Cascara Sagrada 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. Cascara Sagrada Cascara sagrada was formerly introduced into western culture when Eli Lilly & Company introduced "Elixir Purgans," a popular product containing cascara as well as several other laxative herbs. The most notable constituents in cascara sagrada are hydroxyanthraquinone glycosides called cascarosides. Cascarosides exhibit a cathartic effect that induces the large intestine to increase its muscular contraction (peristalsis), causing a bowel movement. Other important constituents include resins, tannins, and lipids which make up the majoriy of the other bark ingredients. Today, many common laxatives use cascara sagrada as an ingredient. To use cascara sagrada as a laxative, the bark must be carefully prepared by curing for at least one year or heated and dried to speed up the aging process. Aging is essential because fresh cascara sagrada is irritating to the gastrointestinal system, causing vomiting and upset stomach. Cascara sagrada is recognized as safe and effective by most medical and health professionals. Health Benefits The value of cascara sagrada as a laxative is clear for easing constipation, when it's taken properly and at a safe dosage. In fact, cascara is such a mild laxative that it can safely be used by the elderly and for the mild constipation that can occur following anal or rectal surgery as it prevents the pressure and pain associated with hemorrhoids and anal fissures. However, additional medical indications have not been substantiated and little is known about additional benefits of this herb. A bowel movement usually will take place within six to eight hours of taking a typically recommended dose of cascara sagrada. Dosage Since everyone responds differently to laxatives, it is always recommended to start with the lowest dose. Be sure to drink plenty of water when using any laxative. For constipation and related discomforts such as hemorrhoids: 1 teaspoon of liquid extract three times a day or 1 or 2 teaspoons at bedtime; or 1 or 2 capsules of dried bark at bedtime. Supporting Literature Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 104-105. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2d ed. New York: John Wiley & Sons, 1996, 128-130.