Cascara sagrada means ‘sacred bark’ in Spanish. The bark of this tree, which grows mostly on the west coast of the United States and parts of South America,1 is mainly used to treat constipation. Cascara sagrada can be found as an ingredient in over-the-counter laxatives.2 In addition to relieving constipation, cascara sagrada has also been used by Native Americans to treat liver problems, gallstones, joint and muscle pain, gonorrhea, indigestion, upset stomach, and dysentery (infection in the intestines that causes pain, fever, and diarrhea).2

Cascara sagrada bark contains anthraquinones. Anthraquinones are substances found in plants that give them their color. Because of this, they have been used as dyes. Certain anthraquinones in cascara sagrada, called cascarosides A and B, are also responsible for the bark’s laxative effect. When a person ingests the bark, the cascarosides interact with bacteria living in the large intestine to form substances that stimulate the intestine to move the bowels.3

Cascara sagrada is available as an over-the-counter laxative in the forms of tablets, capsules, and liquids.

In its raw form, the bark cannot safely be used until it is at least one year old or heated to above 212°F (100°C). Bark that is young or untreated has too strong of a laxative effect and produces severe intestinal spasm and cramping.3