| What is it?
In herbal medicine we use the reddish brown and distinctively bitter bark that comes from the shrubby, deciduous Cascara tree. The bark must always be aged at least a year before use as during this time chemical changes occur in the bark that reduce a kind of griping that would otherwise be certain and entirely unpleasant!
How has it been used?
Cascara has been extensively used as a laxative for millennia and it is thought to be the most widely used cathartic on earth. It was traditionally used by Native Americans and then the bark became known to settlers and made its way back into popular use in Europe and beyond. It is generally regarded as the most gentle of the various stimulating laxatives that are available in herbal medicine.
Cascara has also been widely used when a soft stool needs to be guaranteed, such as when there are anal fissures or haemorrhoids.
Cascara may have great value when there has been a loss of tone in the rectum as can happen from certain types of diseases that affect the bowel or as a long term consequence of an abdominal surgery.
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Science on Cascara
~ No synthetic substance has been found to equal the speed and effectiveness of Cascara at emptying the bowel and it is marketed by many pharmaceutical companies in pills, powders and extracts. The basis for Cascara's action is the presence of a mixture of anthraquinones either free (e.g. aloe-emodin) or as sugar compounds (glycosides). The free anthraquinones remain in the intestines and cause catharsis by irritating the intestinal wall; the anthraquinones that are bound together with a sugar molecule are absorbed into the bloodstream and eventually stimulate a nerve centre in the lower part of the intestine that causes a laxative effect.
~ The chemical components of cascara also stimulate the organs of the digestive tract including the gallbladder, pancreas and stomach, which results in increased digestive fluids (de Witte, P. and Lemli, L. The metabolism of anthranoid laxatives. Hepatogastroenterology 1990;37(6):601-605)
~ Aloe-emodin, a constituent in cascara and aloe, has been reported to have antiviral activity in vitro (Sydiskis, R. J., Owen, D. G., Lohr, J. L., Rosler, K. H., and Blomster, R. N. Inactivation of enveloped viruses by anthraquinones extracted from plants. Antimicrob Agents Chemother 1991;35(12):2463-2466)
Safety of Cascara
There is a definite concern with the overuse of Cascara that it can cause disturbances of electrolyte function that could lead to muscle weakness or a disorder of heart function. Some of the literature will talk about a staining of the bowel from its use but this has been determined to be harmless and soon reverses after discontinuing the herb.
The main worry with Cascara is that of developing a bowel dependency and many people who go on to use this herb on a regular basis do become dependent on it. The reason this in turn is a concern if if the bowel loses its own muscle tone and therefore becomes weakened.
The time the alarm bells should start ringing in this case is when, over time, more frequent or higher doses are required to get the same effect.
To balance this concern it should be fairly stated that it would be far worse for a person to be exposed to the considerable toxicity (let alone the considerable discomfort!) of chronic constipation that it would be to have a dependency on a largely harmless herb...
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It is great to have this potent and effective herb on hand when it is needed and I have certainly had call to give Cascara many times over the years but only rarely have I had to use it for more than a dose or two just to get things cleared whilst we get the deeper work underway. For most people the effects of Cascara will take no more than 8 hours to be felt but there are exceptions to this. The herb should have completely been eliminated from the system within 24 hours.
Dosage, as always, is the key to success with herbal medicine, too little and there won't be a satisfactory evacuation of the bowel, too much and there will be griping (uncomfortable spasms) and an over-stimulation of the bowel that leads to repeated needs to go to the toilet. To make things more complicated there is no one fixed dose of any therapeutic substance that is right for everyone! What is too much for one person may be too low for another.
For what it is worth, from the tincture that we make in our own clinic, around 3-4 mls is usually ample to ensure a certain response without the danger of overdoing it. Incidentally I always add some Fennel seed extract to reduce the chance of griping.
The great majority of people who are habitually constipated need to 1) change their diet to reduce refined foods and eat more naturally 2) move their bodies more and 3) use the cleansing but non-laxative herb Plantago (more info about this important remedy here). The correct use of Plantago alone would see the world-wide market for Cascara and other herbal laxatives plummet within days!
Few people are born with a faulty bowel but many go on to develop one. Cascara may be necessary to clear a blocked or impacted bowel as a short term treatment but over the long term some simple dietary changes and the use of Plantago husks has been seen to gradually work a cure for even some of the worst cases I have come across - i.e. people who have no more than one bowel motion in a month and no I am not exaggerating!
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Much of the information here about the traditional uses of Cascara is consistent with the model of thinking whereby one may treat problem A with plant B. There is value in this approach, especially in how it helps us pass on useful knowledge to one another, but it falls short in one vital area; and that is that people are not all cut from the same cloth! Something that works brilliantly for one person may do less for another -- why is this?
The reason is that people vary in their constitutions as to whether they are more hot or cool and at the same time more dry or damp; more info about this here.
There is an old wisdom in treating the person first and the condition second and in this light Cascara can particularly offer its benefits when a cleansing action is needed in the 'cycle of healing' - something that is discussed here and shown in a chart here.
Excerpt; Historical notes on Cascara sagrada
Many of the 16th century Spanish explorers who first visited Northern California suffered terribly from constipation and the local Indians had a solution which was such a profound relief to those who were suffering that the Spanish named it Cascara sagrada -- Sacred bark.
The Spanish recognised Cascara as a relative of the powerful herb Buckthorn used in Europe since ancient times but when it was sent back to Europe it was seen that its effects were just as reliable but far more gentler than that traditional remedy.
In 1877 a Detroit Eclectic Physician Dr J.H Bundy wrote in the popular press in praise of Cascara and as a result of his praises the pharmaceutical firm Parke & Davis made the first commercial preparation of Cascara for the general market. It has been one of the most popular herbal laxatives in the world ever since this time.
Roy Upton's Parasite Treatment (copied here with his permission)
"When I was treating a lot of kids in the Virgin Islands my primary treatment was for 3 days:
~ Avoidance of high carb foods, milk, cheese, and sugars; lots of broth; chicken-vegetable soup
~ A handful of pumpkin seeds daily chewed very well.
~ 1 cup of fennel tea drunk throughout the day given at tablespoon doses at a time
~ On day 4 give a few drops of cascara fluid extract in warm water.
I seldom had to repeat this"
Roy Upton RH
Executive Director, American Herbal Pharmacopoeia
Please understand that I cannot personally advise you, including on products or dosage, without seeing you in my clinic but ideas
on how you might find a good herbalist in your area are here.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!
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