DaveFoster
Member
My doc mentioned that long-term use of laxatives can lead to melanosis coli due to cellular apoptosis in the intestine.
Does cascara come with similar risks, and does anybody know more information?
"Aetiology The association between melanosis coli and chronic use of anthraquinone laxatives is firmly established. It was first noted by Bartle in 1928, and substantiated by Bockus in 1933. Many subsequent studies confirmed the association. This is further supported by the development of similar pigmentation in laboratory animals after administration of anthraquinones.13 Several experimental studies in different mammalian species documented the appearance, disappearance and re-appearance of the pigment in colorectal mucosa with repeated cycles of laxative administration.12 Melanosis develops in over 70% of persons who use anthraquinone laxatives (eg cascara sagrada, aloe, senna, rhubarb, and frangula), often within 4 months of use, with an average of 9 months. There is an earlier age of onset in the females, with a higher detection rate.14 The condition is widely regarded as benign and reversible, and disappearance of the pigment generally occurs within a year of stopping laxatives.15 However, melanosis can probably result from other factors or exposure to other laxatives and is not pathognomonic for anthraquinone use."
Source: http://web.imu.edu.my/ejournal/approved/7.Review_Kew_s53-s60.pdf
This article offers correlation as a possible explanation:
"On the other hand, the chronic constipation may have been associated with or a causative factor in intestinal damage, and the anthraquinones may have simply darkened the cells but not contributed to the damage nor provided any additional threat to the health of the colon. Repeated damage to cells, especially rapidly replicating cells as found in the intestinal wall, might be expected to increase the rate of cancer formation. A retrospective study in Germany with more than 2,200 patients suggested that there was no increase in colorectal cancer incidence in persons with melanosis coli compared to those without the condition (4). There was a more frequent finding of adenomas in these patients, but this was attributed to easier detection not higher incidence, since the adenomas do not incorporate the pigment and show up as white spots on a black colon wall background. A case report of a woman with melanosis coli after 20 years of laxative use showed no colon abnormalities (16). In a series of over 1,000 rectoscopies conducted in Germany, 10% of the patients were found to have melanosis coli; accompanying inflammation of the colon mucosa was seldom found (17); mild inflammation was attributed to an increased turnover of mucosa cells, which is not necessarily harmful.
Source: Safety Issues Affecting Herbs: How Long Can Stimulant Laxatives Be Used?
Does cascara come with similar risks, and does anybody know more information?
"Aetiology The association between melanosis coli and chronic use of anthraquinone laxatives is firmly established. It was first noted by Bartle in 1928, and substantiated by Bockus in 1933. Many subsequent studies confirmed the association. This is further supported by the development of similar pigmentation in laboratory animals after administration of anthraquinones.13 Several experimental studies in different mammalian species documented the appearance, disappearance and re-appearance of the pigment in colorectal mucosa with repeated cycles of laxative administration.12 Melanosis develops in over 70% of persons who use anthraquinone laxatives (eg cascara sagrada, aloe, senna, rhubarb, and frangula), often within 4 months of use, with an average of 9 months. There is an earlier age of onset in the females, with a higher detection rate.14 The condition is widely regarded as benign and reversible, and disappearance of the pigment generally occurs within a year of stopping laxatives.15 However, melanosis can probably result from other factors or exposure to other laxatives and is not pathognomonic for anthraquinone use."
Source: http://web.imu.edu.my/ejournal/approved/7.Review_Kew_s53-s60.pdf
This article offers correlation as a possible explanation:
"On the other hand, the chronic constipation may have been associated with or a causative factor in intestinal damage, and the anthraquinones may have simply darkened the cells but not contributed to the damage nor provided any additional threat to the health of the colon. Repeated damage to cells, especially rapidly replicating cells as found in the intestinal wall, might be expected to increase the rate of cancer formation. A retrospective study in Germany with more than 2,200 patients suggested that there was no increase in colorectal cancer incidence in persons with melanosis coli compared to those without the condition (4). There was a more frequent finding of adenomas in these patients, but this was attributed to easier detection not higher incidence, since the adenomas do not incorporate the pigment and show up as white spots on a black colon wall background. A case report of a woman with melanosis coli after 20 years of laxative use showed no colon abnormalities (16). In a series of over 1,000 rectoscopies conducted in Germany, 10% of the patients were found to have melanosis coli; accompanying inflammation of the colon mucosa was seldom found (17); mild inflammation was attributed to an increased turnover of mucosa cells, which is not necessarily harmful.
Source: Safety Issues Affecting Herbs: How Long Can Stimulant Laxatives Be Used?
Last edited: