Cascara Sagrada belongs to the family of buckthorn, known in botany as Rhamnus purshiana. Spanish people used to call it ‘Sacred Bark’. It consists of dried bark of the Cascara tree growing widely in some parts of U.S and Canada. Hence its commercial producers include Oregon, southern part of British Columbia and Washington. Cascara Sagrada has been widely used by the local people since centuries as a laxative to prevent and treat constipation. Cascara Sagrada owes its property of laxation to the presence of a group of chemicals called the Anthraquinone glycosides namely Cascarosides. These, on hydrolysis produce other active constituents namely barbaloin and chrysaloin which also has anti-constipating effect.
All the actions of Cascara Sagrada are mainly due to its property of being a stimulant, irritating your bowels to expel its contents thus providing relief from the frequent gripping and unbearable pain in the abdomen. Being milder in action as compared to other laxatives, cascara is not habit-forming. Apart from glycosides, Cascara also includes nutrients like calcium, iron, magnesium, fatty acids, phosphorous, potassium, zinc as well as vitamins like B1 B2 B3 and also vitamin C. As mentioned in the official books, Cascara Sagrada is generally available in the form of extracts, fluidextracts and tablets. The average daily dose of the dried bark can range from a minimum of 150 mg to a maximum of 500 mg for children and double the quantities for adults.
After oral administration, the glycosides of Cascara Sagrada reach the intestine in intact form. Here they get hydrolyzed to active forms which produce their effect in the intestine and finally get out of the body with the feces.
Health Benefits of Cascara Sagrada
Coming from the family of laxatives, Cascara Sagarda is the mildest drug used in small doses as bitter stomachic while in larger doses as a purgative.
Cascara Sagarda used as laxative : Cascara Sagrada is used a short-term treatment for occasional constipation. Normally due to some reasons like improper dietary habits there occurs a disturbance in the rhythmic contractions of intestinal wall which leads to indigestion and constipation.
Cascara glycosides, after being poorly absorbed in the small intestine, reach the colon where they are hydrolyzed by the colonic microbes to free active compounds. These active metabolites then stimulate and irritate the colonic nerves to produce a synchronized contraction-relaxation-contraction cycle (peristalsis) throughout the colon wall. It is due to these peristaltic movements that augmented propulsion of the contents in the gut towards the rectum occurs. During this transit of the colonic contents less amount of fluid absorption occurs from the fecal mass thus facilitating faster excretion. In addition to this, the glycosides of Cascara Sagrada also increase the permeability of the colon muscle cells due to which the amount of water in the large intestine increases thereby promoting expulsion of soft feces. Cascara also prevents future constipation by normalizing the rythymicity in colon muscle movements. When used in recommended dose limits, it does not cause depletion of vitamins to a large extent as caused by some other laxatives even in normal doses.
Prevention of colonic diseases and hemorrhoids : Cascara sagrada has been widely used for preventing a number of colon diseases like Crohn’s disease, colon ulcers etc. This is due to its property of easy and faster elimination of feces thus minimizing the residence time of ulcer causing drugs and food in the colon.
Besides, Cascara Sagrada may also be useful in cases of colon cancer but this fact still needs some more research work. However, Cascara should not be used if you are already suffering from these diseases. Similarly, Cascara Sagrada cannot be used if you are suffering from hemorrhoids but it can act as a prophylactic (protection against diseases) for such conditions as it alleviates constipation which is a major cause of hemorrhoids. ,
Miscellaneous Benefits of Cascara sagrada
Cascara Sagrada has been used in cases of parasitic infections in the colon by promoting the expulsion of these microbes along with the feces.
The World Health Organization (WHO) has mentioned its use internally for diabetes and externally for skin irritations.
Cascara sagrada has been traditionally used for treating some liver disorders like jaundice and also some digestive problems.Some property of Anthraquinone glycosides in Cascara Sagrada has been suggested for its effectiveness in liver diseases. Cascara stimulates secretions from liver, stomach, large intestine, pancreas thus enhancing the digestive process. Apart from this stimulating secretions from gall bladder may also help in discharging gall stones.
Cascara sagrada : Precautions and contraindications
Reduction of dosage of Cascara Sagrada is required if you experience some abdominal discomfort. However overdoses may pose more severe symptoms like gripping, watery stools and colicky abdominal pain. Chronic use may cause electrolyte disturbances and fluid losses which may lead to weight loss, malabsorption and even worsen the conditions of postural hypotension especially in case of elderly people. Hence you should keep a vigil on the electrolyte levels. Abuse of Anthraquinone laxatives found in Cascara sagrada may also lead to pigmentation of colon (Melanosis coli) wall and may also change the color of urine; however these conditions are clinically harmless. It is recommended not to take Cascara Sagrada if you are expecting or if you are a lactating mother, owing to its profound effect on lower abdominal region.
Cascara sagrada : Interaction with drugs
Cascara sagrada should not be given with drugs like thiazide diuretics, corticosteroids or liquorice as electrolyte imbalance may be further worsened by their concurrent use.
Do not take Cascara Sagrada without medical advice as it has been listed by U.S F.D.A (Food Drug Administration) as a drug not safe and effective enough to be included as a over the counter medicine.