Cascara Sagrada supplement for natural constipation relief, side effects as natural laxative herb, safety and risk by Ray Sahelian, M.D.
Why you should not use this product daily for longer than a few days or weeks
April 1 2016

Spanish for “sacred bark”, the dried cascara sagrada bark of the buckthorn Rhamnus purshiana family, is used in medicine as a laxative. The cascara sagrada tree is cultivated in North America and Kenya. It is harvested mostly from wild trees in Oregon, Washington, and southern British Columbia. The 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; it also contains a compound that induces vomiting.

Now Foods, Cascara Sagrada, 450 mg, 100 Capsules
Buy Cascara Sagrada bark supplement, 425 mg per pill, Nature's Way
Indications: For relief of occasional constipation (irregularity). Cascara sagrada herb in many cases produces a bowel movement in 6 to 12 hours.

Directions: Adults and children 12 years of age and over. Take 1 or 2 cascara sagrada capsules once a day at bedtime with a full glass of water. Children 2 to under 12 years of age. Take 1 capsule once a day at bedtime with a full glass of water. Children under 2 years of age: Consult a doctor. To avoid cascara sagrada side effects, do not use longer than one week without taking a break.

Active ingredient: 425 mg Cascara Sagrada bark (Rhamnus purshiana)
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Traditional use and research study
Long used as a laxative by Native American groups of the northwest Pacific coast, cascara sagrada bark was not introduced into formal medical practice in the United States until 1877. It is still used in over-the-counter laxatives available over the counter in the United States. For more information on constipation and natural supplements that are useful in treating constipation.

Colon cleansing regimens. A clinical study in 1200 patients.
Gastrointest Radiol. 1982
The purgative effect of bisacodyl, anthraquinone glycosides, and sodium picosulfate, alone or in combination with a saline purge and a tap water enema, was studied in 1200 patients. The cleansing effect was scored with regard to retained fecal residue evident on double-contrast studies of the colon. The combination of a contact laxative and a saline purge produced good cleansing effect in 52%-80% of the patients. With an additional tap water enema given 1 hour before the colon examination, however, 96% of the colons were clean. The taste and the effects of the cleansing systems were tolerated favorably by more than 90% of the patients. However, 17% reported restriction in work capacity on the day of bowel cleansing.

Current status
Dried, aged cascara sagrada bark is widely accepted as a mild and effective treatment for chronic constipation. The bark contains compounds called anthraquinones (cascarosides A and B) which are transformed by intestinal bacteria into substances that increase peristalsis (intestinal motility) in the large intestine and help restore its tone. The activity apparently results from the combined action of several substances, a number of which have been isolated.

Cascara sagrada is available in capsules, extracts, and as dried bark.

Short term side effects of Cascara Sagrada herb
A Medline search did not reveal any significant short term cascara sagrada side effects as long as it is not used for more than a week or two at a time without a break. It is best to avoid it if you have a chronic intestinal condition such as ulcerative colitis, or diverticular disease.

Long term cascara sagrada side effects
When cascara sagrada or other anthraquinone containing plants are used for prolonged periods, potentially serious side effects can occur. These adverse reactions may include cramping in the abdomen and loss of body fluids. Dark pigmentation in the colon can occur and this is called melanosis coli.

My husband has been taking an herbal fiber product that contains cascara sagrada for several years now. He takes it quite consistently and has benefited greatly from it. Before he began taking this product (Herbal Fiber Blend by NutronX Nutritionals Inc.) he suffered a lot with constipation and all its accompanying issues. Recently I have heard a lot about cascara sagrada staining the colon. My question is how bad is that? Does a stained colon work less efficiently or is it merely a different color? From the limited understanding that I have, I think I would rather have a stained colon than a constipated colon.
   Cascara sagrada side effects include melanosis coli which does not cause symptoms. Melanosis coli usually results from chronic use of laxatives of the anthranoid group, including senna and rhubarb plants. It is a well-known condition in which macrophages filled with a lipofuscin-like pigment are found in the colonic lamina propria. There is also death of certain of the colonic cells. As of November 2010, scientists have not found a definitive association between cascara sagrada use and colon cancer. There are many other options for the treatment of constipation, including drinking 2 or 3 glasses of cold water in the morning, prune juice, and fibers such as psyllium.

I've been using cascara sagrada herb for approximately 10 years at least once a week. I have problems left over from childhood that keep me from having a normal bathroom experience and the herb eliminates that problem. Recently I had to have a colonoscopy and the doctors went balistic, they claim that the cascara sagrada herb has stained my lower colon, thus killing cells and have urged me to not use any supplements with it in them. I’m not taking it full strength. it is a proprietary blend .476g of Cascara Sagrada (bark), Psyllium (seeds), Senna, Turkey Rhubard (root), Aloa Vera (leaf), Barberry root, and Slippery Elm bark.

Combinations with other natural products used to treat constipation
This herb can be used together with psyllium fiber and prune juice, an underestimated natural fruit juice that helps with bowel elimination.

Colon Cure website is using referring to your cascara sagrada web page as a clinical study reference for their product. I have been trying to reach them because they took money out of my account before the trial offer ended. I am furious, plus, the colon cure product doesn't seem to be working. They don't answer the phone. I thought you should know that they are using your cascara sagrada page reference in their colon cure product information. Seems like false advertisement, and false endorsement to me.
    Thanks for letting us know. We have nothing to do with these colon cleanse people and will try to contact them to stop using our cascara sagrada page as a reference.

During a recent colonoscopy, the Dr noted black staining of the bowel wall -- Melanosis Coli -- which he said I needed to reverse. He said the condition was caused by Cascara or Senna, neither of which I take. I have severe peripheral artery disease, due to Agent Orange in Vietnam? and take some herbals for this condition, such as policosanol, pycnogenol, and resveretrol. My vascular surgeon just found pedal pulses where none existed for the past 5 years or so, so SOMETHING is working ! The problem is, I think one or more of theses herbals are causing the black intestines, while helping my circulation.