Cascara Sagrada: Its Most Important Benefit Will Surprise You

Medically reviewed by Vd. Naveen Sharma, BAMS
Written by Ravi Teja Tadimalla

Cascara sagrada is a shrub native to the western parts of North America. Its bark is quite popular for its medicinal benefits. Its most important use is as a laxative – the shrub has been used for ages to relieve constipation. There’s more to this shrub that we must know.

How Does Cascara Sagrada Work?

Cascara sagrada is scientifically called Rhamnus purshiana. Its most important benefit is its use as a laxative. It is also a common ingredient in most OTC (over-the-counter) laxatives.

Cascara sagrada works by stimulating muscle contractions in the intestines. These help move the stool through the bowels, easing constipation.

The compounds that play a role here are the anthraquinones in cascara. They act as irritants to the colon and promote muscle contractions (also called peristalsis) and stool evacuation (1). Anthraquinones achieve this by inhibiting the absorption of water and electrolytes in the intestines.

The constipation-relieving effects of cascara were mentioned in the 1883 edition of The British Medical Journal (2).

But, the FDA has recognized cascara sagrada as a category II agent – which means its use in OTC medications is not considered safe (3).

Hence, we recommend its use in a herbal form – because the efficacy of this shrub is unparalleled.

How Can Cascara Sagrada Benefit You?

The anthraquinones in cascara sagrada help ease constipation. Some sources suggest its efficacy in promoting liver health and preventing cancer – but we need more research on that.

1. Helps Treat Constipation


The anthraquinones in cascara deserve the credit here. These compounds have laxative effects and help in gastric emptying. As discussed, these anthraquinones work by triggering muscle contractions in the intestines.

Studies have recognized the strong purgative effects of the bark of cascara. It also helps to treat various forms of dyspepsia (or indigestion) (4).

Cascara can also be used as treatment for irritable bowel syndrome (5).

2. May Promote Liver Health

Cascara may also benefit the liver. It contains a compound called emodin, which was protective against induced liver damage in rats (6), (7). In the study, rats with acetaminophen-induced liver damage experienced some liver protection after treatment with emodin.

Some anecdotal evidence also suggests that cascara may help treat gallstones.

However, there is limited information on this. We suggest you check with your doctor before using cascara for this purpose.

3. Might Prevent Cancer

One study investigated the anticancer effects of aloe-emodin, a component of cascara, on human liver cancer cell lines. The compound was found to stop cancer cell proliferation and even induce cancer cell death (8). The study concludes by stating that cascara might be useful in preventing cancer – especially that of the liver.

We have very limited research in this regard – so, check with your doctor.

There are certain other anecdotal benefits that are yet to be substantiated with solid evidence. They are discussed below:

  • Might Promote Weight Loss

Cascara sagrada is a popular ingredient used in weight loss supplements (9). It is used as a laxative and may potentially induce some weight loss.

But we strongly recommend against using cascara sagrada for weight loss as there are no proven sources supporting the statement.

  • Might Heal Parasitic Infections

Some sources state that it has antimicrobial properties that might heal parasitic infections. But again, we don’t have concrete research supporting this aspect.

As we saw, a lot of research is still being done, and we are yet to arrive at concrete conclusions. But even with the proven benefits, you need to be careful with the way you use cascara sagrada.

How To Use Cascara Sagrada Safely

If you want to use cascara to treat any health problem, ensure you talk to your doctor first. This is because cascara can cause potential adverse reactions in some individuals (we will discuss these in a while).

If you are pregnant or breastfeeding, stay away from cascara. Same goes for your kids below the age of 12 years.

When buying cascara from the market, ensure you read the label of instructions carefully as it might interfere with certain medications you might be taking.

Drink plenty of fluids. Ensure you drink at least six to eight glasses of water a day. This will keep you hydrated and even soften your stool.

In case you are going for cascara supplements, you may want to keep the following in mind:

Herbal supplements like that of cascara sagrada don’t have the need to undergo rigorous testing in the United States. This can lead to the sale of low-quality supplements. To ensure this doesn’t happen to you, only buy supplements certified by independent bodies. These include NSF International, ConsumerLab, or the US Pharmacopeia (USP).

The reason you need to be extra cautious while using cascara sagrada is the set of side effects it may potentially cause.

What Are The Side Effects Of Cascara Sagrada?

The major problem with cascara sagrada is associated with its long-term use. Hence, ensure you double check on the duration of use. Following are the side effects you would want to avoid:

  • Issues During Pregnancy And Breastfeeding

Not enough is known about the safety of cascara during pregnancy. Please avoid it. Also, stay away from it while breastfeeding as it can cross into breast milk and cause diarrhea in the infant.

  • Hepatotoxicity

Long-term use of cascara can lead to liver injury (1). The time of its onset may vary from a few days to two months of use. In most cases, the symptoms of liver injury resolved after discontinuing cascara sagrada.

  • Other Issues

The long-term use of cascara sagrada can lead to electrolyte imbalance (10). This results in headaches, severe nausea, muscle weakness, irregular heartbeat, numbness of hands and feet, depression, confusion, reduced urine output, and rebound constipation (11).

Cascara sagrada may also interact with certain drugs. These include digoxin, digitoxin, and digitonin (also called cardiac glycosides, which are used to treat heart failure) (12). Cascara can also interact with corticosteroids, drugs used to treat inflammation.


The only benefit of cascara sagrada that is backed by solid research is constipation relief. Other potential benefits need more research and studies. Also, keep a tab on the duration of the intake (and dosage, which depends on the individual and will be prescribed by your doctor).

Any other questions about cascara sagrada you think we haven’t answered? Do let us know by leaving a comment in the box below.

Frequently Asked Questions

How long does cascara sagrada take to work?

Cascara sagrada can induce bowel movement within 6 to 8 hours of intake.

How to make cascara sagrada tea?

You can get loose cascara sagrada tea shavings from the market. Steep about a teaspoon of the loose tea in 2/3rd cup of boiling water for about 10 minutes. Strain before drinking.
Avoid cascara teas sold in larger chunks (as opposed to the shavings) as they may have stronger laxative effects. Also, make sure to buy the actual cascara sagrada tea and not the tea made from the skins of coffee berries.


  1. Cascara” National Institutes of Health.
  2. Cascara sagrada in constipation” The British Medical Journal.
  3. Cascara sagrada” University of Rochester Medical Center.
  4. Note on the bark of Rhamnus…” Dr. W. Craig’s note on Rhamnus purshiana.
  5. New treatments for irritable bowel syndrome…” National Center for Biotechnology Information.
  6. Emodin” US National Library of Medicine.
  7. Dose-dependent hepatoprotective effect of…” Experimental and Toxicologic Pathology, US National Library of Medicine.
  8. The antiproliferative activity of…” Life Sciences, US National Library of Medicine.
  9. Should weight-loss supplements…” The College of Family Physicians of Canada, US National Library of Medicine.
  10. Botanical dietary supplements gone bad” Chem Res Toxicol, US National Library of Medicine.
  11. Electrolyte imbalance” Comprehensive Cancer Center.
  12. Herbal remedies…” Critical Care Nurse.
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Ravi Teja Tadimalla is an editor and a published author. He graduated from SRM University, Chennai, and has been in the digital media field for over six years. He has a Professional Certificate in Food, Nutrition & Research from Wageningen University. He considers himself a sculptor born to chip away at content and reveal its dormant splendor. He started his career as a research writer, primarily focusing on health and wellness, and has over 250 articles to his credit. Ravi believes in the great possibilities of abundant health with natural foods and organic supplements. Reading and theater are his other interests.