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Used for over 1,000 years as a natural laxative, cascara sagrada is Spanish for 'sacred bark' and is what is known as a stimulant laxative. It stimulates the peristaltic pumping action of the intestine that is responsible for the passage of chyme and feces through your intestinal system. It was used first by Native Americans of the North West Pacific coast, and then by the settlers. Its common name to the Chinooks is 'chitticum' - it is a form of Chinook Jargon, and if you say it a couple of times its meaning will be clear!

As with other forms of stimulant laxative, cascara sagrada is most effective when taken with an eight ounce glass of water (~240 ml) on an empty stomach, generally at night. The results should be evident come morning, although it can take up to 24 hours depending on the severity of the problem. It is best used only when needed, and prolonged use can stain the colon although as of January 2011 there is no evidence of this being indicative of health problems other than the death of some colon cells. Occasional use does not lead to this staining.

Cascara sagrada is used to stimulate the intestine and colon into evacuating constipated stools. It is the name given by the Spanish to the American buckthorn tree, and means 'sacred bark', because it is the aged bark that offers the desired properties. Fresh bark can cause vomiting and diarrhea, but when aged for a year its anthraquinones induce strong peristaltic contractions of the intestine. It also increases secretions from the liver and pancreas, and is useful in treating hemorrhoids due to the softness of the stool it induces.

It is important not to take the herb or the herbal extract over long periods because your bowel can get used to it, and fail to work properly without it. There are other problems associated with prolonged usage, but as an incidental treatment for stubborn constipation there is nothing better. The powerful wave-like movements it induces relieve constipation effectively and gently, without pain or any other side effects.