Is Cascara Sagrada a Stimulant Laxative?

Some people have been falsely claiming that cascara sagrada is not a stimulant laxative even though it contains stimulant laxative anthraquinones like other stimulant laxatives (senna, aloe, and rhubarb root). So what does the research, the medical establishment, and alternative medicine sites have to say about this?:


http://www.optimalhealthnetwork.com/Stimulant-Laxatives-Aloe-Cascara-Sagrada-...


“Stimulant Laxatives”

“Cascara Sagrada”

“Cautions With Stimulant Laxatives

The use of botanical stimulant laxatives should be considered only after diet, lifestyle, and bulk laxatives have proven ineffective, and other causes have been ruled out. They are contraindicated in cases of bowel obstruction, acute intestinal inflammation and abdominal pain of unknown origin. They should not generally be used in children under 12 or in pregnant or nursing women.
Overuse and abuse of laxatives is common. Potential dangers include electrolyte imbalance, especially potassium deficiency which can lead to muscle weakness and heart function disorders. This potassium imbalance can be further exacerbated by the use of thiazide diuretics, corticoadrenal steroids or high doses of licorice root. Chronic use of anthraquinone glycosides has been associated with an increased pigmentation of the intestinal mucosa called pseudomelanosis coli. While this has been determined to be a benign condition, it is diagnostic for laxative abuse and often alters the ability to diagnose other colon diseases. While the available evidence is divided on whether chronic use of stimulant laxatives will result in a condition of a “sluggish” colon, all attempts should be made to move to bulk-forming laxatives and refrain from chronic use of stimulant laxatives.”


http://www.ageless.co.za/herb-cascara-sagrada.htm


“It contains hydroxyanthraquinone glycosides made up principally of O-glycosides of aloeemodin, chrysophanol and emodin or C-glycosides (cascarosides A, B, C and D as well as aloin A and B).
Part of the glycosides are degraded in the colon to form anthrones by enzyme activity. This forms the stimulant laxative compound which results in faster bowel movements and less liquid absorption in the colon.”

• “Internal use
o Cascara sagrada bark is used for constipation where a stimulant laxative is required. “

“If taken in excess cascara sagrada causes diarrhea and vomiting. Stimulant laxatives should not be used for long periods, and should be contained to one week maximum, and only be used after a change of diet (with higher bulk contents) was found to be ineffective.”


http://www.ayurvedic-medicines.org/herbal-medicines/cascara-sagrada.htm


“The glycosides found in cascara sagrada are stimulant cathartics that exert their action by increasing the smooth-muscle tone in the wall of the large intestine and have only minor effects on the small intestine.”

“Inform the patient that cascara sagrada products are for short-term use. “


http://www.iconocast.com/News_Files/A0EP1/News5.htm


“If you use cascara in a constipation remedy mixture, do not use this mixture for more than thirty days. After 30 days take a rest from it. Do not use Cascara in large amounts and for long periods since it can cause intestinal distress and become habit-forming. When you use it, you will see results in 1-2 days.”

“Do not use Cascara Sagrada if you have irritable bowel syndrome, hemorrhoids, or ulcers. Use Cascara for a limited time. It can become habit-forming and, if used for an extended time, it can increase the risk of colon cancer. Its use also causes you to lose potassium with each bowel movement.”


http://www.medicinehunter.com/Cascara.htm


“Germany’s Commission E
• Constipation

ESCOP
• For short term use in cases of occasional constipation


Potential Risks
The following information is derived from Germany’s Commission E, ESCOP, and the AHPA Botanical Safety Handbook.

Safety issues and concerns:
• Cascara sagrada may cause cramping and discomfort in the gastrointestinal tract.
• Long term Cascara sagrada use can cause laxative dependency and electrolyte and fluid imbalance. “


http://www.helpforibs.com/messageboards/ubbthreads/showthreaded.php?Cat=&Boar...


“Aloe, cascara sagrada, and senna laxtives can cause cathartic colon

Cathartic Colon

Cathartic colon is the anatomic and physiologic change in the colon that occurs with chronic use of stimulant laxatives (> 3 times per week for at least 1 year). Signs and symptoms of cathartic colon include bloating, a feeling of fullness, abdominal pain, and incomplete fecal evacuation. Radiologic studies show an atonic and redundant colon. Chronic use of stimulant laxatives can lead to serious medical consequences such as fluid and electrolyte imbalance, steatorrhea, protein-losing gastroenteropathy, osteomalacia, and vitamin and mineral deficiencies. When the drug is discontinued, radiographic and functional changes in the colon may only partially return to normal because of drug-induced neuromuscular damage to the colon.

Anthranoid laxatives (aloe, cascara sagrada, and senna) are derived from naturally occurring plants and are considered to be stimulant laxatives. Short-term use of stimulant laxatives may be safe, but abuse of these drugs can cause melanosis coli and possibly increases the risk of colonic cancer. Melanosis coli, a benign condition, is characterized by dark pigmentation of the colonic mucosa that usually develops 9 months after initiating the use of these drugs and disappears just as quickly after the drug is discontinued.


http://www.medscape.com/viewarticle/437034_7”



http://www.drugs.com/cdi/cascara-sagrada.html


“Cascara Sagrada is a stimulant laxative.”


http://www.herbsguide.net/cascara-sagrada.html


“Uses: Cascara sagrada bark is used for constipation where a stimulant laxative is required.”


http://www.naturalstandard.com/index-abstract.asp?create-abstract=/monographs...


“Cascara possesses purgative, toxic, therapeutic, and tonic activity. It is most commonly used as an anthraquinone stimulant laxative for bowel cleansing. Stimulant and cathartic laxatives are the most commonly abused laxatives and have the potential for causing long-term damage.”


http://www.the-natural-choice.co.uk/product.php?productid=16214&cat=284&page=


“WARNING: Cascara sagrada is a stimulant laxative - Do not use if you have abdominal pain, nausea, vomiting or diarrhoea. Discontinue use in the event of diarrhoea or watery stools. Rectal bleeding or failure to have a bowel movement after laxative use may indicate more serious conditions - consult your doctor.”


http://www.peoplespharmacy.com/archives/herb_library/cascara_sagrada.php


“Adverse Effects

Abdominal cramps or diarrhea have been reported.
Chronic use of laxatives may lead to excessive loss of potassium or other electrolytes, which may be dangerous. In addition, anthraquinones can cause pigmentation of the large bowel.
A serious problem associated with chronic use, however, is that a person may become dependent on such a stimulant laxative and become unable to evacuate without it. This leads to problems that resemble ulcerative colitis.
Possible Interactions
If cascara sagrada results in excessive potassium loss, heart rhythm irregularities may occur. This problem could be especially severe for people taking the heart drug Lanoxin.
It would be unwise to use cascara sagrada together with other herbal medicines that can cause potassium loss, such as aloe or licorice.
Medications such as hydrochlorothiazide, Lasix, Hygroton, Lozol, Bumex, and other potassium-wasting diuretics are probably incompatible with cascara sagrada, at least if it were used more than very occasionally.
Cascara sagrada, like other strong laxatives, may reduce the absorption of other medicines taken orally.”


http://www.tpub.com/content/armymedical/md0913/md09130068.htm


“Another stimulant laxative containing cascara sagrada is cascara tablets.”


http://www.healthline.com/natstandardcontent/cascara-sagrada


“Cascara possesses purgative, toxic, therapeutic, and tonic activity. It is most commonly used as an anthraquinone stimulant laxative for bowel cleansing. Stimulant and cathartic laxatives are the most commonly abused laxatives and have the potential for causing long-term damage.”


http://books.google.com/books?id=qBnK2XwjDdgC&pg=PA191&lpg=PA191&dq=%22cascar...


“Like all stimulant laxatives, cascara sagrada can cause laxative dependency.”
Tweet