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Cascara Sagrada Bark Extract

Also known as: Rhamnus purshiana, Cascara sagrada, California buckthorn, Sacred bark, Cascara Sagrada Bark Extract

Overview

Cascara sagrada is a herbal supplement derived from the dried bark of the *Rhamnus purshiana* tree, found primarily in the northwestern United States. Recognized for its active compounds, particularly anthraquinone glycosides such as cascarosides and emodin, cascara sagrada has been traditionally utilized for its laxative properties targeting constipation relief. Despite its historical use, modern clinical research lacks robust evidence supporting its safety and efficacy as a laxative, resulting in its nonprescription usage being scrutinized. Current findings indicate that while it may elicit some bowel movement stimulation, subjects, especially those with chronic constipation or elderly individuals, must exercise caution due to potential risks associated with prolonged usage.

Benefits

Cascara sagrada is primarily valued for its laxative effects, aimed at increasing bowel movement frequency. However, systematic reviews have indicated that it does not yield clinically significant benefits for adults suffering from chronic idiopathic constipation. Despite anecdotal instances of its use against parasitic infections, there exists minimal scientific evidence to substantiate this claim. Elderly individuals may experience transient relief from constipation, yet safety issues like electrolyte imbalances and dehydration arise with extended use. The typical onset of the laxative effect occurs within 6 to 8 hours post-consumption, but lack of strong evidence raises concerns regarding its overall effectiveness.

How it works

Cascara sagrada acts through its active anthraquinone glycosides, which intestinal bacteria convert into active derivatives that stimulate increased secretion of water and electrolytes into the intestine while inhibiting absorption at the large intestine. This process augments stool volume and enhances peristalsis, thereby facilitating bowel movements. Primarily, its effects target the excitability of smooth muscle within the intestinal wall, promoting evacuation.

Side effects

The most common side effects associated with cascara sagrada include abdominal cramping and diarrhea, affecting more than 5% of users. Less frequent adverse effects (1% to 5%) comprise chronic diarrhea, electrolyte imbalance, and dehydration. In rare instances, prolonged use may lead to benign melanosis coli and potential liver toxicity when taken in high doses. Additionally, cascara's impact on potassium levels may cause adverse interactions with medications such as cardiac glycosides and antiarrhythmics. Special precautions should be observed for vulnerable groups including children, pregnant or breastfeeding women, as well as individuals with pre-existing gastrointestinal disorders.

Dosage

The suggested dosage of cascara sagrada typically ranges from 100 to 300 mg of dried bark extract or 2 to 6 mL of fluid extract. Users are advised not to exceed 1 g of bark and should refrain from chronic use that extends beyond two weeks to avoid adverse effects. The laxative action generally manifests within 6 to 8 hours after ingestion. Cascara sagrada can be found in various forms, including tablets, capsules, syrups, and teas, with caution advised against raw, unprocessed bark due to the risk of severe vomiting.