Herbal Supplements
Cascara Sagrada - a Herbal Laxative

Cascara sagrada is a natural laxative that comes from the reddish-brown bark of the Rhamnus purshiana tree. It was used by various Native American Indian tribes, but as a laxative it was not widely adopted until the nineteenth century; today Cascara sagrada is an important ingredient in many common laxatives.

Biological Description

Rhamnus purshiana  is a species of buckthorn that belongs to the Rhamnaceae family. Its other names are: Cascara Buckthorn, Bearberry, Cascara, Sacred Bark, Chittem Bark, or just Chittam or Chitticum. Cascara sagrada from Spanish means "sacred bark".

This is the largest species of buckthorn that grows up to 15 m tallwith a trunk 20-50 cm in diameter. It occasionally looks like a broad large shrub or small tree. The bark of it is brownish to silver-grey with light splotching. Dark green leaves are deciduous, oval and fuzzy. Tiny flowers are greenish yellow and bellshaped with sepals larger than the petals. The berries arebright red at first, then quickly maturing deep purple or black and contain ovate, black seeds.

Growing

Rhamnus purshiana is native to  the Pacific Coast of North America, from California to British Columbia, and as far inland as Montana. Today it is grown worldwide and cultivated primarily on the pacific coast of Canada and North America as well as in East Africa.

This deciduous shrub or small tree can be found growing naturally in the moist acidic soils under coniferous forests or the sides of roads.It prefers shady sides.

Parts Used

In folk medicine the bark of the Rhamnus purshiana is used. The harvested bark must be aged for one year or heat-treated prior to use - to make its effect milder (fresh cut, dried bark causes vomiting and violent diarrhea). It is stripped from the trunk of the tree in the spring and summer and left to age for a few years. The number of wild trees has been greatly reduced due to indiscriminate cutting, that is why the tree is now cultivated.

Market

Cascara sagrada is one of the few herbs approved as an over-the-counter drug by the U.S. FDA (Food and Drug Administration). It is available on the market in its dried form; dried bark can be made into tea, although it tastes bitter. In its fresh form – fresh cascara bark should not be used, as it can cause bloody diarrhea and vomiting.

Cascara can be found in other various forms: in capsules, tablets taken orally, and  in liquid extracts taken internally, also in the form of  a powder,dry extract for infusion, decoction, elixir, or a cold maceration. Capsules and tablets should be swallowed with a large drink of water, with or without food. If you have a sensitive stomach you should better take Cascara Sagrada in other form, as the comminuted drug.

Cascara should be taken for no more than one to two weeks. Individual dosages should be the smallest amount possible to achieve effectiveness. A typical dosage of cascara is a 300 mg capsule taken in the early evening to stimulate a bowel movement in the morning (the laxative effect usually occurs 6 to 12 hours after cascara is taken). It is stored at room temperature between 15 and 30°C. The raw herb, tinctures or infusions should be stored in airtight, dry, and light resistant containers. Keep away from the children.

Action

Today Cascara Sagrada is one of the most common herbal rather powerful laxatives. It is appeared to influence the motility of the colon, inhibition of stationary and stimulation of propulsive contractions. It also stimulates peristalisis, active chloride secretions and increases water and electrolyte content. The component which is responsible for such laxative effects isanthroquinones. These ingredients eventually trigger contractions in the colon (called peristalsis), which causes the urge to have a bowel movement.

Other notable constituents in cascara sagrada are hydroxyanthraquinone glycosides called cascarosides (A, B, C and D, which account for about 70% of the total with other glycosides in minor concentrations), they exhibit a cathartic effect that also induces the large intestine to increase its muscular contraction (peristalsis), causing a bowel movement.

Some more important constituents include resins, tannins, and lipids which make up the majoriy of the other bark ingredients.Along with such properties cascara is also believed to improve the muscle tone of the colon walls.

Health Benefits

Cascara Sagrada is one of the most effective herbal remedy for getting relief from constipation. Special attention should be paid for proper dosage of the laxative. However, it is a really mild laxative and is acceptable for the elderly, as it is rather safe. Cascara also prevents the pressure and pain associated with hemorrhoids and anal fissures, so it can be used for mild constipation that can occur following anal or rectal surgery.

The proper dosage means that you start with the lowest dose you can, and increase the dose (if only needed) very slowly. It is explained be the fact that everyone responds differently to laxatives. Important issue is to know that a bowel movement usually will take place within six to eight hours of taking a typically recommended dose of cascara. For constipation and related discomforts such as hemorrhoids take 1 teaspoon of liquid extract three times a day or 1 or 2 teaspoons at bedtime; or 1 or 2 capsules of dried bark at bedtime. The usual dose of any form of cascara ranges from 20 mg to 70 mg daily of the anthraquinones. Products containing cascara sagrada should not be used for more than eight or ten days.

Side effects of Cascara Sagrada: it should not be used for longer than 7 days in a row and should not be taken by children, pregnant women, breastfeeding mothers, or by people having severe hemorrhoids, blood vessel disease, liver and kidney disease, and gastrointestinal cancer (and some others). Side effects of cascara may include strong cramping in the abdomen, and with longer term use one may experience dark pigmentation in the colon (melanosis coli).If you notice side effects – just stop usage  and report it to your health care professional. Long-term use can cause dependence. Large doses of anthraquinones may cause bloody diarrhea or vomiting.

Other traditional usage of Cascara Sagrada is for dyspepsia, and a treatment for liver and gallbladder problems. But these applications have not been clinically validated.

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Testimonials
deb
2015-01-22 21:47:39
Been using cascara sagrada and senna for over 45 years and thank God everything is fine.
Rangdrol
2012-05-13 20:30:37
Though you may say that you use it every day for 7 years, there are serious and severe side effects published in peer reviewed scientific papers and abstracts which show that Cascara sagrada, which even on this site, it is advised, "should not be used for longer than 7 days in a row" because of the colon cancer, mutagenic, and potential genotoxic effects. It is also reported to cause melanosis coli, a disease "which has no side effects" and is due to the constant and long term use of this kind of laxative.

Cascara sagrada, while promoted as a safe herbal laxative, has "been associated with the development of cholestatic hepatitis, complicated by portal hypertension." This from a 1999 abstract.

In Germany, reports state that "cascara...can be habit forming, and contains compounds "suspected of being cytotoxic, genotoxic, mutagenic, and even tumorigenic; epidemiological studies in Germany reveal that abusers of anthropoid laxatives have three times higher rate of colon carcinoma (AEH)."

While by no means anti-herbal, the FDA has recently considered that this effective but potentially disatrous herb, when used long-term, should be considered a Class II medicine.

To note: The last line in the above description of the herb states: "But these applications have not been clinically validated." The scientific papers and abstracts that I have read indicate exactly the warnings I included above, which makes this herbal remedy a very short term remedy, with serious carcinogenic, etc., properties!
me
2010-08-09 00:21:50
I used this as part of a bowel cleasing formyla for two or three months and it put my chrohn's desease into remission for two years!
Anonymous
2009-08-26 17:12:57
My husband and I have used this for 25 years. We take 2 pills every day and this is the only thing that works for us.
let it go
2008-03-14 09:21:01
use it every day for last 7 years, usually twice a day and its the only thing that works, thank goodness
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