Abstract: Objective To investigate the intestinal toxicity and mechanisms of action of anthraquinone laxatives, so as to provide a reference for the rational use of anthraquinone laxatives. Methods A comprehensive review and analysis were conducted through literature and database searches on the mechanisms of intestinal toxicity of an-thraquinone compounds and the presence of these compounds in clinical drugs. Results Long-term use of anthraquinone-containing laxatives can damage the enteric nervous system and gastrointestinal pacemaker cells (interstitial cells of Cajal), leading to cathartic colon. Additionally, these compounds can cause damage and apoptosis of intestinal epithelial cells, resulting in melanosis coli. Correlative studies indicate a significant association between melanosis coli and the detection rates of colonic polyps and adenomas, though its link to colorectal cancer remains controversial. Conclusion Future development of laxative drugs and foods should prioritize balancing efficacy with intestinal toxicity. Systematic evaluation of the long-term effects of anthraquinone laxatives on interstitial cells of Cajal is necessary, along with the establishment of daily limits and usage duration guidelines. Restoring intestinal function is essential for addressing functional constipation. Hence, there is an urgent need to focus research on developing drugs or foods that can be used long-term and aid in the recovery of intestinal function.

Key words: Anthraquinones, Laxatives, Intestinal, Melanosis Coli, Enteric Nervous System, Interstitial Cells of Cajal, Cathartic Colon, Toxicity