Casgara Sagrada, known as sacred bark, is a natural laxative that comes from the reddish-brown bark of the Rhamnus purshiana tree native to the Pacific Northwest. It was used by various Native American Indian tribes, who also passed it on to Spanish explorers. As a nutritional support for the eliminative function, the bark has been used by cultures around the world. Today, many common laxatives use casgara sagrada as an ingredient. It is such a mild laxative that it can safely be used by the elderly. Its most notable constituents are cascarosides, which exhibit a cathartic effect that induces the large intestine to increase its muscular contraction (peristalsis), causing a bowel movement. Other important constituents include resins, tannins, and lipids which make up the majority of the other bark ingredients. For constipation and related discomforts such as hemorrhoids, a typically recommended dose would be: 1 teaspoon of liquid extract three times a day or 1 or 2 teaspoons at bedtime; or, 1 or 2 capsules of dried bark at bedtime. A bowel movement usually will take place within six to eight hours after taking the recommended dose.