Constipation and Cascara Sagrada

When exercise and a change in diet don’t help your constipation, your body may need a little extra help to get the job done. Cascara sagrada is an herbal remedy that used to be a common ingredient in some over-the-counter laxatives.

Did You Know?
Cascara sagrada means “sacred bark” in Spanish

The bark comes from a tree called the California buckthorn, which grows on the Pacific coast of the United States and parts of South America. Historically, it was used by Native Americans to treat a host of issues, including:

  • constipation
  • digestive problems
  • joint and muscle pain
  • gonorrhea
  • gallstones
  • dysentery

Read about how this spice may aid digestion »

How Does It Work?

Did You Know?
Typically, only bark that’s been treated or is over a year old is safe to use. Young bark creates severe cramping.

Cascara sagrada is a stimulant laxative. It works by causing muscle contractions in the intestines, which moves stool through the bowels. The bark contains chemicals called anthraquinones that give it its color and its laxative effect. These chemicals react with bacteria in the intestines to stimulate the bowels.

Cascara sagrada is available on its own or as an ingredient in pill and liquid laxatives. Make sure you read label instructions carefully. For laxatives that contain other substances, doses depend on how much cascara sagrada is present.

Recommended Doses
Bark Extract Powder1-2g
Liquid Extract2-6ml
Dried Extract325mg

With any laxative, remember to drink plenty of liquids — about six to eight glasses per day. This will keep you hydrated and soften your stool. Follow any additional instructions on the product label.

Cascara sagrada was an ingredient used in several over-the-counter laxatives in the United States for many years. But manufacturers can misrepresent the ingredient. In 2002, the U.S. Food and Drug Administration (FDA) ruled that cascara sagrada, along with some other types of over-the-counter stimulant laxative ingredients, is not a safe and effective treatment.

As a result, you can no longer buy over-the-counter laxatives that contain cascara sagrada. However, it’s still available as an ingredient in some prescription laxatives and as an herbal supplement.

Things to Keep in Mind

There are several safety concerns to take into account when using cascara sagrada. Like other stimulant laxatives, it can cause abdominal cramping, loss of electrolytes, and dependency. Using cascara sagrada for longer than two weeks can lead to lazy bowel syndrome. This condition prevents you from having bowel movements without the help of a laxative.

Because of the potential side effects, pregnant women and children 12 and under should avoid laxatives unless prescribed by a doctor.

Cascara sagrada isn’t recommended for:

  • people with inflammatory bowel diseases like ulcerative colitis or Crohn’s disease
  • intestinal blockages
  • stomach pains with unknown cause
  • kidney disease
  • appendicitis 

This laxative may also interact with other medications.

It’s generally recommended that you only use stimulant laxatives occasionally and as a last resort after diet, exercise, and other treatments fail. Talk to your doctor before using cascara sagrada. They can rule out other health issues and tell you if it’s a safe treatment option for your situation.