Herbs for constipation:Purgative or cathartic laxatives

Purgative laxatives is the category most utilized; and purgative herbs are used in healthfood store formulations and in many commercial over-the-counter laxatives. This group includes aloe, buckthorn, cascara sagrada, rhubarb, and senna. All the herbs in this category contain anthraquinones, strong and irritating chemical compounds that force the bowels to evacuate. They should be used only as a last resort.

Pregnant or nursing mothers should not use these irritants, nor should people with gastrointestinal problems including ulcers, ulcerative colitis, irritable bowel syndrome, and hemorrhoids.

Avoid the prolonged use of purgative laxatives. The continual use can cause lazy bowel syndrome. When this negative cycle develops the result is a sluggish digestive system unable to evacuate without the use of more laxatives. Studies also show that chronic over-use of constipation relieving drugs can lead to disturbances of the bodies electrolyte equilibrium. In turn this can result in potassium deficiency and a concomitant problem for those who are taking heart medications. ("In Germany, the law requires that the labels on all anthraquinone preparations must bear the warning that possible potassium deficiency can intensify the effect of chemical heart drugs -cardiac glycosides"; The Family Herbal, p.188)

The gentlest of this class of cathartic laxative herbs is cascara sagrada, known as "sacred bark" from a native American tree (Rhamnus purshiana). Michael Castleman says cascara sagrada is the "World's most popular laxative". Many herbalists claim that in addition to its laxative quality it also tones the intestinal tract and colon. It can be purchased in over- the-counter preparations or taken as a tincture (1/2 teaspoon at bed). Although a decoction (tea) is sometimes recommended, it is very bitter. It should never be used for more than 2 weeks, and a reputable source is important because unless the cascara is prepared correctly it can have negative side-effects. (Fresh bark cannot be used; the bark needs to be dried and stored for at least a year).

Dr. Weil, the well-known physician/author and lecturer, says "If you must use an irritant laxative, try rhubarb root (Rheum officinale). It is one of the safest and least violent, but it should be reserved for occasional use only. You can get preparations of rhubarb root in health food stores. (Natural Health, Natural Medicine, p 274)

Senna (Cassia acutifolia) is a bit stronger and also quite popular. It, too, is a main ingredient of many over-the-counter laxatives. Kathi Keville states that it is the most often purchased laxative herb in North America. And my perusal of over-the-counter laxatives supports this. In fact, the company that manufactures Ex-Lax recently updated its formula. Senna has replaced the key ingredient, the chemical phenolphthalein, which proved to have carcinogenic tendencies. Again, taste is a reason that herbalists might not recommend this remedy in its natural state. "The taste of senna is nauseating... herbalists generally discourage using the plant material and instead recommend over-the- counter products containing it."

Some herbalists recommend blends that pair the strongly bitter herbs with others that are better tasting and more easily tolerated. Kathi Kevilles approach is to combine the irritant herbs with tasty ones like peppermint, ginger, and fennel, that also relax the intestines and prevent cramping.

A commercial example of such a mixture is the blend Smooth Move sold by Traditional Medicinals. The main ingredient is senna, combined with licorice, and cinnamon, ginger, orange peel, fennel and coriander seed.

Another herb in this category, aloe, is even more problematic. Its popularity has recently increased and it is a wonderful herb to use externally for skin care. But because of its use, its name is becoming more known, and some people assume that because it is safe for one purpose, that it is ok to try for another reason. But this is not so!

A recent magazine article suggested drinking aloe vera juice on a daily basis. But many western herbalists do not recommend aloe as a laxative because it is too strong, although it has a history of use in Ayurvedic medicine. Michael Castleman in his popular book The Healing Herbs, has a headline under aloe, "Never a laxative". He says it is the "most drastic" of the cathartics and that it is least recommended "because it often causes severe intestinal cramps and diarrhea."




Ayurvedic herb mixture

Dr. Andrew Weil suggests using Triphala, an herbal mixture from the Ayurvedic tradition. He says this mixture of three herbs is a "superior bowel regulator rather than a laxative,...take it regularly, it's benefits accumulate the longeryou stay on it." Available in health food-stores in capsule form, follow the directions on the label.