Cascara Sagrada Information and Facts

Scientific Name(S): Rhamnus pushiana DC. (Syn. Frangula purshiana (D.C.) A. Gray ex J.C. Cooper) Family: Rhamnaceae

Common Name(S): Buckthorn, cascara sagrada, chittem bark, sacred bark

Cascara sagrada is a natural laxative that comes from the reddish-brown bark of the Rhamnus purshiana tree native to the Pacific Northwest. It was used by various Native American Indian tribes, who also passed their "sacred bark" on to Spanish explorers.

Botany: The official cascara sagrada is the dried bark of Rhamnus pushiana collected from small to medium-sized wild deciduous trees. They usually range from 20 to 40 feet high and possess thin, elliptic to ovateoblong, acutely pointed leaves. The greenish flowers are arranged in umbellate cymes and the fruit is purplish-black and broadly obovoid (8 mm long). The commercial bark is flattened or transversely curved, longitudinally ridged with a brownish to red-brown color. It has gray or white lichen patches and occasional moss attachments. Cascara trees are found in North America in California, Oregon, Washington, Idaho, Montana and as far north as South­east British Columbia.

History: The American cascara is a folkloric medicine of relatively recent origin, having been introduced as a tree bark laxative by early Mexican and Spanish priests of California (probably Rhamnus Californica). R. purshiana itself was not described officially until 1805 and the bark was not brought into regular medicinal use until 1877 . The European counterpart (European buckthorn, Rhamnus frangula) was described much earlier by the Anglo­Saxons. In fact, the berries were official in the 1650 London Pharmacopoeia.

Uses of Cascara

Cascara extracts are used in laxatives. As it is much milder in its laxative action than the herb buckthorn, cascara became popular in Europe as a treatment for constipation . Cascara has been an approved treatment for constipation in the U.S. Pharmacopoeia since 1890.

Side Effects of Cascara

Cascara should not be used during pregnancy and lactation, or in ileus of any origin. Extended use may cause chronic diarrhea and attendant ills.

Possible Drug Interactions
Because laxatives such as Cascara can cause fluid loss and potassium deficiency, you should not combine it with other potassium-depleting medications, including:

• Licorice root
• Steroid medications such as prednisone (Deltasone)
• Thiazide diuretics such as HydroDIURIL

When potassium is low, certain heart medications may have a stronger effect. Be wary of laxatives such as Cascara while taking digoxin (Lanoxin) or a medication for heart irregularities.

You may also want to avoid Cascara if you are taking the arthritis drug Indocin; it can reduce the medication's effect.

Dosage

Only the dried form of cascara should be used. Capsules providing 20-30 mg of cascarosides per day can be used. However, the smallest amount necessary to maintain soft stool should be used. As a tincture, 1/4-1 teaspoon (1-5 ml) per day is generally taken. It is important to drink eight 6-ounce (180 ml) glasses of water throughout the day while using cascara. Cascara should be taken consecutively for no longer than eight to ten days

Toxicology: Extended or habitual use of cascara is to be avoided because it can cause chronic diarrhea and weakness, due to excessive potassium loss. Chronic use can cause melanin pigmentation of the mucous membranes of the colon. Emodin can produce dermatitis.

Summary: Cascara bark is an anthraquinone-containing stimulant laxative commonly used for managing simple constipation in doses ranging from about 20 to 70 mg daily of total hydroxyanthracene derivatives. A laxative effect occurs 6 to 8 hours after administration.

Some commercial products containing cascara are Concentrated Milk of Magnesia-Cascara, Herbal Laxative and Kondremul with Cascara or Veracolate.