Brand name:                          Cascara                                                   Latin name: Rhamnus purshianus                          Other names: Bitter Bark, California Buckthorn, Cascara Sagrada, Chittem                         Bark, Dogwood Bark, Purshiana Bark, Sacred Bark, Sagrada Bark, Yellow                         Bark                                                   A Remedy For                                                             Constipation                                                 Because it produces quick, easy bowel movements with a soft or loose                                                   stool, Cascara is used by people with hemorrhoids or anal fissures (crack                       in skin near the anus). It is often recommended following anal or rectal                         surgery, and is used for bowel cleansing prior to bowel examinations and                       similar diagnostic tests.                                                   What It Is; Why It Works                          Native to the Pacific Northwest, Cascara probably earned the name                         "sacred bark" through its ability to relieve constipation so quickly. The                         medicinal bark is dried for one year before use in order to allow its                         naturally harsh ingredients to mellow.                                                 The active ingredient in Cascara is found in several over-the-counter                                                 laxatives, including Doxidan and Peri-Colace. A strong, stimulant-type                                                 laxative, Cascara causes vigorous muscular contractions of the intestinal                                                   wall. This speeds passage of intestinal contents, leaving less time for                       liquid to be absorbed by the body and thus assuring a softer stool.                                                 Cascara may be active against herpes simplex, the virus that causes cold                                                 sores and genital herpes. Research on this possibility is currently                                                   underway.                                                   Avoid If...                          Do not take Cascara if you have an intestinal obstruction, appendicitis,                         abdominal pain of unknown origin, or an inflammatory intestinal disorder                         such as ulcerative colitis, irritable bowel syndrome, or Crohn's disease.                       Not for children under 12.                                                 Avoid the fresh rind of the Cascara plant. Taking it can lead to intestinal                                                 spasms and pain, bloody diarrhea, and kidney irritation.                                                   Special Cautions                          Cascara may cause cramping and nausea. Long-term use can deplete the                         body's stores of potassium and sodium, which are necessary for normal                         heart and muscle function. Chronic use may also cause kidney problems                         and fluid retention, irregular heart rhythms, bone deterioration, and laxative                       dependence. Do not use any stimulating laxative such as Cascara for                       more than 2 weeks without consulting your doctor.                                                   Possible Drug Interactions                          Because laxatives such as Cascara can cause fluid loss and potassium                         deficiency, you should not combine it with other potassium-depleting                         medications, including:                                                 Thiazide diuretics such as HydroDIURIL                                                 Steroid medications such as prednisone (Deltasone)                                                   Licorice root                                                 When potassium is low, certain heart medications may have a stronger                                                 effect. Be wary of laxatives such as Cascara while taking digoxin (Lanoxin)                                                 or a medication for heart irregularities.                                                 Special Information If You Are Pregnant or Breastfeeding                                                 Consult your doctor before using this medication.                                                   How To Prepare                          You can make a tea by pouring boiling water over 2 grams (about                         three-quarters of a teaspoonful) of finely cut Cascara. Steep for 10                         minutes, then strain.                                                   Typical Dosage                          Cascara is taken orally. Use the smallest amount necessary to maintain a                         soft stool.                                                   Cascara is available as crushed, powdered, or dry extracts and in various                       liquid forms. Strengths of commercial preparations may vary. Follow the                       manufacturer's labeling whenever available.                                                   Overdosage                          No information on overdosage is available.