In 1943, Heilbrun published an article on extensive changes in the colon, apparently as a result of excessive and prolonged use of irritant cathartics. To our knowledge, no other report on this subject has appeared in the literature. During the past two years we have seen 2 patients with changes in the colon very similar to those described by Heilbrun. A brief résumé of his case and a report of our own cases follow. All 3 of these cases were thoroughly studied. Only the pertinent data are presented. Case Reports Case I (Heilbrun): A 36-year-old white female had from adolescence experienced a feeling of abdominal fullness and bloating, which seemed to be relieved by a complete evacuation. To insure this evacuation, she had taken cathartic tablets daily for the past twenty years. The cathartic was a well known patent medicine containing phenolphthalein, aloin, and podophyllum. During this twenty-year period the feeling of bloating and fullness persisted, although the patient's general health and nutrition remained good. In November 1938, a gastrointestinal examination and barium enema study were done to determine whether any organic defects existed to account for the patient's complaints. There was considerable delay in transit time of the barium meal through the small bowel. No recognizable mucosal pattern could be seen in the distal ileum, and it had a rigid, tube-like appearance. The colon was narrowed, spastic, lacking in haustrations, and without the normal mucous membrane pattern. The radiographic appearance was that of an advanced chronic ulcerative colitis, though there was nothing in the patient's history to suggest such a diagnosis. She denied any period of weight loss, diarrhea, loose stools, or daily fever. The patient refrained from ingestion of any cathartic for one month and was then re-examined. No appreciable change was seen in the right side of the colon, but there was some increased activity of the left side. After five months without cathartics, there was no further improvement. The patient gave up the use of cathartics for only six months, after which she gradually returned to her daily purgation. She was examined again in 1951, and the colon had not changed in appearance. Her general health remained good. Case II: A 54-year-old white female was admitted to the hospital Nov. 22, 1950, because of anorexia of long standing and recent severe nausea and vomiting. Questioning revealed that the patient had taken either eight cathartic pills or six ounces of milk of magnesia every day for the past thirty years to relieve a feeling of discomfort and bloating in the upper abdomen. Under this regimen she had what she considered normal bowel movements. The cathartic used was the same preparation as that taken by Heilbrun's patient (Case I). A plain film of the abdomen showed a long shadow in the right upper quadrant which was thought to represent a calcified gallbladder. A cholecystogram was done but the gallbladder was not visualized.