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Cascara Sagrada

What is cascara sagrada? What is it used for?

Cascara sagrada is a tall, thin plant native to the western part of the United States, with grayish branches and oblong shaped leaves. The plant has a variety of names, including sacred bark, dogwood bark and California buckthorn. The bark is used in herbal remedies and medicinal preparations.

The most common use of cascara sagrada bark is as a laxative. The plant contains compounds known as anthracene derivatives, which work in conjunction with intestinal bacteria to produce intestinal peristalsis. Clinical trials conducted in 1989 and 1991 have shown that cascara sagrada also relieves acute and chronic constipation and can be used to aid in digestion.

How much cascara sagrada should I take?

The amount of cascara sagrada to be taken depends on the form being administered. As a capsule, dosages are available from between 425-850 mg. As a tea, many herbal practitioners recommend two cups (one in the morning, one in the evening). As part of a homeopathic formula, up to five drops may be taken every hour, or 1-3 times daily depending on the level of constipation. Individually, however, the correct dosage is the smallest dosage necessary to produce a softening of the stools.

What forms of cascara sagrada are available?

Cascara sagrada is available in capsule, extract and powder forms. Dry extracts may be used for infusions, decoctions or elixirs. A cascara sagrada tea can also be made using extracts or powders.

What can happen if I take too much cascara sagrada? Are there any interactions I should be aware of? What precautions should I take?

Prolonged use of cascara sagrada may result in a variety of side-effects, including spastic colon, heart arrythmias, nepropathy and edema. Long-term use can lead to loss of electrolytes, particularly potassium ions. Conditions such as hematuria, muscle weakness and albuminuria may result from long-term cascara use. In addition, cascara may interact negatively with a number of pharmaceuticals, including thiazide diuretics, corticoadrenal steroids, antiarrythmics, digitalis and indomethacin. Cascara sagrada should not be taken by patients with intestinal obstructions, colitis, Crohn’s disease, appendicitis or unknown abdominal pain. It should not be administered to children under the age of 12.

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References

  • Hagemann TM. Gastrointestinal medications and breastfeeding. J Hum Lact September 1998;14(3):259-62.
  • Mereto E, Ghia M, Brambilla G. Evaluation of the potential carcinogenic activity of senna and cascara glycosides for the rat colon. Cancer Letter March 1996;101(1):79-83.
  • Manitto P, et al. Studies on cascara, part II. Structure of cascarosides E and F. JNP 1995;58(3):419-423.
  • Siegers CP, Siemers J, Baretton G. Sennosides and aloin do not promote dimethylhydrazine-induced colorectal tumors in mice. Pharmacology 1993a Oct;47 Suppl 1:205-8.
  • Siegers CP, von Hertzberg-Lottin E, Otte M, et al. Anthranoid laxative abuse — a risk for colorectal cancer? Gut 1993b Aug;34(8):1099-1101.


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