Review article: anthranoid laxatives and their potential carcinogenic effects

Anthranoid laxatives are widely used laxatives of natural origin, Because o f their chemical structure they are carried unabsorbed to the large bowel, where metabolism to the active aglycones takes place, These aglycones exert their laxative effect by damaging epithelial cells, which leads directly a nd indirectly to changes in absorption, secretion and motility, Damaged epi thelial cells can be found as apoptotic bodies in the pigmented colonic muc osa, characteristic for pseudomelanosis coli, Pseudomelanosis coli is a con dition caused by chronic (ab)use of anthranoid laxatives and has recently b een associated with an increased risk of colorectal carcinoma. In vitro and animal studies have shown a potential role of anthranoid laxatives in both the initiation and promotion of tumorigenesis. Studies in humans have also suggested tumour promoting activities for these laxatives, Although the sh ort-term use of these substances is generally safe, long-term use cannot be recommended.