Senna

Efficacy rating:

ÒÒÒ...Positive clinical trials

Safety rating:

What is Senna?

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C. acutifolia is native to Egypt and the Sudan while C. angustifolia is native to Somalia and Arabia. Plants known as “wild sennas” (C. hebecarpa and C. marilandica) grow on moist banks and woods in the eastern US. This plant should not be confused with “cassia,” a common name for cinnamon. The top parts are harvested, dried, and graded. The hand-collected senna is known as Tinnevally senna. Leaves that have been harvested and graded mechanically are known as Alexandria senna. There are more than 400 known species of cassia.

What is Senna used for?

Senna first was used medicinally by Arabian physicians as far back as the 9th century AD. It has long found use in traditional Arabic and European medicine as well, primarily as a cathartic. The leaves have been brewed and the tea administered for its strong laxative effect. Because it often is difficult to control the concentration of the active ingredients in the tea, an unpredictable effect may be obtained. Therefore, standardized commercial dosage forms have been developed, and these concentrates are available as liquids, powders, and tablets in OTC laxatives. The plant derives its name from the Arabic “sena” and from the Hebrew word “cassia,” which means “peeled back,” a reference to its peelable bark.

Senna contains anthraquinones and sennosides, as well as other active ingredients that all appear to contribute to the laxative effect. Senna is most commonly used as a laxative with clinical evidence to support this use.

What is the dosage of Senna?

Senna leaves or pods have been used as a cathartic laxative at doses of 0.6 to 2 g/day, with a daily dose of sennoside B from 20 to 30 mg. Senna should not be used at higher doses or for extended periods of time.

Is Senna safe?

Patients with intestinal obstruction.

Documented endometrial stimulation and mutagenic and genotoxic. Avoid use.

None well documented.

The chronic use of senna has resulted in pigmentation of the colon, reversible finger clubbing, cachexia (a weight loss condition occurring in people with advanced illness), and a dependency on the laxative.

Various case reports of senna toxicity are available, and include coma and neuropathy after ingestion of a senna-combination laxative as well as hepatitis after chronic use of the plant.

References

Copyright © 2006 Wolters Kluwer Health

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