Cascara Sagrada

Syed T, Afzal M, Ashfax A, Holt A, Ali A, Ahmad S. Management of genital herpes in men with 0.5%Aloe vera extract in a hydrophilic cream: a placebo-controlled double blind study. Journal of Dermatological Treatment 1997; 8:99-102.94

relieves constipation, treats cold sores

Aloe (Aloe vera) contains polysaccharides and anthraquinones - both anti herpetic, but anthraquinones make you poop.  200:1 extract powder available for about 60 per 454 grams.   Be aware that the U.S. Food and Drug Administration does not strictly regulate herbs and dietary supplements. There is no guarantee of strength, purity or safety of products containing or claiming to contain aloe. Decisions to use herbs or supplements should be carefully considered. Individuals using prescription drugs should discuss taking herbs or supplements with their pharmacists or health care providers before starting. Evidence Unproven Uses Potential Dangers Interactions Dosing Summary Resources   Evidence Scientists have studied aloe for the following health problems: Constipation Scientific research suggests that some of the chemicals in aloe latex (the dried inner lining of the leaf) may work as laxatives. However, there are few studies of aloe latex taken by mouth as a laxative. Further study is needed to answer whether aloe is a good treatment for constipation and how it compares to other laxatives. Burns Early research suggests that aloe gel applied to the skin may help to heal minor burns. However, these studies are small and of low quality. Further research is necessary before a definitive answer is known. Pressure ulcers Pressure ulcers occur when people are not able to move around well and their skin breaks down because of pressure placed on one spot for a long time. These ulcers can become very deep or infected. There is early evidence that aloe does not help the healing of pressure ulcers. Therefore, aloe should not be used for this purpose. Surgical wounds Early evidence suggests that when aloe gel is placed on surgical wounds, they take longer to heal. Therefore, aloe should not be used for this purpose. Other Early evidence suggests that aloe may be helpful for treating psoriasis, seborrheic dermatitis and genital herpes in men. However, there is not enough research to make a clear recommendation. Aloe has also been studied for radiation skin damage, type 2 diabetes, HIV infection and cancer prevention, but clear answers are not known at this time.   Unproven Uses     Aloe has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially very serious and even life-threatening. You should consult a health care provider before taking aloe for any unproven use.     Arthritis Asthma Birth control Bladder stones Chronic fatigue syndrome Congestive heart failure Corneal abrasions Corneal ulcers Frostbite Hair loss Heart disease (for prevention) Inflammatory bowel disease Liver inflammation (hepatitis) Lupus Post-dermabrasion healing Radiation protection Skin infections Stomach ulcers Sunburn Worm infections of the intestine or skin   Potential Dangers     Allergies     People with allergies to aloe or plants in the Liliaceae family (garlic, onions, tulips) should avoid using aloe. Skin rashes have been reported with long-term use of aloe gel. Aloe injections have caused severe reactions and should be avoided.     Side Effects     At recommended doses, aloe taken by mouth may cause cramping and diarrhea. Because of its laxative effects, aloe should be avoided by people with diarrhea or intestinal conditions, such as bowel obstruction. Laboratory and animal studies show that aloe taken by mouth may lower blood sugar or potassium levels. Therefore, people with diabetes, kidney disease, heart disease or electrolyte abnormalities should use oral aloe only under medical supervision. Using any laxative, including aloe, for more than seven days in a row may make constipation worse or cause dependency.     Pregnancy And Breast-Feeding     Taking aloe by mouth should be avoided during pregnancy, because of the possibility of causing uterine contractions. Traditionally, it is believed that oral use of aloe leaves during breast-feeding should be avoided, although there is not enough scientific information in this area.     Interactions     Interactions with drugs, supplements and other herbs have not been thoroughly studied. The interactions listed below have been reported in scientific publications. If you are taking prescription drugs, speak with your health care provider or pharmacist before using herbs or dietary supplements.     Interactions With Drugs     Taking aloe by mouth should be avoided by people taking oral drugs for diabetes or using insulin. Aloe should be used cautiously by people taking thiazide diuretics, such as hydrochlorothiazide; oral corticosteroids; or digoxin (Lanoxin). Taking aloe latex by mouth at the same time as laxatives may increase diarrhea, dehydration or electrolyte imbalances in the blood. When taken by mouth, aloe gel may interfere with the absorption of other drugs.     Interactions With Herbs And Dietary Supplements     When taken by mouth, aloe may increase the laxative properties of agents such as senna and may cause diarrhea. Aloe may also add to the effects of herbs that lower blood sugar levels, such as bitter melon (Momordica charantia). Aloe latex may increase the potassium-lowering effects of other herbs such as licorice (Glycyrrhiza glabra).     Dosing     The doses listed below are based on scientific research, publications or traditional use. Because most herbs and supplements have not been thoroughly studied or monitored, safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients even within the same brand. Combination products often contain small amounts of each ingredient and may not be effective. The appropriate dosing should be discussed with a health care provider before starting therapy; always read the recommendations on a product's label. The dosing for unproven uses should be approached cautiously, because scientific information is limited in these areas.     For Minor Skin Burns     Adults (Aged 18 Or Older)     Aloe gel: The gel is often used liberally on the skin, and there are no reports of harmful effects. Severe burns should be treated by a health care provider immediately.     Children (Younger Than 18)     Aloe gel: The gel is often used on children's skin, and there are no known reports of harmful effects. Severe burns should be treated by a health care provider immediately.     For Constipation     Adults (Aged 18 Or Older)     Capsules: A common dose is 40 to 170 milligrams of aloe latex (dried inner lining of the leaf) per day, for no longer than seven days, may be taken by mouth. Combination products containing aloe latex and other laxative herbs or supplements are available.     Children (Younger Than 18)     Aloe taken by mouth has not been studied in children and theoretically may have harmful effects, such as lowering blood sugar levels. Therefore, it is not recommended.     Summary     Aloe has been suggested for many conditions. Chemicals in aloe latex have been shown to have laxative effects. However, there are only a few human studies of aloe latex for constipation, and safety and long-term effects are not yet known. There is early evidence that aloe gel applied to the skin may be helpful for treating psoriasis, seborrheic dermatitis, burns and genital herpes in men. Further research is necessary before a strong recommendation can be made. Aloe gel should not be used on pressure ulcers or surgical wounds, because healing may take longer. Aloe taken by mouth should be avoided by pregnant women, children and individuals with heart disease, kidney disease and electrolyte imbalances. It should be used only under medical supervision by people with diabetes or those taking drugs that lower blood sugar levels. Consult your health care provider immediately if you experience side effects.     The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.     Resources     Natural Standard: An organization that produces scientifically-based reviews of complimentary and alternative medicine (CAM) topics National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research     Selected Scientific Studies: Aloe     Natural Standard reviewed more than 200 articles to prepare the professional monograph from which this version was created.     Some of the more recent English-language studies are listed below:     Kaufman T, Kalderon N, Ullmann Y, et al. Aloe vera gel hindered wound healing of experimental second-degree burns: a quantitative controlled study. J Burn Care Rehabil 1988;9(2):156-159. Montaner JS, Gill J, Singer J, et al. Double-blind placebo-controlled pilot trial of acemannan in advanced human immunodeficiency virus disease. J Acquir Immune Defic Syn Hum Retrovirol 1996;12:153-157. Olsen DL, Raub W Jr., Bradley C, et al. The effect of aloe vera gel/mild soap versus mild soap alone in preventing skin reactions in patients undergoing radiation therapy. Oncol Nurs Forum 2001;28(3):543-547. Schmidt JM, Greenspoon JS. Aloe vera dermal wound gel is associated with a delay in wound healing. Obstet Gynecol 1991;78(1):115-117. Syed TA, Afzal M, Ashfaq AS. Management of genital herpes in men with 0.5% Aloe vera extract in a hydrophilic cream: a placebo-controlled double-blind study. J Derm Treatment 1997;8(2):99-102. Syed TA, Ahmad SA, Holt AH, et al. Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health 1996;1(4):505-509. Syed TA, Cheema KM, Ahmad SA, et al. Aloe vera extract 0.5% in hydrophilic cream versus aloe vera gel for the measurement of genital herpes in males: a placebo-controlled, double-blind, comparative study. J Eur Acad Derm Veneriol 1996;7(3):294-295. Thomas DR, Goode PS, LaMaster K, et al. Acemannan hydrogel dressing versus saline dressing for pressure ulcers: a randomized, controlled trial. Adv Wound Care 1998;11(6):273-276. Vardy AD, Cohen AD, Tchetov T. A double-blind, placebo-controlled trial of Aloe vera (A. barbadensis) emulsion in the treatment of seborrheic dermatitis. J Derm Treatment 1999;10(1):7-11. Vogler BK, Ernst E. Aloe vera: a systematic review of its clinical effectiveness. Br J Gen Pract 1999;49(447):823-828. Williams MS, Burk M, Loprinzi CL, et al. Phase III double-blind evaluation of an Aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. Int J Radiation Oncol Biol Phys 1996;36(2):345-349.   Last updated February 26, 2002 Chats And Discussion Boards     Printer-friendly format         Send this page to a friend

In Spanish, cascara sagrada means "sacred bark," perhaps because this woody shrub has provided blessed relief for more than a few constipated souls. The reddish-brown bark of this herb is harvested, dried, aged and used as a laxative, either as a powder or a liquid extract.

Cascara sagrada's purgative power has earned it a reputation as the world's most widely used laxative and made it the main ingredient in several over-the-counter laxatives.

"The active ingredients in cascara sagrada - anthraquinones -- probably act by irritating the intestines to produce wavelike contractions of the muscles of the intestinal wall," explains Norman R. Farnsworth, Ph.D., director of the Program for Collaborative Research in the Pharmaceutical Sciences at the University of Illinois at Chicago. "Most people see results within eight hours."

Even though laxative products containing cascara sagrada are sometimes marketed as "nature's remedy" or "all-natural," or said to "restore bowel tone," they present the same risks as all stimulant laxatives. If you use them on a regular basis, you can develop a condition known as lazy bowel syndrome -- you can't go without chemical stimulation! "A bulk laxative, such as psyllium, is a better choice for long-term chronic constipation," Dr. Farnsworth says.

Some anthraquinones, including some of those found in cascara sagrada, have the ability to kill herpes simplex, the virus that causes cold sores, reports Heinz Rosler, Ph.D., associate professor of medicinal chemistry at the University of Maryland School of Pharmacy in Baltimore.

Another ingredient in cascarda sagrada -- aloe-emodin -- has an anti-leukemia action in laboratory animals, lending some support to the herb's traditional use as an alternative cancer treatment. Unfortunately, aloe-emodin is also quite toxic, and scientists say more research is needed before it can be used to treat leukemia.

 

Hirschsprungs Disease

Some babies are being born now without any nerves to the bowel and NOTHING can get them to have a bowel movement on their own.

[Dr. Schulze]

It is really pretty simple. See, there are certain plant chemicals, phytochemicals, in a few herbs, called anthraquinones. There is a particular one called Emodin that is in certain varieties of Aloe that grow near the equator, and in Senna leaf and pod and in Cascara Sagrada bark.

Emodin doesn't have to be digested, or assimilated. It doesn't have to get into your nervous system. It has a direct chemical reaction with the smooth muscles in the intestine and makes them contract, along with other stimulating herbs in the formula like Cayenne pepper that do the same thing. I have never met a bowel to date that had the audacity to disobey this herbal order.

I have had babies that were so plugged up that they vomited fecal matter, that when x-rayed the fecal matter was found backed up into their stomachs. One had fecal matter backed up in its esophagus. The doctors always said there was no hope of ever having a working bowel and wanted to do colostomies on 6- month and 8-month old babies. I got ALL of their bowels working again, IN DAYS.

ALOEVERA(Aloe vera) Kathi J. Kemper, MD, MPH Page 1 Longwood Herbal Task Force: http://www.mcp.edu/herbal/default.htmRevised July 29, 1999 (continued) SUMMARY: The numerous species of aloe contain two types of herbal remedies: the mucilaginous gel from the middle of the fleshy leaf (used primarily on the skin and mucus membranes) and the sticky, bitter leaf lining (used as a potent stimulant laxative). Aloe gel's traditional use as a topical remedy for burns, abrasions and mucosal irritations is supported by its biochemical constituents as well as in vitro, animal and human data. The leaf lining contains anthraquinones that cause diarrhea and cramping acutely, and laxative dependency, dehydration, potassium loss and pseudomelanosis coli with chronic administration. Treatment of peptic ulcers and viral infections with aloe remains experimental. Aloe gel is safe for external use; allergies are rare and adverse interactions with other medications have not been reported. Aloe should not be used internally during pregnancy, lactation or childhood, nor by persons with undiagnosed abdominal pain, appendicitis or intestinal obstruction. POPULARUSES:External uses (gel):Minor burns, abrasions, insect bites, acne, poison ivy, skin irritations, frostbite and canker sores Internal uses (gel):Peptic ulcers and other digestive disorders; HIV and cancer are experimental uses Internal use (latex leaf lining): Laxative CHEMICALCONSTITUENTS:In the gel: Polysaccharides (acemannan and glucomannan), carboxypeptidase, and others 
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(continued) In the leaf lining: Anthraquinones(aloin. aloe-emodin, barbaloin)SCIENTIFICDATA: In vitro: Aloe vera has antimicrobial and antifungal activity against Pseudomonas aeruginosa, Klebsiella pneumoniae, Serratia marcescens, Citrobacter, Enterobacter cloacae, Streptococcus pyogenes, Streptococcus agalactiae, Staphylococcus aureus, Escherichia coli, Candida albicans, Helicobacter pylori, Mycobacterium tuberculosis, Trichophytontonsuransand Bacillus subtilis. It also blocks reproduction of HIV and Herpes viruses. It modulates several aspects of the immune system, boosting monocyte and macrophage activity and blocking leukotriene and prostaglandin production; it also enhances angiogenesis. Animal data:Animal studies generally support the efficacy of aloe in treating experimentally-induced wounds, frostbite, burns, and gastric ulcers. Multiple animal studies have demonstrated antineoplastic and immune modulating effects of acemannan extracted from aloe gel. Aloe's anthraquinones are potent cathartics; they had no abortifacient effects in rats. Human data: In most human studies, aloe vera gel has been an effective topical vulnerary for abrasions, burns and frostbite. In one double blind, placebo controlled study among adults with psoriasis, treatment with an aloe extract cream was markedly helpful. Pilot studies suggest it may be helpful in patients with duodenal ulcers. More studies are needed to determine its effectiveness as an adjunctive therapy for HIV and cancer. Aloe's leaf lining has proven an effective laxative, but it has severe side effects including cramping and diarrhea. TOXICITYANDSIDEEFFECTS:Side effects: External use:No reported toxicity. Allergic reactions are rare. Internal use:Aloe gel appears safe. Anthraquinones in the leaf liningcan cause severe diarrhea and intestinal cramping. Chronic internal use of anthraquinones can lead to Kathi J. Kemper, MD, MPH Aloe Vera Clinical Information Summary Page 2 Longwood Herbal Task Force: http://www.mcp.edu/herbal/default.htmRevised July 29, 1999 (continued) 
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potassium loss, dehydration, pseudomelanosis coli and intestinal dependence on laxatives. Interactions with other medications: External use:None known Internal use:The leaf lining (laxative) may reduce absorption of drugs due to decreased bowel transit time, may increase potassium loss in patients taking corticosteroids or thiazide diuretics, and may potentiate digitalisand other cardiac glycosides due to low potassium levels. Mucilage in the gel may interfere with the absorption of other oral medications taken concurrently. Contraindications: External use: None known Internal use: Contraindicated in intestinal obstruction, intestinal inflammation (eg. Crohn's disease, ulcerative colitis), appendicitis and abdominal pain of unknown origin. Pregnancy and lactation:No clinical studies. Pediatric use:No clinical studies or systematic surveillance. ADDITIONALRESOURCES*HOME: http://www.mcp.edu/herbal/default.htm*Aloe Vera Complete Monograph: http://www.mcp.edu/herbal/aloe/aloe.pdf*Aloe Vera Patient Fact Sheet: http://www.mcp.edu/herbal/aloe/aloe.ph.pdf*University of Texas Center for Alternative Medicine Research in Cancer: http://www.sph.uth.tmc.edu/utcam/summary/aloe.htmKathi J. Kemper, MD, MPH Aloe Vera Clinical Information Summary Page 3 Longwood Herbal Task Force: http://www.mcp.edu/herbal/default.htmRevised July 29, 1999 

Aloe vera

Aloe vera contains a potent antiviral immune stimulant polysaccharide called acemannan. Acemannan has been proved to work against many viruses including HIV, influenza, and measles. Acemannan improves the effect of AZT to decrease the amount of AZT needed and decrease toxic side effects and cost. Some acemannan clinical tests with AIDS patients have shown immune system improvement and longevity increases while others have not.

Acemannan (Carrisyn)

The potentially active ingredient in aloe vera juice. A few studies have suggested that acemannan has activity against HIV and also up-regulates cell-mediated immunity.

We suspect millions of people would swear by their own experience that applying aloe to the skin can drastically reduce the time it takes for burns (including sunburn) to heal. However, aloe appears to be ineffective for treating sunburn and may actually be detrimental for second degree burns.^1,2

Studies in animals suggest that topical aloe gel may improve wound healing.^3,4,5 However, one report suggests that aloe can actually impair the healing of severe wounds.⁶ Aloe has also failed to prove effective for protecting the skin during radiation therapy.⁷

There is actually better evidence (although still imperfect) for three lesser-known uses of topical aloe: genital herpes, psoriasis, and seborrhea.

Intriguing evidence suggests that aloe gel taken orally might be helpful for type 2 diabetes.^8,9

Oral Aloe vera is also sometimes recommended to treat AIDS, asthma, stomach ulcers, and general immune weakness. While the evidence for benefit in these conditions is slight to nonexistent, one of the constituents of aloe, acemannan, does seem to possess numerous interesting effects. Test tube and animal studies suggest that it may stimulate immunity and inhibit the growth of viruses.^10,11,12 However, it remains to be discovered whether this preliminary research will translate into actual benefits in human beings. Aloe vera is definitely not a proven treatment for any of these conditions.

Genital Herpes

A 2-week double-blind placebo-controlled trial enrolled 60 men with active genital herpes.¹³ Participants applied aloe cream (0.5% aloe) or placebo cream 3 times daily for 5 days. Use of aloe cream reduced the time necessary for lesions to heal (4.9 days versus 12 days), and also increased the percentage of individuals who were fully healed by the end of 2 weeks (66.7% versus 6.7%).

A previous double-blind placebo-controlled study by the same author enrolling 120 men with genital herpes found that aloe cream was more effective than pure aloe gel or placebo.¹⁴

Inactivation of enveloped viruses by anthraquinones extracted from plants.

Sydiskis RJ, Owen DG, Lohr JL, Rosler KH, Blomster RN. Department of Microbiology, University of Maryland, Baltimore 21201.

To determine the extent of antiviral activity present in a number of plant extracts, hot glycerin extracts were prepared from Rheum officinale, Aloe barbadensis, Rhamnus frangula, Rhamnus purshianus, and Cassia angustifolia and their virucidal effects were tested against herpes simplex virus type 1. All the plant extracts inactivated the virus. The active components in these plants were separated by thin-layer chromatography and identified as anthraquinones. A purified sample of aloe emodin was prepared from aloin, and its effects on the infectivity of herpes simplex virus type 1 and type 2, varicella-zoster virus, pseudorabies virus, influenza virus, adenovirus, and rhinovirus were tested by mixing virus with dilutions of aloe emodin for 15 min at 37 degrees C, immediately diluting the sample, and assaying the amount of infectious virus remaining in the sample. The results showed that aloe emodin inactivated all of the viruses tested except adenovirus and rhinovirus. Electron microscopic examination of anthraquinone-treated herpes simplex virus demonstrated that the envelopes were partially disrupted. These results show that anthraquinones extracted from a variety of plants are directly virucidal to enveloped viruses. PMID: 1810179

Introduction
The immune system is a complex network of soluble factors, cells, and tissues that can recognize and respond to a wide range of potentially harmful agents. The function of the immune system is to protect the body from damage caused by invading organisms including bacteria, viruses, fungi, parasites, and environmental toxins. On initial exposure to an antigen (e.g., virus), the immune system mounts a two-step response. First, a nonspecific inflammatory response isolates the virus and, with the assistance of antigen-specific immune cells, destroys it. Secondly, specialized memory cells function to "remember" the invader and produce cells and circulating antibodies that will respond more rapidly with subsequent exposure to the same virus.1,2 However, dysregulation of the immune system may cause autoimmune disorders, such as rheumatoid arthritis, or hypersensitivity disorders including allergic rhinitis and certain types of asthma,1 and suppression of the normal immune response may contribute to the development of certain types of cancer.1 Thus, a properly functioning immune system is essential for optimal health.

Aloe (Aloe vera, A. barbadensis): A familiar plant long used topically for burn and wound healing, aloe is an excellent antiulcer and vulnerary.^20,21 Herpes sufferers can apply aloe topically to lesions and also take it internally for its antiviral effect.²² Recent research has identified several immune-stimulating compounds in the pulpy gel of the aloe plant.²³ Acemannan, a long-chain polysaccharide, has been noted to have immune activity useful in combating viral infections.²⁴ Acemannan, like other immune-enhancing polysaccharides, has been shown to increase white blood cell counts and promote the cells' phagocytic abilities, produce interferon and fight viruses. Those with chronic viral infections might consider drinking 1-2 ounces of aloe juice mixed with fruit juice each day. The amount of aloe vera juice can be increased as needed, up to a pint or more per day. Research involving acemannan and the AIDS virus has shown that drinking one-half to 1 liter of aloe juice per day may enhance the effects of the pharmaceutical drug AZT and allow AIDS patients to decrease their dosage.²⁵ [For more on aloe usage, see story on
page 16.]

22 Singer JA. Randomized placebo-controlled trial of oral acemannan as an adjunctive to antiretroviral therapy. Int Conf AIDS 1993;9(1):494.

Aloe (Aloe vera, A. barbadensis): A familiar plant long used topically for burn and wound healing, aloe is an excellent antiulcer and vulnerary.20,21 Herpes sufferers can apply aloe topically to lesions and also take it internally for its antiviral effect.22 Recent research has identified several immune-stimulating compounds in the pulpy gel of the aloe plant.23 Acemannan, a long-chain polysaccharide, has been noted to have immune activity useful in combating viral infections.24 Acemannan, like other immune-enhancing polysaccharides, has been shown to increase white blood cell counts and promote the cells' phagocytic abilities, produce interferon and fight viruses. Those with chronic viral infections might consider drinking 1-2 ounces of aloe juice mixed with fruit juice each day. The amount of aloe vera juice can be increased as needed, up to a pint or more per day. Research involving acemannan and the AIDS virus has shown that drinking one-half to 1 liter of aloe juice per day may enhance the effects of the pharmaceutical drug AZT and allow AIDS patients to decrease their dosage.25 [For more on aloe usage, see story on 
page 16.] 

To determine the antiviral activity present in some plant extracts, Sydiskis et al.¹⁶ tested extracts from Aloe barbadensis among other plants. The active components in these plants were identified as anthraquinones. Anthraquinones are compounds found in the sap of aloe and include aloe emodin and aloin. The researchers used a purified sample of aloe emodin prepared from aloin, and tested its effects on the infectivity of herpes simplex virus type 1 and type 2, varicella-zoster virus, pseudorabies virus, influenza virus, adenovirus, and rhinovirus. The results showed that aloe emodin inactivated all of the viruses tested except adenovirus and rhinovirus. Microscopic examination of the anthraquinone-treated herpes simplex virus demonstrated that the envelopes were partially disrupted. The researchers concluded from these results that "anthraquinones extracted from a variety of plants are directly virucidal to enveloped viruses." In other words, the active components of Aloe vera have antiviral activity.

-Sydiskis R J et al

Title: Inactivation of enveloped viruses by anthraquinones extracted from plants.

ABSTRACT