Women who are pregnant or breast-feeding, and children under the age of 12 should not use cascara without the advice of a physician. People with an intestinal obstruction, Crohn’s disease, appendicitis or abdominal pain should not employ this herb.⁷ Long-term use or abuse of cascara may result in weakened bowel function. It may also cause a loss of electrolytes (especially the mineral potassium). Loss of potassium can lead to abnormalities of heart function and may augment the action of digitalis-like medications with fatal consequences.