    Reply

    I’m curious to know if you are now off the Cascara Sagrada now? I, too, have inadvertently become reliant on CS for a daily BM and didn’t know that it might be a problem. I’ve been taking CS for years as well. What did you do and how did it turn out? Being constipated and bloated is just the worst feeling. Anything you can tell me that would be helpful for getting off of it?
    Thanks.

  10. KS
    Reply

    I never really had much of problem with constipation until after I used a colon cleanser that contains Cascara Sagrada as one of it’s main ingredients. Not knowing that it was primarily a laxative, I was simply making sure I got all excess waste out while using a natural substance. But after I’d stop using it then did I notice the difficulty and the fact that I had to use it more and more in order for things to function properly. It’s better to make sure you know what you’re taking. Had I read up on just that one ingredient I never would’ve touched the stuff.

  11. Bonnie S.
    Reply

    After I stopped using cascara sagrada, I noticed bowel movement issues, but that’s usual. Imagine you stop using any laxative, that’s going to be what happens post-use. I increased my fiber intake, digestive enzymes and probiotics – all was ‘cured’. It was my initial lack of understand on the topic which put me into the use of CS, but now I know I could have gotten the same results with way less dependence.
    Bonnie S.

  12. Julia S.
    Reply

    My husband has had a constipation problem for years… getting worse and trying anything to ease it… psyllium is latest and don’t see that it helps either…I make a paste of figs, dates, raisins, honey, senna tea, and that seems to help the most but he complains it is to sweet… I would love to have you book of 10 tips to combat it and to learn what your Power pudding is… thanks a lot we are at a loss as to what to do ….

  13. LS
    Reply

    I am a fan of psyllium myself… I’ve struggled with constipation since I was a small child. I really am happy with the results and my mother started taking it and she is happy too. :D

  14. SDW
    Reply

    Try priobiotics capsules (the ones with the most different forms of bacteria – which is also, unfortunately, the most expensive), they have helped me a lot.

  15. cpc
    Reply

    Is not a daily diet of fruits, veggies and high fiber also addictive? Without them there could be constipation problems also.
    Seems like anything we eat regularly can be termed “Addictive”.

  16. Russ1a
    Reply

    Hi All,
    I’m 64. About 4 years ago I started to have a really big problem with constipation. I tried 1/2 cup/day of wheat bran plus 2 T/day of psyllium fiber. That worked on and off. Them I added 3/4 teaspoon/day of epsom salts USP dissolved in 1/2 cup hot water taken orally. Adjusting the epsom salts between 1/2 t and 1 t/day solved the problem with my constipation, BUT, I wasn’t happy with the thought that all of a sudden my body required such a massive increase in magnesium. I put that question to my doctor. He did not know why that was.
    Being that I’m interested in preventing cancer, I was taking 1 tsp/day of turmeric and 1/2 tsp/day of ground black pepper. When I heard the PP show on high ORAC foods, I did some research and added 1/2 tsp/day of ground cloves (ORAC= 314446!!). It is now 2 months later and my constipation is GONE! I no longer take added fiber or magnesium, just the three spices. I make a thin slurry of the spices, chasing that with water.
    Wishing you all good health.
    Sincerely,
    Russ

What Do You Think?

Share your thoughts with others, but be mindful of protecting your own and others' privacy. Not all comments will be posted. Advice from web visitors is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. In posting a comment, you agree to our commenting policy and website terms and conditions.