Are herbals appropriate for constipation?

DEAR DR. GOTT: Is it safe to use cascara sagrada as a laxative? I’ve tried everything else, such as heaping tablespoons of Metamucil and using two stool softeners twice each day with little success.

DEAR READER: Cascara sagrada is a shrub native to the western coast of North America. The dried bark of this plant was used by Native Americans for years but was not widely adopted until the 19th century as a stimulant laxative. The main ingredients are anthraquinones, organic compounds whose structures serve as the basic building blocks for a number of naturally occurring plant pigments. The compound is used in the production of dyes, as a catalyst for the production of wood pulp and has a number of other purposes. The product is available in capsule form, liquid extract and as a dried bark that can be made into a bitter tea. [Read more...]