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Cascara sagrada

Relieves constipation, treats cold sores

In Spanish, cascara sagrada means "sacred bark," perhaps because this woody shrub has provided blessed relief for more than a few constipated souls. The reddish-brown bark of this herb is harvested, dried, aged and used as a laxative, either as a powder or a liquid extract.

Cascara sagrada's purgative power has earned it a reputation as the world's most widely used laxative and made it the main ingredient in several over-the-counter laxatives.

"The active ingredients in cascara sagrada — anthraquinones — probably act by irritating the intestines to produce wavelike contractions of the muscles of the intestinal wall," explains Norman R. Farnsworth, Ph.D., director of the Program for Collaborative Research in the Pharmaceutical Sciences at the University of Illinois at Chicago. "Most people see results within eight hours."

Even though laxative products containing cascara sagrada are sometimes marketed as "nature's remedy" or "all-natural," or said to "restore bowel tone," they present the same risks as all stimulant laxatives. If you use them on a regular basis, you can develop a condition known as lazy bowel syndrome — you can't go without chemical stimulation! "A bulk laxative, such as psyllium, is a better choice for long-term chronic constipation," Dr. Farnsworth says.

Some anthraquinones, including some of those found in cascara sagrada, have the ability to kill herpes simplex, the virus that causes cold sores, reports Heinz Rosler, Ph.D., associate professor of medicinal chemistry at the University of Maryland School of Pharmacy in Baltimore.

Another ingredient in cascarda sagrada — aloe-emodin — has an anti-leukemia action in laboratory animals, lending some support to the herb's traditional use as an alternative cancer treatment. Unfortunately, aloe-emodin is also quite toxic, and scientists say more research is needed before it can be used to treat leukemia.

Putting the herb to work

Your best bet for taking cascara sagrada safely is to purchase a product that contains this herb as its active ingredient and to follow the product directions for use, Dr. Farnsworth says. If you are using the bark of this shrub, make sure it has been aged for at least a year before use. As long as the product is labeled "Cascara Sagrada Bark U.S.P.," you can be sure this has been done. Bark that has not been aged correctly contains chemicals that can cause violent diarrhea and severe intestinal cramps.

To make a laxative tea, boil one teaspoon of well-dried bark in three cups of water for 30 minutes. Drink the tea at room temperature, taking one to two cups a day before bed.

Avoid using cascara sagrada if you are pregnant or have ulcers, ulcerative colitis, irritable bowel syndrome, hemorrhoids or other gastrointestinal conditions.

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