Cascara sagrada (Rhamnus purshiana)

rhamnus-spp-bark.jpg

Cascara Sagrada Summary

Cascara sagrada is a commonly used herb for constipation. It's extremely bitter, and iritates the intestinal mucosa to stimulate bowel movement. Careful use of this herb is needed to avoid adverse reactions, however, it's one of the best lower bowel tonic herbs for constipation. Compared to other laxative herbs, cascara sagrada is one of the most gentle, and can even be used on children and the elderly (expert usage only for these individuals).

 

+ Indications

  • Constipation (Acute and chronic)
  • Flatulence
  • Bloating
  • Abdominal fullness
  • Postprandial bloating
  • Dyspepsia
  • Weak gastric secretion
  • Anorexia
  • Itching skin
  • Headache (Due to constipation or intestinal weakness)
  • Haemorrhoids
  • Itching skin

+ Contraindications

  • Pregnancy or lactation
  • Intestinal obstruction
  • Intestinal inflammations (Crohn's disease, ulcerative colitis, appendicitis)
  • Children under the age of 12
  • Not appropriate for long term use

Herbal Actions:

  • Stimulating laxative
  • Cholagogue
  • Bitter digestive stimulant
  • Antiparasitic
  • Mild Laxative
  • Stomachic
 

What Is Cascara Sagrada Used For?

Cascara sagrada is mainly used as a lower bowel tonic for treating constipation.

 

Traditional Uses

Traditional use of cascara sagrada included: intestinal tonic, dyspepsia, constipation, digestion related headaches, to loosen stool for conditions such as haemorrhoids, rheumatism, biliary catarrh with jaundice, and chronic liver diseases [6].

Native Americans used cascara sagrada as a cathartic [6].

 

Weekly Dose

Part Used

Aged Bark

Family Name

Rhamnaceae

Distribution

North America

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Constituents of Interest

  • Anthrone glycosides
  • Anthraquinones
  • Aloins
  • Tannins

Common Names

  • Cascara sagrada
  • Buckthorn
  • Sacred bark
  • Californian buckthorn
  • Rhamnus purshiana
  • Frangula purshiana

CYP450

  • Unknown

Quality

  • Unknown

Pregnancy

  • contraindicated during pregnancy.

Taste

  • Unknown

Duration of Use

  • Avoid long-tem use.
 

Botanical Information

The Rhamnaceae (buckthorn) family of plants contains 55 genera, and 950 different species. This family has a wide distribution, especially throughout the tropics.

 

Harvesting Collection, and Preparation

The bark of cascara sagrada is harvested in spring and early summer. During this time it is easily peeled from the tree. It is then dried in the shade. Aged bark (3 years) is generally the preferred product, as the emetic effects lessen over this time and is much less likely to cause issues with griping and emesis [5].

 

Pharmacology & Medical Research

+ Anticancer

The anthraquinone emodin, contained within cascara sagrada and other herbs in its family (Rhamnaceae) as well as the families Lilliaceae, and Leguminoseae, is an important medicinal constituent. It is similar in structure to anthracycline, which is a class of chemicals used in cancer chemotherapy. They work to intercalate the DNA of cancer cells. Similar antitumor antibiotics includes daunorubicin and mitoxantrone. [7]. Emodin possesses many of these effects as well, with documented anti-proliferative [1-3], anti-angiogenic [8, 9], and radio-sensitizing/chemotherapy sensitizing actions on cancer cells [10-12]. It has even been found to reverse multidrug-resistant cancer cells [13].

Emodin has been shown to have a broad spectrum inhibitory action on such cancer cell lines as leukemia [14, 15], lung cancer [16-18], hepatic cancer [27-29], gallbladder cancer [21-23], pancreatic cancer [24-26], breast cancer [30-32], colon cancer [19, 20], and cervical cancer [33]. Most of this research has been conducted in China, and it should be noted that this chemical is contained within some of the most important and widely used traditional Chinese herbal medicines including Chinese rhubarb (Rheum palmatum) [34].

The anticancer actions of emodin, has been suggested to be due to a variety of mechanisms such as the casein kinase Ⅱ and ERK1/2 pathways [7].

The bioavailability of this chemical is quite low however, and has some toxicity in vivo as well [7]. It may however prove useful in combination, as in the case of many Chinese formulas containing emodin containing botanicals, or may prove useful administered via intravenous, or through modification of one of it's side chains [7]. It was shown in fact, that with the addition of polymethyleneamine, sugar or heterocycle as side chains may actually improve the antitumor activity [35-37]. Rhamnus frangula has been found to have emodin-glycoside derrivatives [38], some of which fit the earlier hypothesis, showing that these emodin glycoside derivatives (emodin with the addition of sugar chains) have a significantly higher antitumor activity than emodin, and have an improved bioavailability as well [39-41].

The emodin glycoside derivative EM-d-Rha for example has shown a 10 fold improvement in anti-proliferative activity and growth inhibition of cancer cells (HepG2 cells and OVCAR-3 cells). The mechanism of action for this chemical was suggested to be through induction of apoptosis via the intrinsic apoptotic signal pathway (release of apoptosis-inducing factors and Cytochrome C from mitochondria, followed by the activation of caspase-3) [7].

+ Antiviral

In an older study (1991) anthraquinones extracted from cascara sagrada were found to inhibit enveloped viruses from adsorption into a cell through an interaction with the viral envelope. Thus it was able to prevent its subsequent replication. [4].

+ Laxative

The laxative actions of cascara sagrada are reported to be from the hydroxyanthracene derivatives. They travel through the digestive tract unabsorbed to the large intestine where they are metabolized to form active aglycones. Here they exert laxative effects by a localized modification of intestinal motility via stimulation of intestinal muscle, and an accumulation of fluid. This occurs due to mediators such as prostaglandin release, and nitric oxide synthase production. [6].

 

Clinical Applications Of Cascara Sagrada:

Cascara sagrada is mainly used for constipation and as a tonic for poor bowel motility.

 

Cautions:

Caution adviced with this herb. Contraindicated with intestinal blockages and pregnancy.

Avoid Use During:

  • Pregnancy and lactation (only very small doses acceptable) [6]
  • Intestinal obstruction [6]
  • Intestinal inflammations such as: [6]
  • Chrons disease
  • Ulcerative colitis
  • Appendicitis
  • May cause bowel pigmentation
  • Do not use over 2 weeks without medical supervision [6]
  • Do not use fresh cascara sagrada. Severe vomiting, and intestinal spasm may occur [6].
 

Synergy

Suggested synergy with boldo for digestive complaints such as constipation, flatulence, and abdominal fullness [6].

Combine with rhubarb, boldo, and gentian for dyspepsia [6].

 

Author

Justin Cooke, BHSc

The Sunlight Experiment

(Updated November 2018)

 

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References:

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