History

• Cascara sagrada was used in over the counter (OTC) laxative medications until 2002, and Senna is believed to have been in use since the 9th century. Both are still popular with herbal remedy enthusiasts.
  
  In May 2002, The American Food and Drug Administration (FDA) issued a new rule that stated cascara sagrada---including casanthranol, cascara fluidextract aromatic, cascara sagrada bark, cascara sagrada extract, and cascara sagrada fluidextract--- "...have not been shown to be generally recognized as safe and effective..." as an over the counter (OTC) laxative. Due to that decision, cascara sagrada had to be removed as an ingredient in OTC laxatives within 180 days of the FDA ruling.
  
  

Function

• Both herbs work as purgatives. They cause the internal colon muscles to contract more forcefully, which moves bile and waste through the colon and out of the body more quickly.
  
  

Usage

• While both can be used as herbal supplements in capsule form, Senna is commonly diffused---or steeped in water and made into a tea. Depending upon how severe the constipation is and how much Senna or Cascara you take, relief can take six to 12 hours.
  
  Senna is also included in many common OTC medications such as Ex-Lax, Dosaflex and Fletchers Castoria.
  
  

Side Effects

• Since these herbs cause your intestinal muscles to contract more strongly, abdominal cramps are a common side effect.
  
  Long term use of these laxatives can cause loss of potassium and other critical vitamins, minerals and fluids from your body.
  
  Prolonged use can cause your body to become dependent on them and not be able to move bile through the colon regularly on its own.
  
  

Warnings

• Senna and Cascara may not be safe for use in children. From a nine-month evaluation of six poison control centers, the Kentucky Regional Poison Center concluded that "Unintentional ingestion of senna-containing laxatives in young children may potentially cause severe diaper rash, blisters, and skin sloughing."
  
  Strong purgatives such as these could cause miscarriages in pregnant women.
  
  Regardless of whether taken via OTC medications or herbal supplements, neither Senna nor Cascara Sagrada should be continued for more than one week without supervision by a doctor.