# Cascara sagrada



## Mary5 (Apr 17, 2006)

Someone told me to try taking Cascara Sagarada in the morning before eating anything. Anyone?


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## Kathleen M. (Nov 16, 1999)

It is an herbal stimulatory laxative similar to the more common senna.


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## annie7 (Aug 16, 2002)

HI Maryi take cascara sagrada--two 425 mg capsules--at night and then it works in the am for me. works quite well. Kathleen's right--it's a lot like senna.


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## Mary5 (Apr 17, 2006)

How would you say it compares to senna and bisacodyl? My gastro told me to go ahead and use senna or bisacodyl as needed (given that Amitiza Miralax etc don't work with any consistency).


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## amg (Mar 29, 2009)

I use senna daily. I have the same story, nothing worked, so they just told me to take it a feel better. I think senna is much more gentle than bisacodyl. I take about 15 mgs. in the evening, and perhaps one in the morning, if I'm having a bad time. I generally feel ok on this routine.


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## Mary5 (Apr 17, 2006)

I agree that bisacodyl is much stronger than senna. I was asking about the cascara sagrada because as you know for some us the effects wear off after a short time so we need to rotate and try different things.


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## annie7 (Aug 16, 2002)

i've read that cascara is a milder laxative than senna but for me it works about the same--possibly stronger. since meds have a tendency to quit working for me i rotate cascara sagrada with senna, bisacodyl and tegibs (generic zelnorm) so as to hopefully avoid building up a tolerance to any one of them.


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## Mary5 (Apr 17, 2006)

Annie7 do you take something every night? What are your doses?


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## annie7 (Aug 16, 2002)

yes now i do take something every night. i started this regimen about four years ago when perimenopause kicked itself a nasty notch up making my c so bad i could barely go at all and nothing i tried would help except laxatives and occasionally zelnorm. out of desperation i started taking the minimum dose of each of those three laxatives and alternated them and zelnorm. now that menopause has settled in my c has become even worse and i'm up to the max dose on everything--two 425 mg cascara sagrada, four 25 mg senna, three 5 mg bisacodyl and 12 mg tegibs (generic zelnorm) --all rotated. so that regimen keeps things moving--what a relief. and i do the healthy things too-- eat a certain amount of fiber--had to adjust that slightly downward recently after some experimenting--better results that way--too much just plugs me up. and also drink lots of water, eat activia, lots of exercise, meditation and some yoga. but i've had to add laxatives to the mix. it's a last resort for me since i've tried everything over the years (40 yrs) and nothing absolutely nothing else works now but this regimen.


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## Mary5 (Apr 17, 2006)

Mine has also gotten worse with menopause.I had managed to stop taking laxatives for quite a while but have had to go back to them, get so plugged up I can hardly breathe.It is hard to enjoy anything with this condition.Thanks


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## annie7 (Aug 16, 2002)

oh yes mary--you are so right. it's so very hard to enjoy anything when you're all plugged up and in pain and discomfort 24/7. periodically i go off laxatives just to see how i do without them but then nothing moves--just one or two little rabbit poops if i'm lucky--total misery. i'm not real happy about having to take laxatives so frequently but at this point this regimen is the only thing that works for me other than enemas.there is one new drug in the pipeline--prucalopride/resolor-- that really looks good to me and i'm hoping and praying it'll make it through the approval process. it's specifically designed to restore impaired bowel motility and help people with ibs-c and chronic constipation. it's through phase three now and being reviewed for approval in europe--i sure hope it makes it to the states... http://www.movetis.com/product/resolor-prucalopride


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## Mary5 (Apr 17, 2006)

That sounds really interesting! I do hope it makes it, there seems to be so much research done for IBS-D and not so much for -C. I guess we must never lose hope. Have you had all the tests? Has the doc ever suggested surgery to you?


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## annie7 (Aug 16, 2002)

i've had everything but the sitz marker--have you had it? . i've been thinking of going back and asking for it to determine if my ibs-c has turned into chronic constipation although i'm not really sure it's actually possible for ibs-c to morph into chronic constipation but it sure seems like it has with menopause..things have really slowed down. doc's won't do surgery for ibs-c--only cc. right now life has been pretty complicated (when is it never?) and i'm too chicken to take the sitz marker. a couple women i know with the same symptoms as mine had it and much to their surprise passed it and told me if i decided to have it to be sure and go at least two weeks without any laxatives whatsoever to make sure the laxatives are completely out of your system and won't affect the results. they were very emphatic about that. both women felt they hadn't abstained from laxatives long enough and that affected their results.occasionally i go off laxatives for a week. it's absolute misery. two weeks?? omg...only if i were a hermit...although seriously--well, like i said now is a bad time but i do plan to do the sitz marker eventually...just wish there was an easier way to determine cc.


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## Mary5 (Apr 17, 2006)

When I said without laxatives I meant without dulcolax/senna, I did take Miralax and also tried Kristalose. But these two just don't work with any consistency, they helped but I was very uncomfortable the whole time. I obviously need an "irritant" to get things OUT. Cause seems like the highway is full of traffic jams, it is a stop and go thing and so never complete. What stays jammed in there hurts like hell.I don't dare do the sitz marker test!My gastro once told me that if it was "refractory" constipation-not responding to anything-he would have me look at surgery.But to me that needs to be a very very last resort. For many reasons: It is Surgery after all. Also, it appears that obstructions are a common side effect due to scarring. The disruption from home and work. And last but definitely not least, the out-of-pocket COST. My life revolves around my colon. What happens after I first wake up tends to set the tone for the day. Haven't been to the excercise club in ages, down to a couple of pants, skirts with elastic...It is difficult to feel cheerful. But one must not lose hope!


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## janetmtt (May 28, 2007)

Someone told me to take Andrew Liver Salts every morning - anyone tried that?


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## annie7 (Aug 16, 2002)

oh yes mary--i too need that peristalic push that stimulant laxatives (or zelnorm/tegibs) provide to push things out. if i just take an osmotic like miralax, milk of mag, epsom salts etc it all just sits in the colon and sloshes around--a little comes out but not much--utter misery. amitiza affected me the same way. the osmotics wet the stool but they don't push it out--at least not for me. gotta have that push. that's why i'm hoping prucalopride will be approved. from what i've read it sounds like it affects peristalis.and yes i agree with you on the surgery. it would only a last resort if the laxatives quit working--like your gastro doc said--and it has risks--the scar tissue problem especially concerns me--and totally unaffordable if insurance won't pay for it.i can only wear elastic waist stuff too--and it has to be a size too big or else i cut the elastic. anything tight on the waist or tummy drives me crazy...it's hard..you're right--i feel like my colon is pretty much in charge of my life too. on a good day i feel great and have lots of energy and optimism. on a bad day like today--some days the laxatives don't work quite as well--it's misery. i still force myself to do things and try to think positive and not focus on the pain but i'm simply not up to doing as much and everything seems like a struggle.janet--i looked up the liver salts and it sounds like they are like epsom salts--an osmotic--which never worked for me. but thanks for the suggestion. if i ever see any around i might give it a try although it looks like andrews is only available in the uk.


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## janetmtt (May 28, 2007)

Yes think it is a bit like epsom salts but it contains magnesium and someone said they thought I was lacking that (think I am in all honesty) but it also contains bicarbonate of soda and citric acid too so maybe not as harsh as epsom salts. My mum says ES are nicknamed "horse medicine" because they can make anything go!I agree this is a nightmare and I'm fed up with having a bloated stomach. I found another product which I've posted on another thread and hoping that Ian Ramsay responds and that is a probiotic with a digestive enzyme and the woman said that it should work the next day. On her website it also says that it helps get rid of that horrible fat we tend to get around the middle whether we are watching diets or not - I know I watch my diet and I'm sure someone must pump me up in the middle of the night.I'm wondering - does magnesium help sort out the water balance in your body as I feel I'm having a few issues with fluid at the moment.But I'm also keen to try the triphala which has been sat in my cupboard for months and I've read some good reports on that.Even aloe vera doesn't seem to do much for me.


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## Mary5 (Apr 17, 2006)

Annie yes I have come to that conclusion, that there is definitely a short circuit along the line and that is why the osmotics don't help, it is all about the peristaltic push as you say. Sometimes osmotics help but in the end always end up needing a stimulant to get the job done. That is probably why Zelnorm was so effective, because it helped the nerves transmit the message correctly and fully. I do hope the prucalopride works out, I have marked that page under my favorites to check on it. Still, don't hold your breath, there are many many medications available in Europe, South America and Canada that never make it to the States.!!!I am so tired of trying things and nothing really works, always the pain and discomfort. I wonder if perhaps a neurologist could help? Janet, we have talked before. I tried the Triphala (Indian mix of fruits) and the magnesium and probiotic enzymes...for me nothing helps with any consistency or after a certain time. I end up with a backup that needs a stimulant. Still, we are all unique so try!


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## janetmtt (May 28, 2007)

Hi Mary - yes we have talked before - I've not tried the triphala yet - how did you do on it and did it work at all - if so for how long - think I'm like you I also need a stimulant.I've just today had my first Vital Shape probiotic and digestive enzyme and see what that does - trouble is if it doesn't work within a couple of days I have to take something to get rid of what starts to be a back-up - otherwise from past experience I start and get serious problems.But I'm really worried at the moment that my bloating is really out of hand - it's never been so bad - have been taken aloe vera juice and that helped for 2 days but now it's worse than ever so I'm wondering has the AVJ which I've taken for two weeks making the bloating worse. I know it helps some people but it doesn't say it helps everyone so tomorrow I'm not going to take any. However if this bloating doesn't subside within a couple of days I know I have to go and see my GP - saw him last week and he agreed my bloating was really bad and that is why he did full blood count along with a liver function test but everything came back normal.Does magnesium help bloating?The bloating is really really depressing me and I've gone past the looking 6 months pregnant stage to looking 9 months now. Wondering in all honesty if the senokot which I've been taking is making it worse?I'm just sick to death of it all now and feel it takes over your life.


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## Mary5 (Apr 17, 2006)

Janet as far as I know magnesium doesn't help bloating. It is a mineral and when taken in certain dosages-say from 400mg to 1000mg (+drinking lots of liquid)- at night (per day) it acts as an osmotic laxative, that means it draws water in (it is not a stimulant) and loosens things up. The bloating can be attributed to many things and one of those I think is as a reaction to all the stuff we take. The only 2 solutions I have ever found are 1. take a day and try different positions to help the gas out, like lying down, lying on your left in the fetal postiion, massaging yourself, etc whatever works, 2. taking something strong to get cleaned out.Unfortunately nothing really solves the problem because the vicious circle starts all over again. But what can you do? One day at a time is the only way.


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## janetmtt (May 28, 2007)

For some reason the last couple of weeks I've been terrible with the bloating - actually wondering if the AVJ has made it worse. And that doesn't make me go every day if I take it neither - every other day but someone said it made her constipated if she took it every day.I'm just sick to death and totally miserable. Take 2 of the new probiotics and DE's today so will see what that does - but I am very keen to try the triphala because that is supposed to be like a laxative. But this new vitalSHAPE one also says it's good for constipation and bloating.Mary - did you get any side effects from triphala and how long did it work for you.I've taken magnesium in the past and Iknow when I took it my bloating reduced but it also gave the a horrible tight chest!  Perhaps the Andrews Liver Salts is a good idea actually - at least you would go every day. Maybe I should try the magnesium.Does the magnesium not work for you Mary?


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## sarah jane (Apr 1, 2009)

my computer has been crashed for awhile, so have not been in these forums for a couple of weeks.am now using my husbands' computer for the time being..wow!it is such a comfort to check in on this website..IBS is so lonely as a personal experience, that when I start to read people's messages here, i feel like I'm at least back with my 'tribe'..people talk about so much that is my experience also, and then i feel a little less 'crazy'..having your colon come to a screeching halt is extremely bizarre.. and then all of us have gone through months of wondering, checking, testing,scratching our heads, and generally being completely freaked out by what has happened to our bodies.when all the typical testing comes back 'normal' and we are dismissed to take laxatives, we feel confused and abandoned by the system..no-one is really helping us!!..it makes me feel that we are still in the Dark Ages..anyway..wanted to emote, as i am feeling incredibly comforted by having this forum and feeling great compassion for all of us.a few comments on this particular dialogue in this particular arm of the forum..[nothing brilliant or enlightening]..I have been using Triphala, and it has enabled me to stop daily use of oral laxatives, but it is not a miracle by any means..it seems to work just like everything else..ie for awhile and then i need to resort back to a mix of say ..Miralax one day..MOM the next...senna/cascara the next..then back to Triphala for a few days..I like taking things like Triphala, since it is an herbal-type product versus an irritant..the ayurvedic practitioner that recommended it to me said it is very good for the colon..toning and flushing..he said to be sure and order it in powder form and to gag down a good teaspoon of it in juice/water [very bitter]..my other comment is that I clearly have colonic inertia, because like many of you writing on this forum, I can do all of the above and it will usually stay in my colon sloshing around..NO peristalsis/ motility to move it through my colon..my other daily habit has been to use suppositories in conjunction with the oral stuff,..the only way to actually move waste out of my colon..I don't read much about others using supps...and i'm curious to hear if any of you do?sarah jane


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## fizzixgal (Apr 6, 2007)

Glycerin suppositories? Yes! I've just recently started using them and found that in combination with everything else I use, they can make the difference between going and not going. But the fact that they work makes me wonder if I may NOT have colonic inertia but pelvic floor dysfunction or some other problem with the rectal musculature, since they are effectively a saline laxative confined to the lower colon. They don't help to move anything from higher up, but do allow what's "in position" to come out to do so, often with a lot of force.Then again, sometimes they don't work... in that case, the next night I will take senna, the only thing that works for me sure fire, every time, without fail. At least so far (knock on wood and don't use too often).


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## Mary5 (Apr 17, 2006)

The triphala did nothing for me, nothing at all.The magnesium worked but as usual stopped after a while. Haven't tried it lately.Lately I had been using Miralax and the other lactulose but not very successfully. So last week I had to go back to laxatives and you know they don't really solve anything but I don't dare not take something at least every other day. I had to stay home sick one last week, could hardly breathe I was so bloated and nothing was coming out. Spent the day trying different positions to help the gas out, and drank lots of liquid and a laxative that night.Have been taking cascara sagrada and it sort of works...No real complete satisfactory experience. In fact I can hardly remember what that is like anymore. Always in pain and discomfort. Life has been reduced to getting to work and getting through the workday, all the time planning what to take at night.


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## janetmtt (May 28, 2007)

MaryThanks for that - life shouldn't be like this - well it's not a life is it - just an existence - wish there was something that would sort it out for all of us sufferers.Hope you find some relief.


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## annie7 (Aug 16, 2002)

oh yes mary--i too hope you find some relief--and all of us...i'm always thinking about what i'm going to be taking at night too..and hoping whatever i take will work because sometimes it doesn't work as well as it should...there are good days and bad days.and i am so very thankful i was able to take an early retirement late last year because struggling through the work day being sick and in pain every minute is really hard. my constipation was a big factor in my deciding to retire. it was a scary move especially with this economy but i just couldn't take the stress of work anymore coupled with the pain of ibs. it was getting to the point where i was driving into work everyday with a heating pad strapped to my belly, going out to my car at lunch so i could lie down in the backseat and try different positions to get the gas out and attempt to relieve the pain...just couldn't take it anymore. at least now when i'm having a bad day i can (usually) take it easy at home and pace myself.good luck to you...


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## Mary5 (Apr 17, 2006)

Annie, I am sincerely happy you were able to retire and therefore take care of yourself without the stress of work and schedules and such. I am 53 and don't see myself retiring, ever! Unless I am forced to.Because it is just me, and how else am I going to pay the bills, especially dental and medical? So I don't even think about it anymore.But I am glad for you that if you must suffer from this terrible disease at least you can just stay home.Janet, we just have to keep trying different things!


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## janetmtt (May 28, 2007)

Yes we just have to keep trying but I'm finding it expensive - when things don't work and it goes in the bin!


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## Mary5 (Apr 17, 2006)

I hear you Janett!I have a cupboard full! So for a while now I am just using what I have in there, going back to "old" stuff.


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## Mary5 (Apr 17, 2006)

Has anyone tried Epsom Salts ?


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## janetmtt (May 28, 2007)

Long long time since I used ES - my mum uses them - she's on so much medication she gets terribly constipated and sometimes senokot doesn't work for her. So she takes ES and she calls it "horse medicine" because it will shift anything! I gave her some Ortisan Fruit and Fibre cubes to try.But someone told me to take Andrews Liver Salts - they contain ES but also bicarb of soda and I think they are a bit more gentle.


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## Mary5 (Apr 17, 2006)

As far as I know it doesn't exist as such here in the US. The 2 separate ingredients do, sodium bicabonate + magnesium sulfate (Epsom Salts).


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## janetmtt (May 28, 2007)

Perhaps it goes by a different name or is there something similar on the market?


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## SpaceNeedle (Jul 22, 2000)

Mary5 said:


> Life has been reduced to getting to work and getting through the workday, all the time planning what to take at night.


well said, well said. You took the words right out of my mouth. This is my life as well.


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## SpaceNeedle (Jul 22, 2000)

Mary5 said:


> Has anyone tried Epsom Salts ?


Ironically I've been "playing around" with Epson Salts lately, after initially being put off by the taste many years ago. I took a half glass of water+Epson Salts yesterday, and I noticed that my stomach was fairly happy (less bloating) afterwords. I also had a small BM in the afternoon, but that might have been do to the Zelnorm I took the prior day. (..I usually get a BM from Zelnorm 2-4 hours after taking a pill, but can get another BM that day or the next day after taking a Zelnorm. The following BM's are usually smaller however..)I'm not a huge fan of drinking so much salt, so as soon as I get up enough nerve I'm going to get an enema bag at the drugs store and put the salty solution directly where its needed! ..haha..


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