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Senna

Medically reviewed on Jun 7, 2018

What is Senna?

See also: Amitiza

C. acutifolia is native to Egypt and the Sudan while C. angustifolia is native to Somalia, the Middle East, and India. The top parts are harvested, dried, and graded. Wild sennas grow on moist banks and woods in the eastern US. Cassia is also a common name for cinnamon, but that is a different plant. Senna is a low-branching shrub and has a straight, woody stem and yellow flowers. There are more than 400 known species of Cassia.

Scientific Name(s)

Cassia acutifolia with Cassia senna. Also Cassia angustifolia.

Common Name(s)

Senna

What is it used for?

Traditional/Ethnobotanical uses

Senna first was used by Arabian physicians in the 9th century AD. 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. It has long been used in traditional Arabic and European medicine, primarily as a laxative. The leaves have been brewed and the tea used for its strong laxative effect. Because it often is difficult to control the amount of active ingredients in the tea, the effect can be unpredictable. Therefore, standardized commercial dosage forms have been developed and are available as liquids, powders, and tablets in over-the-counter laxatives.

General uses

Senna is most commonly used as a laxative.

What is the recommended dosage?

Senna leaves or pods have been used as a laxative at doses of 0.6 to 2 g/day, with a daily dose of sennoside B from 20 to 30 mg. A bitter tea can be made containing senna 0.5 to 2 g (ie, ½ to 1 teaspoon). Senna should not be used at higher doses or for long periods of time.

Contraindications

Senna should not be used in patients with bowel obstruction, ulcerative colitis, appendicitis, or Crohn disease. Senna is not recommended for children younger than 2 years of age.

Pregnancy/Lactation

There is some information that suggests senna can affect the womb or cause genetic problems. No effects on stools in infants or on lactation have ben reported with short-term use during lactation, although small amounts of senna do cross into breast milk.

Interactions

Use of senna with drugs that reduce potassium should be avoided.

Side Effects

Senna may cause diarrhea, loss of fluids, high blood potassium, and stomach pain or cramping. The long-term use of senna has resulted in coloration of the colon, reversible finger clubbing, wasting, and laxative dependence. Children, particularly those wearing diapers, may experience severe diaper rash, blister formation, and skin sloughing.

Toxicology

Case reports of senna toxicity include coma and nerve damage after use of a senna-combination laxative, as well as liver damage after long-term use of the plant.

References

1. Senna. Review of Natural Products. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; October 2013.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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