Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Cascara sagrada, derived from the bark of the Rhamnus purshiana tree, has a long history of traditional use as a natural laxative. Native American tribes originally used cascara sagrada for its laxative properties, and it was later adopted into Western herbal medicine. The active compounds, primarily anthraquinones, stimulate bowel movements by increasing peristalsis in the colon and reducing water absorption, leading to softer stools. Because of these effects, cascara sagrada was commonly included in over-the-counter laxative preparations throughout the 20th century.

However, the scientific evidence supporting its use, especially in children, is limited and mostly based on historical use rather than robust clinical trials. Most available studies and safety data focus on adults, and there is a lack of high-quality, large-scale studies in pediatric populations. Safety concerns—including the risk of electrolyte imbalance, dehydration, and dependency—have led to regulatory agencies such as the U.S. FDA removing cascara sagrada from the list of generally recognized as safe (GRAS) ingredients for over-the-counter laxatives.

In summary, while cascara sagrada has traditionally been used to treat constipation (including in children), there is insufficient scientific evidence to support its safety and efficacy in pediatric patients. Its use in children is generally not recommended by modern medical guidelines due to potential adverse effects.

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