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Cascara sagrada (Rhamnus purshiana)

What is Cascara Sagrada?

Cascara sagrada is primarily used for constipation.

The aged bark is exceptionally bitter — which stimulates the vagus nerve, liver, and digestive organs. As bile acids and pancreatic secretions begin moving in the gastrointestinal tract, it triggers the gastric mucosa to expand and contract. This is important to help foods move through the digestive tract.

Some of the active compounds in the herb (work by irritating the digestive mucosa — causing them to writhe and contract.

This herb needs to be used carefully — high doses can be very uncomfortable and result in serious harm.

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].

Herb Details: Cascara Sagrada

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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 Liliaceae, and Leguminoseae, is an important medicinal constituent. It's 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 include 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 have 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 yet prove useful in combination, as in the case of many Chinese formulas containing emodin containing botanicals, or may prove useful when administered via intravenous, or through modification of one of its side chains [7].

It was shown that with the addition of polyethyleneimine, sugar or heterocycle as side chains may actually improve the antitumor activity [35-37]. Rhamnus frangula has been found to have emodin-glycoside derivatives [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 earlier 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.

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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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