Cascara
Common name
Cascara sagrada
ID
HD0013
Scientific name of the plant
Rhamnus purshiana DC.
Anatomical part for use
bark
Human use
Constipation
Summary
Frangula purshiana (cascara, cascara buckthorn, cascara sagrada, bearberry, and in the Chinook Jargon, chittem stick and chitticum stick; syn. Rhamnus purshiana) is a species of plant in the family Rhamnaceae. It is native to western North America from southern British Columbia south to central California, and eastward to northwestern Montana.
The dried bark of cascara was used as a laxative in folk medicine by the indigenous peoples of the Pacific Northwest. (Source: Wiki)
Evidence Level
Level 4 (Individual reports repeated observed over 5 years among different countries)
Hepatotoxicity reports in literature
- Cascara sagrada-induced intrahepatic cholestasis causing portal hypertension: case report and review of herbal hepatotoxicity : (Source)
- [Toxic hepatitis following consumption of the herbal medicinal product Cascara Sagrada] : (Source)
- A Serendipitous Find: A Case of Cholangiocarcinoma Identified Incidentally After Acute Liver Injury Due to Cascara sagrada Ingestion : (Source)
Hepatotoxicity Description
Use of cascara in the recommended doses for a limited period of time has been associated with few side effects, most of which are mild and transient. With longer term use of high doses of cascara, however, adverse events have been described including several cases of clinically apparent liver injury. The time to onset of liver injury has varied from a few days to 2 months of use, and the pattern of serum enzyme elevations varied from hepatocellular to cholestatic. The liver injury ranged from mild to severe, but usually resolved rapidly with discontinuation. Immunoallergic features and autoimmune markers were not prominent or consistently present in the published cases. (Source: LiverTox)
Traditional medicine
Cascara was used in traditional medicine as a laxative. The dried, aged bark of R. purshiana used by indigenous native peoples and immigrant Euro-Americans as a supposed laxative is based on anthraquinone-containing herbal preparations of leaves and fruits of senna, the latex of Aloe vera, and the root of the rhubarb plant. Commercially, it is called "cascara sagrada" ('sacred bark' in Spanish), while traditionally it is known as "chittem bark" or "chitticum bark". The historical interest in using cascara damaged native cascara populations during the 1900s due to overharvesting. (Source: Wiki)
Preparation in folk medicine
The bark is collected in the spring or early summer, when it easily peels from the tree. Once stripped from the tree, the bark must be aged for many months because fresh cut, dried bark causes vomiting and violent diarrhea. This drying is generally done in the shade to preserve its characteristic yellow color. This process can be quickened by simply baking the bark at a low temperature for several hours. In her book, Major Medicinal Plants, Dr. Julia Morton suggested using a dosage of 10–30 grains, dissolved in water, or 0.6–2 cc for fluid extract. James A. Duke suggested an effective dosage of approximately 1 to 3 grams (15 to 46 gr) dried bark, or 1 to 2.5 grams (15 to 39 gr) powdered bark. (Source: Wiki)
Common name
Cascara sagrada
ID
HD0013
Scientific name of the plant
Rhamnus purshiana DC.
Anatomical part for use
bark
Human use
Constipation
Summary
Frangula purshiana (cascara, cascara buckthorn, cascara sagrada, bearberry, and in the Chinook Jargon, chittem stick and chitticum stick; syn. Rhamnus purshiana) is a species of plant in the family Rhamnaceae. It is native to western North America from southern British Columbia south to central California, and eastward to northwestern Montana. The dried bark of cascara was used as a laxative in folk medicine by the indigenous peoples of the Pacific Northwest. (Source: Wiki)
Evidence Level
Level 4 (Individual reports repeated observed over 5 years among different countries)
Hepatotoxicity reports in literature
- Cascara sagrada-induced intrahepatic cholestasis causing portal hypertension: case report and review of herbal hepatotoxicity : (Source)
- [Toxic hepatitis following consumption of the herbal medicinal product Cascara Sagrada] : (Source)
- A Serendipitous Find: A Case of Cholangiocarcinoma Identified Incidentally After Acute Liver Injury Due to Cascara sagrada Ingestion : (Source)
Hepatotoxicity Description
Use of cascara in the recommended doses for a limited period of time has been associated with few side effects, most of which are mild and transient. With longer term use of high doses of cascara, however, adverse events have been described including several cases of clinically apparent liver injury. The time to onset of liver injury has varied from a few days to 2 months of use, and the pattern of serum enzyme elevations varied from hepatocellular to cholestatic. The liver injury ranged from mild to severe, but usually resolved rapidly with discontinuation. Immunoallergic features and autoimmune markers were not prominent or consistently present in the published cases. (Source: LiverTox)
Traditional medicine
Cascara was used in traditional medicine as a laxative. The dried, aged bark of R. purshiana used by indigenous native peoples and immigrant Euro-Americans as a supposed laxative is based on anthraquinone-containing herbal preparations of leaves and fruits of senna, the latex of Aloe vera, and the root of the rhubarb plant. Commercially, it is called "cascara sagrada" ('sacred bark' in Spanish), while traditionally it is known as "chittem bark" or "chitticum bark". The historical interest in using cascara damaged native cascara populations during the 1900s due to overharvesting. (Source: Wiki)
Preparation in folk medicine
The bark is collected in the spring or early summer, when it easily peels from the tree. Once stripped from the tree, the bark must be aged for many months because fresh cut, dried bark causes vomiting and violent diarrhea. This drying is generally done in the shade to preserve its characteristic yellow color. This process can be quickened by simply baking the bark at a low temperature for several hours. In her book, Major Medicinal Plants, Dr. Julia Morton suggested using a dosage of 10–30 grains, dissolved in water, or 0.6–2 cc for fluid extract. James A. Duke suggested an effective dosage of approximately 1 to 3 grams (15 to 46 gr) dried bark, or 1 to 2.5 grams (15 to 39 gr) powdered bark. (Source: Wiki)