- Cascara is obtained from the dried bark of Rhamnus purshianus (Rhamnaceae), both a medicinal and poisonous plant. It is found in Europe, western Asia, and in North America from northern Idaho to the Pacific coast in mountainous areas. In Spanish, cascara sagrada means "sacred bark," perhaps because this woody shrub has provided relief for several constipated individuals. Cascara has been used as a tree bark laxative by Native American tribes and Spanish and Mexican priests since the 1800s. The cascara sagrada bark is aged for a year so that the active principles become milder, as freshly dried bark produces too strong a laxative for safe use.
- Cascara possesses purgative, toxic, therapeutic, and tonic activity. It is most commonly used as an anthraquinone stimulant laxative for bowel cleansing. Stimulant and cathartic laxatives are the most commonly abused laxatives and have the potential for causing long-term damage.
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Cascara sagrada (Rhamnus purshiana)
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These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Early studies have examined the use of cascara for bowel preparation. Evidence is insufficient to suggest effectiveness over conventional treatments for this indication.
Cascara sagrada is widely accepted as a mild and effective treatment for chronic constipation. However, limited data is available. Additional study is needed before a strong recommendation can be made.
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Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to . Selected references are listed below.
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View Abstract - Lai GH, Zhang Z, Sirica AE. Celecoxib acts in a cyclooxygenase-2-independent manner and in synergy with emodin to suppress rat cholangiocarcinoma growth in vitro through a mechanism involving enhanced Akt inactivation and increased activation of caspases-9 and -3. Mol.Cancer Ther 2003;2(3):265-271.
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View Abstract - Marchesi M, Marcato M, Silvestrini C. [Clinical experience with a preparation containing cascara sagrada and boldo in the therapy of simple constipation in the elderly]. G.Clin.Med. 1982;63(11-12):850-863.
View Abstract - Mereto E, Ghia M, Brambilla G. Evaluation of the potential carcinogenic activity of Senna and Cascara glycosides for the rat colon. Cancer Lett 3-19-1996;101(1):79-83.
View Abstract - Nadir A, Reddy D, Van Thiel DH. Cascara sagrada-induced intrahepatic cholestasis causing portal hypertension: case report and review of herbal hepatotoxicity. Am.J.Gastroenterol. 2000;95(12):3634-3637.
View Abstract - Stern FH. Constipation--an omnipresent symptom: effect of a preparation containing prune concentrate and cascarin. J Am Geriatr Soc 1966;14(11):1153-1155.
View Abstract - Tramonte SM, Brand MB, Mulrow CD, et al. The treatment of chronic constipation in adults. A systematic review. J Gen.Intern.Med 1997;12(1):15-24.
View Abstract
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