Cascara

Cascara

Recommended Cascara Sagrada Product

Cascara Sagrada Bark Herb Flier

 

Other Names

 

• The word cascara comes from the Spanish cascar, which means to crack or break, a good name for a laxative. The full name Cascara sagrada also comes from the Spanish, and means sacred bark.

• Cascara, Rhamnus, sacred bark, chittem bark, bitter bark

 

What Is It?

 

The widely used laxative Cascara sagrada is the dried bark of Rhamnus purshiana, a medium sized deciduous tree native to the Pacific Northwest of the United States. The reddish brown laxative bark is harvested from April through summer’s end and the rainy season, and is dried and stored for approximately 1 year or more before use. 1,2,3,4,5,6 This storage is necessary in order to destroy compounds called anthrones in the fresh bark, which cause vomiting. The color of the bark indicates its anthraquinone value. Anthraquinones are pigments as well as laxatives. This family of compounds occurs in other laxative plants including aloe and buckthorn. 3,5,7

 

Cascara is used by itself, in preparations with other laxatives, in herbal teas, in solid form and as an extract. 6

 

Medicinal History

 

Cascara sagrada was first employed by Native Americans in the Pacific Northwest. The bark was used as a laxative by the Cowlitz, Flathead, Green River Group, Haisla, Hanaksiala, Karok, Klallam, Kwakiutl, Lummi, Nitinaht, Okanagan-Colville, Quileute, Quinault, Sanpoil, Shuswap, Skagit, Squaxin, Swinomish, Thompson, Tolowa, and York tribes. Nobody knows which tribe used Cascara sagrada first, or the sequence of knowledge of its use from one Native American group to another. But in that region, Cascara sagrada became an important plant in the native pharmacopoea. Its widespread use among natives speaks to its popularity and effectiveness.

 

Among native tribes the bark was also used as a poultice for wounds, to dispel worms, to induce vomiting, to disinfect cuts and sores, to purify the blood, to treat dysentery, as a skin wash for sciatica, and to treat ulcers, liver diseases, and gonorrhea. 8

 

Cascara sagrada was first described in 1805, was introduced into medicine in 1877, and was listed in the US Pharmacopoea in 1890. Both Parke-Davis & Co and Eli Lilly & Co. introduced laxative drugs containing Cascara sagrada. 3,9,10

 

Habitat & Cultivation

 

Most of the Cascara sagrada harvested today comes from Oregon, Washington and southern British Columbia. During the harvest season from April through August, longitudinal incisions are made in the bark, and are easily stripped off. The trees are usually then felled, and the bark is stripped off the branches. Bark is dried and stored away from moisture, to prevent molding. 9,10

 

Indiscriminate stripping of Cascara sagrada bark led to the destruction of an estimated 100,000 trees, as reported in 1909.  Today the tree is planted to ensure a steady supply.  3

 

How It Works

 

Cascara sagrada contains the laxative anthraquinones, which act as stimulant irritants to the digestive tract, promoting intestinal contractions, bowel movement and elimination. This accelerated intestinal passage results in reduced liquid absorption into the intestines.  According to The German Commission E Monographs, more specific activity of cascara sagrada in the body remains unknown. 1,2,4,5,6,7,9,10,11

 

 Contemporary Uses Approved by Authoritative Bodies

 

Germany’s Commission E

·        Constipation

 

ESCOP

·        For short term use in cases of occasional constipation

 

 

Potential Risks

The following information is derived from Germany’s Commission E, ESCOP, and the AHPA Botanical Safety Handbook.

 

Safety issues and concerns:

• Cascara sagrada may cause cramping and discomfort in the gastrointestinal tract.

• Long term Cascara sagrada use can cause laxative dependency and electrolyte and fluid imbalance.

 

Cascara sagrada should not be used in cases of:

• Intestinal obstruction

• Dehydration and/or electrolyte depletion

• Inflammatory intestinal diseases including Crohn’s disease, ulcerative colitis, irritable bowel syndrome, or diverticulitis.

• Cramps, colic, hemorrhoids, nephritis, or undiagnosed abdominal pain, nausea, or vomiting.

• By pregnant women or nursing mothers

• By children under age 12.

 

Potentially harmful drug interactions 

·        Cascara sagrada may modify the effectiveness of cardiac glycosides and antiarrhythmic drugs.

 

5,11,12,13

 

Usage Tips

The following dosage guidelines are derived from Germany’s Commission E, ESCOP, and the AHPA Botanical Safety Handbook.

 

• Use Cascara sagrada for occasional constipation only after you have tried increasing your dietary fiber intake.

• To relieve occasional constipation take a dose of Cascara sagrada of 300 mg - 1 gram cut or powdered bark, or a dose specified to containing 10 – 30 mg. (not more than 30 mg) of anthraquinones in the evening. This will produce a bowel movement in 6 – 12 hours.

• Consume no more than 2 grams of Cascara sagrada bark per day without medical supervision.

 

5,111,12,13

 

Product Choosing/Buying Tips

 

• Look for products which specify anthraquinone content whenever possible. This may be listed as “cascaroside A.”

• Cascara sagrada comes in a variety of forms, in tablets, capsules, and liquid extracts. With products whose active components are not specified on the label, be conservative in use. Follow usage instructions as stated on products. You can always take more if you need it, but you can never take less once you have consumed a dose.

 

1.      Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics, 2nd ed., (New York: John Wiley & Sons, Inc. 1996), 128 – 129

2.      Bruneton J. Pharmacognosy, Phytochemistry, Medicinal Plants. 2nd ed., (Paris: Lavoisier Publishing 1993), 360 - 361

 

3.      Bown, Deni. The Herb Society Of America Encyclopedia of Herbs & Their Uses. (1^st ed., (New York: Dorling Kindersley,1995), 340.

 

4.      Wichtl M, Bisset NG (eds.). Herbal Drugs and Phytopharmaceuticals. Trans from 2^nd German ed., (Stuttgart: Medpharm GmbH Scientific Publishers. 1994), 412-414.

 

5.      Blumenthal M, Goldberg A, Brinckmann J (eds). Herbal Medicine: Expanded Commission E Monographs. 1^st ed., (Newton, MA: Integrative Medicine Communications. 2000), 47 – 51.

 

6.      Bradley PR (ed.). British Herbal Compendium Volume 1: A Handbook of Scientific Information on Widely Used Plant Drugs. 1^st ed., (Dorset, England: British Herbal Medicine Association. 1992).

 

7.      Agricultural Research Service, Dr. Duke’s Phytochemical and Ethnobotanical

           Databases. Retrieved from World Wide Web may 4, 2002.

           http://www.ars-grin.gov/duke/

 

8.      Moerman, D., Native American Ethnobotany. 1^st ed., (Portland, Oregon Timber

           Press 1998), 237.

 

     9.   Evans, W.C., Trease and Evans’ Pharmacognosy, 13^th ed., (Philadelphia, Bailliere

           Tindall, 1989), 404 – 408.

 

10.  Tyler, Varro., Brady, Lynn., Robbers, James., Pharmacognosy. 9^th ed., (Philadelphia,

       Lea & Febiger, 1988), 60 – 62.

 

 

 

11. Blumenthal M, Busse W, Goldberg A, Gruenwald J, Hall T, Riggins CW, Rister RS

     (eds.). The Complete German Commission E Monographs: Therapeutic Guide to

     Herbal Medicines. S. Klein, R.S. Rister (trans.). 1st ed.,  (Austin, TX: American

          Botanical Council. 1998), 104 – 105.

 

12.  European Scientific Cooperative on Phytotherapy. ESCOP Monographs on the

      Medicinal Uses of Plant Drugs. 1^st ed., (Exeter, U.K.: ESCOP 1997), Fascicule 5.

 

13.  McGuffin M, Hobbs C, Upton R, Goldberg A (eds.). American Herbal Products 

     Association’s Botanical Safety Handbook. 1^st ed., (Boca Raton, FL: CRC Press. 

     1997), 96.