Last Updated on June 12, 2019 by Marc Seward
Medically Reviewed by Dr. BENGEBARA Omar
MD, ER Doctor & Surgery Resident – Reviewed & Approved on June 09, 2019
–Written by Marc Seward
A Natural Laxative
For anybody that suffers from constipation, cascara sagrada can offer some genuine, natural relief.
While the vast majority of people who use this natural remedy use it as a laxative, it can also do a whole lot more.
If you are interested in finding out just what it is and how it can help your health beyond as a laxative, then read on..
What is Cascara Sagrada?
Cascara sagrada is produced from the bark of the Rhamnus purshiana tree which is a native of western parts of North America. Other common names for the product are bitter bark, cascarinde, buckthorn, chitem bark, Rhamnus and sacred bark.
As far as we know, it was originally used by the Native Americans of the Pacific Northwest mainly for treating constipation. In 1877, the herb was admitted into the US Pharmacopoeia.
It has a very long history of use as a laxative and was traditionally taken by the Native Americans as a treatment for constipation. In 1999, cascara sagrada made up over 20% of the US commercial laxative market and had an estimated of around $400 million.
When the Spanish conquerors made their appearance, they were introduced to the herb and gave it one of its common names – Sacred bark because of its incredible effectiveness.
There are also records of its use as a natural laxative by monks dating back to the early part of the 19th century.
Plant chemists quickly identified the main active constituents responsible for the herb’s laxative effects as anthraquinone derivatives. These chemical compounds stimulate strong wavelike contractions in the large intestine known as peristalsis.
However, in 2002 the FDA banned its use as an ingredient in over the counter laxative products.
The Health Benefits of Cascara Sagrada
1) A Natural Laxative for Constipation
Constipation can be very uncomfortable and is a bit embarrassing to talk about but if you are a sufferer, you are most certainly not alone.
Estimates suggest that over 60 million people suffer from the condition in North America along with hundreds of millions also suffering in the rest of the world.
While adding more fiber to the diet is a big help, it does not always work and natural remedies like cascara sagrada offer an effective, natural alternative to over the counter medications. The herb offers fast and effective relief from constipation for many people.
Studies have demonstrated why the herb works as a laxative.
Researchers have identified that anthraquinone derivatives present in the bark helped to stimulate peristalsis or the strong, wavelike contractions in the large intestine.
This action helps to keep your food moving through the entire digestive system and aids in the evacuation.
Cascara sagrada helps speed up the process and produce more efficient bowel movements because there is less time for the intestine to absorb the stool’s liquid.
How to Use Cascara for Constipation
To treat constipation, Casgara sagrada is usually taken orally in the form of a tea or liquid extract giving a dose of between 20 and 30 mg of hydroxyanthrecene derivatives.
The tea is made by steeping two grams of chopped bark in a cup of boiling water for 10 minutes or so. Strain the tea before you drink it and add some honey to taste.
The recommended dose of liquid extract is between two and five mL taken three times a day. The best dose to take is the minimum necessary to maintain stool softness.
Note: In November 2002, America’s FDA declared that OTC laxatives containing Cascara Sagrada were not considered safe or effective.
Before 2002, the herb was approved as an OTC medication for the treatment of constipation. However, some concerns were raised about its effectiveness and safety. The manufacturers were given an opportunity to answer the concerns by the FDA but they decided that the cost of the efficacy and safety studies would exceed any profits expected from sales. This resulted in the FDA telling manufacturers to reformulate or remove any OTC laxatives containing cascara sagrada in 2002.
Despite the FDA’s ruling, you can still but the herb as a supplement. Dietary supplements are not regulated by the FDA and do not have to achieve the standards applied to OTC medications.
Studies on elderly populations have shown that the majority of people using laxative products long term could discontinue their use if they added a fiber supplement.
2) Hemorrhoids
Hemorrhoids are another common and often painful condition that can be helped by taking cascara sagrada especially if the condition is caused by bearing down aggressively.
Because of its well-known laxative properties which also help soften the stool, you can evacuate your bowels far more comfortably. This means there is less need to strain which can help diminish the occurrence of hemorrhoids.
3) Antimicrobial Actions
Apart from its well-known laxative abilities, cascara sagrada has been studied for its other benefits with attention shifting to a compound called emodin which may have a number of beneficial effects.
In vitro studies have shown that emodin – one of the main active compounds in cascara sagrada has antibacterial and anti-fungal effects.
It is effective against a range of bacteria including Helicobacter pylori, E coli, and several strains of Staphylococcus aureus. It has also demonstrated anti-fungal action against Candida. (1)
4) Anti-inflammatory Actions
Studies have also been done to examine the anti-inflammatory effects of emodin isolated from the plant. The results have proved very promising but the exact way in which it works remains unclear.
Researchers believe that emodin gets its inflammation-fighting ability from its ability to influence cytokines.
5) Cancer
Cascara sagrada is among a huge collection of herbs that have been investigated for their potential applications in cancer treatment and management.
Once again, it is the active constituent emodin that is causing quite a bit of excitement. In vitro experiments have demonstrated that emodin can inhibit a range of human cancer types although the precise mechanism remains unclear. (2) (3) (4)
Emodin has, however, showed both cancer cell death and anti-tumor potential under laboratory conditions. Experts have suggested that emodin may have a role to play as an adjunctive therapy to traditional cancer treatments.
Unfortunately, up to now, very few experiments have been done on animals and clinical trials are necessary before its actual potential is known.
6) Central Nervous System Effects
Cascara sagrada, and its constituent emodin, in particular, has also demonstrated the potential to improve emotional well-being, anxiety and other conditions related to the nervous system.
Studies conducted in the laboratory, as well as a few animal studies, suggest that emodin may exert an action on the brain’s receptor signaling mechanism.
Animal models have demonstrated that it might possess serotonin and can protect against amnesia in induced animals. (5)
How to Use Cascara Sagrada
As with most herbal remedies, there are several ways of taking cascara sagrada. It is usually taken in liquid extract form or in tablets and capsules made from the dry herb extract.
Typical doses are one gram of bark, between two and six ml of liquid extract. The dosage recommendations for the dried extract is 325 mg.
Laxative action can usually be felt within 6 or 8 hours after administering the remedy.
Do not take more than the recommended dose and avoid taking the herb for more than 2 weeks at a time.
How to Make Cascara Sagrada Tea
First of all, it is important that you buy from a reputable company. The bark needs to have been properly aged for a year or more before it is safe to use.
Look for the label – ‘Casgara Sagrada Bark U.S.P’ which ensures that the product is genuine and has been aged sufficiently.
If the bark has not been correctly aged, it may expose you to certain chemicals that have nasty effects like stomach cramps, vomiting, and severe diarrhea.
Once you have the right product, it is very simple to make a tea with the bark.
Simply add a teaspoon of cascara sagrada bark to three cups of distilled water and bring the liquid to the boil. Simmer for around 30 minutes to ensure you are getting all the medicinal benefits of the herb. Strain and allow to cool before drinking.
You can drink one or two cups of your cascara sagrada tea each night before bed. Do not drink the tea for more than 2 weeks at a time.
Precautions and Side Effects
As is the case with many herbal remedies, the simple fact that it is a natural product does not guarantee its safety.
There are certain potential side effects that you should be aware of and you must always consult a doctor before taking the herb. Like Senna, Cascara Sagrada is a stimulant and should never be used long term.
- There is documented evidence that cascara sagrada is UNSAFE for pregnant women and breastfeeding mothers. Studies have demonstrated that the herb has both emmenagogue effects which can stimulate menstruation. It also has abortifacient properties that may stimulate miscarriage.
- As regards nursing mothers, anthranoid metabolites contained in the herb might get excreted in a mother’s breast milk causing harm to the child.
- Cascara sagrada should not be used on children under the age of 10.
- Long-term use of the herb may result in certain adverse side effects. These include chronic diarrhea with resultant complications caused by an electrolyte imbalance.
- Overdoses of anthraquinone laxative products can result in severe diarrhea and severe intestinal pain. It can also lead to subsequent dehydration and an electrolyte imbalance.
- In November of 2002, the US FDA ruled that over the counter cascara sagrada preparations were not recognized as being safe and effective.
- The most serious issue is the potential to cause toxic hepatitis as it contains anthracene glycoside (6,7).
Potential Interactions with Medications
Cascara sagrada may interact with certain medications including the following:
- Corticosteroids and other drugs for inflammation: Medications for inflammation like corticosteroids may reduce the body’s levels of potassium. Being a laxative, cascara sagrada may also decrease potassium levels and a combination could be dangerous.
- Digoxin (Lanozin) : Low levels of potassium can increase the potential for side effects from digoxin.
- Stimulant Laxatives : Being a laxative itself, taking cascara sagrada along with another stimulant laxative can reduce the minerals in the body and cayuse dehydration.
- Warfarin (Coumadin) : Avoid using cascara with warfarin. Cascara sagrada can cause some people to suffer diarrhea. This can increase the effect of warfarin increasing the risks of bleeding.
- Diuretic Medication : Like diuretic pills, cascara can reduce the amount of potassium in the body. A combination could reduce potassium levels too much.
Can Cascara Sagrada Interact with other Herbs and Supplements?
Cascara could interact with certain herbs and supplements including the following:
- Supplements containing chromium : Cascara sagrada contains chromium increasing the risk of toxicity when it is taken along with supplements that contain chromium. These include horsetail, bilberry and brewer’s yeast.
- Herbs containing cardiac-glycosides : These chemicals can cause a loss of potassium in the body. Because cascara may also cause a loss of potassium, potassium levels may become too low increasing the risk of complications including heart damage. Herbs which contain cardiac-glycosides include figwort, motherwort, Canadian hemp root, hedge mustard and oleander leaf.
- Horsetail : Horsetail has diuretic effects and taking a stimulant laxative like cascara at the same time can cause a drop in minerals like potassium.
- Licorice : Licorice might also cause a reduction ion potassium levels so avoid taking stimulant laxatives like cascara at the same time.
- Other stimulant laxative herbs : Do not use cascara sagrada along with another laxative herb. It may cause a dangerous drop in potassium levels as well as other minerals. Other herbs with stimulant laxative properties include senna, yellow dock, European buckthorn, gamboge, fo ti and aloe.
(1) https://www.ncbi.nlm.nih.gov/pubmed/17019678
(2) https://www.ncbi.nlm.nih.gov/pubmed/17935676
(3) https://www.spandidos-publications.com/ijo/46/4/1619
(4) http://europepmc.org/abstract/med/16828249
(5) https://www.ncbi.nlm.nih.gov/pubmed/18301953
(6) https://www.ncbi.nlm.nih.gov/pubmed/19925744
(7) https://www.ncbi.nlm.nih.gov/pubmed/11151906
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