What is Constipation?

Constipation is one of the most common gastrointestinal disorders affecting the
population. It impacts quality of life immensely, with a prevalence in Western countries
ranging from 2% to 27%, and a global estimate of 14%. ^1,2

Constipation can present as passing fewer than three stools a week, with a feeling of
incomplete bowel evacuation. As defined by the Bristol stool chart, people who experience
constipation may describe their stools as type 1, separate hard lumps, or type 2, lumpy
and sausage-like as seen in Figure 1. ^3,4

Figure 1

https://giupdate.com/constipation-bristol-stool-chart ⁵

Symptoms of Constipation Include:

• Less than three stools a week
• Straining and/or pain when passing a bowel motion
• Incomplete evacuation (feeling that you haven’t passed your whole bowel motion)
• Dry stools
• Sensation of anus obstruction⁶

What causes Constipation?

There are many reasons why you may be experiencing constipation, these include lack of
fibre and water, a sedentary lifestyle, medical conditions, certain medications, change of
routine, or age.

Thankfully, there are many supportive diet and lifestyle changes you can make in your life
to support regular bowel motions. These include increasing water and fibre intake,
reducing low GI foods (for example swapping white bread for whole meal), daily exercise,
managing stress, and not ignoring your urge to pass a bowel motion.⁴

Need Additional Help?

Frangula purshiana (Cascara)

Frangula purshiana is commonly known as Cascara and belongs to the buckthorn family
(Rhamnaceae). It is distinctive by its smooth, silver-grey bark and dark green, glossy
leaves, which are oval shaped with deep parallel veins.

The dried stem bark of Cascara has a long history of use in traditional Western Herbal
Medicine as a remedy for constipation. The dried stem bark has been used as a laxative to
promote bowel evacuation, therefore, relieving constipation.

Cascara is as a gentle laxative that helps relieve constipation through certain compounds
called Hydroxyanthracene derivatives, calculated as Cascarosides A, contained within the
stem bark. Cascara exerts a laxative action through stimulating contractions of the bowel,
helping move your stool through the large intestine.^7,8,9

Probiotics

Probiotics are live beneficial bacteria that live within the human gastrointestinal system.
When experiencing constipation, it is important to support friendly intestinal flora as a
healthy balance of gut microbiota plays an important role in maintaining gastrointestinal
system health and gastrointestinal mucosal membrane health while also supporting
healthy gastrointestinal function. Additionally, probiotics help maintain general health and
wellbeing.^10,11

Caruso’s Poo Eze®Probiotic

Caruso’s Poo Eze® Probiotic contains Cascara and probiotics! Our Cascara is
standardised to contain Hydroxyanthracene derivatives calculated as Cascaroside A to
ensure a gentle yet effective action.

Relieves constipation with Cascara:

Traditionally used in Western Herbal Medicine to:

• Increase bowel evacuation
• As a laxative

Contains Probiotics to:

• Maintain intestinal beneficial flora
• Support gastrointestinal system health and healthy gastrointestinal immune function
• Support intestinal health
• Maintains gastrointestinal mucosal membrane health
• Supports general health and wellbeing
  

Always read the label and follow directions for use.

References
1. Song, C., Zhang, Z., Zhu, S., & Tong, H. (2025). Association between the dietary index for gut microbiota and constipation in American adults. Nutrition Journal, 24(98). https://doi.org/10.1186/s12937-025-01164-y
2. He, N., Sheng, K., Li, G., & Zhang, S. (2024). The causal relationship between gut microbiota and constipation: A two‑sample Mendelian randomization study. BMC Gastroenterology, 24(271). https://doi.org/10.1186/s12876-024-03306-8
3. Wald, A. & Rao, S. C. (2025). Etiology and evaluation of chronic constipation in adults. https://www.uptodate.com/contents/search.
4. Diaz, S., Bittar, K., Hashmi, M. F., Mendez, M. D. (2023). Constipation. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK513291/
5. GI Update. (2025). Constipation Bristol stool chart. https://giupdate.com/constipation-bristol-stool-chart
6. Mayo Clinic. (2025). Constipation. Constipation - Symptoms and causes - Mayo Clinic
7. Heath Canada Monographics. (2018). Natural health product cascara sagrada – frangula purshiana.
8. Barnes, J., Anderson, L. A., & Phillipson, J. D. (2007). Herbal Medicines. Pharmaceutical Press.
9. Blumenthal, M., Goldberg, A., Brinckmann, J. (2000). Herbal medicine: Expanded commission E monographs. American Botanical Council.
10.Valdes, A. M., Walter, L., Segal, E., & Spector, T. D. (2018, June 13). Role of the gut microbiota in nutrition and health. BMJ, 361. https://doi.org/10.1136/bmj.k2179
11.Braun L & Cohen M. (2015). Herbs and Natural Supplements an: Evidence-based Guide 4th Ed. Elsevier. pp.771-796.