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Cascara sagrada: Benefits, Origin and Possible Risks

Cascara sagrada, scientifically named Rhamnus purshiana,  is a shrub native to temperate North America. It has elliptical leaves, little toothed, that measure between 4 and 8 centimeters. In addition, the tree reaches between 6 and 12 meters in height. Although it blooms and bears black drupe-shaped fruits, its bark, which concentrates medicinal substances, is often used.

In particular, it is known as a natural laxative, since it promotes intestinal motility to facilitate the evacuation of stool. Still, its use is not approved by the United States Food and Drug Administration (FDA), which makes some warnings about its possible risks. Do you want to know more about it?

Benefits of Cascara sagrada

Cascara sagrada is also known as “sacred bark”, “bitter bark” or “yellow bark.” Since ancient times, the natives used the bark of this tree for medicinal purposes, especially for the relief of digestive disorders such as constipation.

In fact, in the 1890s, the United States Food and Drug Administration (FDA) approved its initial use as an over-the-counter laxative. However, this approval was withdrawn in 2002, given the lack of evidence on its safety and efficacy.

That said, it is important to note that there are not enough scientific studies on the properties and effects of cascara sagrada. A review released through Phytotherapy Research details that emodin, an anthraquinone present in the plant, is behind its laxative effect.

This substance is responsible for inhibiting the absorption of water and electrolytes in the intestines. Thus, the volume of stool increases, as does the pressure within the intestine. The result of this process is the stimulation of peristalsis, which allows an optimal evacuation of feces.

However, the plant has been classified as a “stimulating laxative” and its effect is milder than other plants such as senna. Even its mechanism is different from options such as psyllium, since the latter creates a kind of gel that facilitates the removal of waste retained in the intestine.

However, keep in mind that it is not currently an FDA-approved treatment to relieve constipation. Still, it is available as a herbal dietary supplement or as an ingredient in prescription laxatives. It is estimated that it induces evacuation about 8 or 12 hours after consumption.

Possible risks and contraindications

To calm constipation , this plant should be used only occasionally and in the short term. Its use is estimated to be safe and well tolerated in most healthy adults. Still, some may experience abdominal pain or cramps when ingesting the remedy.

The most serious problems arise from the excessive consumption of cascara sagrada. The studies determined that the anthraquinone are harmful when ingested in quantities exaggerated. It is also believed to cause melanosis coli, an abnormal blackish-brown color located in the colon.

If consumed for one or two weeks, it causes a significant loss of electrolytes that leads to a state of dehydration. Consequently, the following symptoms are also possible:

  • Severe nausea.
  • Feeling of weakness or fatigue.
  • Headache.
  • Muscle spasms.
  • Heart rhythm disturbances.
  • Numbness or tingling in the extremities.
  • Decreased urine output.
  • Confusion.
  • Rebound constipation.

Due to the lack of scientific studies, it is not known if it is safe in certain populations with special characteristics. Therefore, it is contraindicated in the following cases:

  • Pregnancy and breastfeeding.
  • Kids.
  • Patients with diverticular disease, ulcerative colitis, Crohn’s disease, or severe hemorrhoids.
  • People with cardiovascular diseases.
  • Severe anemia
  • Recent colon surgery.
  • Gastrointestinal cancer patients.
  • People with liver or kidney disease.
  • Suspicion of appendicitis.

The simultaneous consumption of cascara sagrada with the following medications is not recommended:

  • Cardiac glycosides, such as digoxin, digitoxin, and digitonin.
  • Corticosteroid drugs.

Dosage and mode of consumption

To date, a recommended dose for ingesting cascara sagrada has not been specified. It can vary according to the age, weight and health of the person.

Therefore, it is essential to follow the recommendations of the supplement manufacturer. The plant is available in the form of powder, capsules, tinctures, and teas. It should not be used for more than 3 days.

What should you remember about cascara sagrada?

You will likely come across cascara sagrada supplements when looking for complementary constipation remedies. Still, you should know that it is not a first-line treatment for this disease. In fact, it must be used with great caution, due to the risks involved.

If you choose to consume it, you should not exceed the dose suggested by the manufacturer or prolong your intake for many days. If possible, consult your doctor to find other alternatives.

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