July 2026

Constipation

• Why am I constipated?
• Dandelion – Move Your Shit
• Cascara Sagrada – A Stimulant Laxative
• Psyllium -Bulk Your Poop

Constipation is painful, uncomfortable, and tiring. When you are constipated, pooping is the only thing on your mind;  you are willing to do what it takes for a healthy bowel movement. Cascara sagrada is sold as an off the counter laxative. However, it has some safety issues that are worth considering. 

Before you reach for a stimulant laxative like cascara sagrada or senna, take the time to research and understand how they work and how to best use them.

Cascara Sagrada – A Stimulant Laxative

Degree: Cascara sagrada is a 3rd degree remedy. It’s only used as medicine; however, it is not a low dose botanical. 

Description

Cascara Sagrada is a large deciduous shrub or small tree that grows 15 to 40 feet tall. It features a slender trunk (8 to 20 inches in diameter) with ascending branches that form a narrow, upright crown. 

Bark: The outer bark is brownish to silver-gray and often splotched with light-colored lichens. The inner bark is bright yellow or smooth, intensely bitter, and darkens upon exposure to sunlight.

Leaves: Simple, alternately arranged, and clustered near the ends of twigs. They are oblong, 2-6 inches long. The top of the leaf is dark, shiny green, while the bottom is paler. In autumn, the foliage turns a vibrant yellow. 

Flowers: Small, umbrella shaped clusters of tiny greenish yellow or greenish-white flowers appear briefly in the spring (May to June). Each flower is cup shaped and measures about 3-5 mm across. 

Berries: Round berries, about the size of a large pea. They start bright red and quickly ripen to a deep purplish-black by late summer. Each berry contains 2 to 3 seeds. 

Growing 

Cascara Sagrada is native to the Pacific Northwest and grows in zones 4a-9b.  It prefers a partly shaded area in moist, hummus rich soil with a pH of 4-7. 

History and lore

Cascara sagrada has a long history of use by the native Americans of the Pacific Northwest, who introduced it to white settlers in 1870. Dr. Bundy, who was an Eclectic physician from Northern California, wrote about cascara sagrada in 1878:

“It acts upon the sympathetic nervous system, especially upon the solar plexus, stimulating the nutritive and assimilative forces, increasing the digestive processes generally. It acts upon the secretory system in a marvelous manner, especially where the secretions are deficient and perverted, and this seems to be one of its special indications. Constipation depends upon the nature of the diet, deficiency or a faulty composition of the intestinal secretions, disordered glands that pour their secretions into the intestines, impairment of muscular power, which leads to a deficiency in their propelling power which may result from nervous or mechanical influences, congestion of the portal circulation, normal secretion of intestinal juices interfered with, deficiency in biliary secretions of a healthy character, congestion of mucous membranes of intestines, and last and the most frequent, constipation which has been caused by resisting the calls of nature from carelessness or circumstances that prevent obedience at the proper time.”

Following the listing of cascara sagrada in the Pharmacopeia of the United States (1890), the use of cascara sagrada as a digestive stimulant and to relieve constipation skyrocketed. 

Energetic Architecture

Psychological profile

Cascara is used to help clear energetic blockages and release stagnant emotions, such as frustration or repressed anger. It is for the person who has a hard time letting go of clinging to old habits, past grievances, leading to emotional constipation.

Taste

Intensely bitter

Energetics

Temperature: Cooling

Fluids: Drying

Tone: Increasing tone

Tissue State

Damp/Stagnation – Cascara works well for people with a sluggish digestive system when digestion, absorption, and elimination are stagnant. Sluggish, infrequent bowel movements. They might feel heavy or full but have a hard time eliminating. 

It acts as a stimulant that irritates the lining of the digestive tract, increasing heat and excitation; therefore, it should not be used with people who are in a hot or excited state. 

Lax tissue state – Cascara is specific for the type of constipation caused by smooth muscle tone loss in the colon. Peristalsis is weakened and doesn’t effectively propel stool into the rectum. 

Pharmacology

Anthraquinone glycosides – are aromatic carbon based compounds that give the inner root its yellow color. The anthraquinone glycosides in cascata sagrada include emodin, chrysophanic acid, aloe-emodin, cascarosides A, B,C, and D. They have antiviral, antifungal, antibacterial, laxative, insecticidal, and antioxidant properties. 

Tannins – that can help balance the inhibiting effect of cascara on the reabsorption of water and electrolytes

Volatile oil

Actions

Foundational action

Foundational action is associated with the energetic pattern and can be experienced viscerally in the body.

Cascara sagrada is a stimulant as it moves stagnation by creating irritation and excitation. 

Primary actions 

Primary actions relate to organs, systems, or tissues.

Laxative – cascara works by actively stimulating colonic motility through the enteric nervous system.

Cholagogue – cascara improves bile production by the liver and the release of bile by the gallbladder. By doing so, cascara addresses the roots of constipation in a sluggish, stagnant liver. 

Bitter – as a bitter herb, it promotes digestive enzyme secretion and motility, hence improving digestion and absorption of nutrients. 

Purgative/Aperient – cascara actions are dose dependent.  In high doses, cascara is purgative; it will stimulate rapid, forceful bowel evacuation with watery, urgent, often multiple evacuations. In low doses, however, cascara is an aperient acting as a gentle, mild laxative that produces soft formed stool and supports natural bowel rhythm.

Organ affinity

Colon 

Clinical Pattern

Laxative

The most common use of cascara sagrada is as a short term laxative for constipation. However, not all constipation can be attributed to the same root cause. Cascara is specific for constipation due to atony of the bowel, meaning the smooth muscles of the colon are underactive and not functioning properly. 

Cascara helps relieve constipation through two pathways:

promoting peristalsis

The anthraquinone glycosides in cascara are not metabolized in the stomach and small intestine but reach the colon mostly intact. In the colon, gut bacteria convert the glycosides into their anthrone aglycones. These active aglycones irritate the mucus membrane, promoting spasmodic peristalsis movement that propels the stool downward. Food takes about 6 hours to reach the colon; therefore, cascara sagrada produces its laxative effects about 6 hours after a meal.

Cascara sagrada is considered a mild laxative compared to senna, for example, which also contains anthraquinone glycosides. However, long term use of cascara causes smooth muscle atrophy from disuse, and the enteric nervous system loses functional tone because the colon becomes increasingly dependent on external stimulation to move anything. 

Inhibiting the reabsorption of water and electrolytes

Chyme arrives at the colon as a soup of fiber, waste products, fluids, enzymes, bile acids, and electrolytes. In the colon, most fluids and electrolytes are absorbed back into the body. Cascara sagrada inhibits the reabsorption of water and electrolytes, leading to softer stool and increased bowel pressure, which facilitates evacuation. 

Long term use of cascara sagrada can have a drying effect on the body and lead to an electrolyte imbalance. 

Simon Mill warns us about the effects of long term use of herbs containing anthraquinone glycosides, due to the risk of loss of colonic muscle tone. He suggests the use of one part anthraquinone glycosides containing herb with two parts chamomile, which is anti-spasmodic and anti-inflammatory, and four parts psyllium that bulk the stool. 

Preparation and dosage

It is rare to give cascara or any stimulant laxative by itself; They are mostly used in a formula with carminative herbs. The addition of a carminative and a bulking herb (psyllium) can help prevent intestinal cramps and explosive bowel movements. 

Cascara sagrada requires the presence of sugar and bile to be activated in the colon. Simon Mills recommends using cascara with bitter roots that promote bile secretion and also contain polysaccharides such as dandelion. 

The tea is unpleasant. 

Tincture: aged dried bark 1:5 40%A

Dosage: 1-2 ml (0.2-0.4 tsp) in a little water just before bedtime. Normally, it will promote morning evacuation.

Capsules: 500-1000mg morning and or evening. 

Safety

Cascara sagrada or any herb containing anthraquinone glycosides is not appropriate for constipation associated with tension or spasm in the bowel induced by tension in the gut brain axis. Constipation worsened by stress, alternating with diarrhea, or with passing small goat like stool should not be treated with stimulant laxatives but instead with a visceral relaxant or herbs that relax smooth muscles, such as chamomile, valerian, lobelia, or carminatives like fennel and anise. 

Use with cautious 

Fresh cascara bark has emetic, or vomit inducing properties. 

Cascara sagrada should be used for no longer than seven days. Long term use of anthraquinones might have notable side effects:

Development of Melanesia coli, a condition in which the colon lining takes on a dark brownish black hue, increasing the risk for cancer 

Anthraquinone dependency is developed in individuals who have been using it as a laxative over prolonged periods. The muscles in the colon lose tone and can’t propel stool down into the rectum, leading to chronic constipation.

Overconsumption of anthraquinones causes abdominal cramps, gastrointestinal discomfort, vomiting, dermatitis, nausea, bloody diarrhea, and dizziness. 

Overuse of cascara sagrada can cause potassium deficiency and cardiovascular complications. Also, potassium deficiency might be exacerbated by the simultaneous application of thiazide diuretics, corticosteroids, and licorice root.

When to avoid

Avoid during pregnancy or breastfeeding, or in children under 12 years old.

Avoid in inflammatory bowel conditions, intestinal obstruction, acute intestinal inflammation, Crohn’s disease, ulcerative colitis, appendicitis, abdominal pain of unknown origin, fever, and liver conditions.