Synopsis

Source of validity: Traditional
Rating (out of 5): 3

Cascara sagrada (Rhamnus purshiana) has a long history of traditional use as a natural laxative. Native American tribes originally used the dried bark to treat constipation and other digestive issues. Its main active compounds, anthraquinones (such as cascarosides), stimulate bowel movements by increasing peristalsis (the muscular contractions that move stool through the colon). Because of these properties, cascara sagrada has been used historically to support the health and function of the lower digestive tract, including the rectum, primarily by preventing or alleviating constipation and facilitating regular evacuation.

While there is some scientific evidence confirming cascara sagrada's laxative effects, most modern medical guidelines caution against long-term use due to the risk of dependence and potential side effects (such as electrolyte imbalance or damage to the colon lining). The US FDA has removed cascara sagrada from its list of approved over-the-counter laxatives due to insufficient safety data. Nonetheless, cascara sagrada’s use in supporting the rectum is rooted in centuries of traditional herbal practice, rather than robust clinical trials. Thus, its evidence base for supporting rectal health is primarily traditional, with moderate support reflecting both long-standing use and some acknowledgment of its physiological effects on the lower gastrointestinal tract.

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