Subject(s)
Adenoma/diagnosis , Cathartics/adverse effects , Colonic Diseases/chemically induced , Colonic Neoplasms/diagnosis , Melanosis/chemically induced , Rhamnus/adverse effects , Senna Extract/adverse effects , Adenoma/pathology , Adenoma/surgery , Colonic Diseases/pathology , Colonic Neoplasms/pathology , Colonic Neoplasms/surgery , Colonoscopy , Early Detection of Cancer , Humans , Male , Melanosis/pathology , Middle AgedABSTRACT
The use of anthranoid laxatives such as Cascara sagrada can, in rare instances, produce a hepatitis that resolves with discontinuation of the offending supplement. However, the clinical presentation of abdominal pain, jaundice, clay-colored stools, and darkening urine can mimic the presentation of a variety of hepatobiliary illnesses, including cholangiocarcinoma. This case report describes a local patient diagnosed with an extrahepatic cholangiocarcinoma following workup for an acute hepatitis due to ingestion of large quantities of Cascara sagrada.
Subject(s)
Bile Duct Neoplasms/diagnosis , Bile Ducts, Extrahepatic , Chemical and Drug Induced Liver Injury/diagnosis , Cholangiocarcinoma/diagnosis , Phytotherapy/adverse effects , Rhamnus/adverse effects , Aged , Cathartics/adverse effects , Chemical and Drug Induced Liver Injury/etiology , Constipation/drug therapy , Female , Humans , Incidental Findings , Plant Preparations/adverse effectsSubject(s)
Colonic Diseases/chemically induced , Colonoscopy , Laxatives/adverse effects , Melanosis/chemically induced , Phytotherapy/adverse effects , Rhamnus/adverse effects , Aged , Chronic Disease , Colonic Diseases/diagnosis , Constipation/drug therapy , Female , Humans , Macrophages/pathology , PhagocytosisABSTRACT
Herbal medicinal products can cause toxic hepatitis. This case report presents a patient who developed severe toxic hepatitis with beginning liver failure following four weeks of consumption of the herbal medicinal product Cascara Sagrada. A similar case was reported from the United States. Cascara Sagrada is found in 30-40 herbal medicinal products in Denmark. We recommend that herbal medicinal products containing Cascara Sagrada be withdrawn from the market.
Subject(s)
Cathartics/adverse effects , Chemical and Drug Induced Liver Injury/etiology , Phytotherapy/adverse effects , Rhamnus/adverse effects , Dietary Supplements/adverse effects , Female , Humans , Liver/drug effects , Liver/pathology , Middle AgedABSTRACT
Herbal medicines are gaining widespread popularity. Much of the public believes that botanical herbs are both harmless and useful for the treatment of a variety of symptoms. This belief stands in contrast with the fact that many herbal therapies have been shown to be toxic. In the present case report, cascara sagrada (CS) has been associated with the development of cholestatic hepatitis, complicated by portal hypertension. CS is a mixture of ingredients, among which is anthracene glycoside--an herbal agent that previously has been associated with chronic hepatitis. The liver injury in the case herein reported is believed to be related to either anthracene glycoside or one of the other constituents of CS.
Subject(s)
Cathartics/adverse effects , Chemical and Drug Induced Liver Injury/etiology , Cholestasis, Intrahepatic/chemically induced , Cholestasis, Intrahepatic/complications , Hypertension, Portal/etiology , Phytotherapy , Rhamnus/adverse effects , Biopsy , Chemical and Drug Induced Liver Injury/pathology , Cholestasis, Intrahepatic/pathology , Humans , Hypertension, Portal/pathology , Liver/drug effects , Liver/pathology , Male , Middle AgedABSTRACT
The effect of acute and chronic administration of various doses of Melo's Conquer Mixture (MCM) on the histological appearance of the small and large intestine was investigated in albino Wistar rats. Obtained results show that at recommended therapeutic dose, MCM is able to evoke an acute inflammatory response, with infiltration of the mucosa and submucosa by neutrophils, lymphocytes and eosinophils. In addition, there was submucosal lymphoid follicle hyperplasia and increased mucus secreting cells. The severity of these changes were dependent more on prolonged administration than dose. These findings suggest strongly that MCM is a potential toxic agent. We therefore recommend further chemical analysis to identify the possible toxic agent(s) in this mixture.
Subject(s)
Cathartics/adverse effects , Ileitis/chemically induced , Ileitis/pathology , Intestine, Large/drug effects , Intestine, Large/pathology , Intestine, Small/drug effects , Intestine, Small/pathology , Magnesium Sulfate/adverse effects , Rhamnus/adverse effects , Animals , Drug Combinations , Drug Evaluation, Preclinical , Female , Hyperplasia , Male , Rats , Rats, Wistar , Time FactorsSubject(s)
Cathartics/adverse effects , Melanosis/chemically induced , Rhamnus/adverse effects , Stomach Diseases/chemically induced , Substance-Related Disorders/complications , Adult , Biopsy , Female , Gastric Mucosa/drug effects , Gastric Mucosa/pathology , Humans , Melanosis/pathology , Stomach Diseases/pathologyABSTRACT
Several methods have been used to cleanse the large bowel prior to roentgen examination and rectoscopy for more than ten years. A method with administration of a salt solution (SALAX) in combination with different oral laxatives (Cascara sagrada, Dantron, Bisacodyl) without cleansing enemas is described. Hospitalized patients should have an individual preparation while ambulatory patients are almost completely cleansed if they carefully follow the given instructions.
