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.  Cascara sagrada is harvested mostly from wild trees in Oregon, Washington, and southern British Columbia. The cascara sagrada 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.

Cascara Sagrada bark, 425 mg, 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 cascara sagrada 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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Cascara Sagrada Research Update
Colon cleansing regimens. A clinical study in 1200 patients.
Gastrointest Radiol. 1982;7(4):383-9
The purgative effect of bisacodyl, anthraquinone glycosides ( Cascara sagrada ), 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.

Cascara sagrada bark emails
Q. 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 cascara sagrada 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 Cascara sagrada in them, because of this reason. 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). I’d like to know if there is any evidence to this since the cascara sagrada is the ONLY thing that I feel comfortable with. Your response will be greatly appreciated, I assure you. I’m really upset over this.
   A. Cascara sagrada side effects can occur with long term use including staining of the colon called melanosis coli.

Q. 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. Could you shed a little more light on this dark subject?
   A. Cascara sagrada side effects include melanosis coli. Melanosis coli does not cause symptoms. Melanosis coli usually results from chronic use of laxatives of the anthranoid group, including senna and rhubarb plants. Melanosis coli 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 2007, 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.