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Nutritional Supplement

Senna

Also indexed as:Cassia angustifolia, Cassia senna

  • Digestive Support

    Constipation

    Senna is considered a stimulant laxative because it stimulates bowel muscle contractions. Senna is the most popular of these stimulant herbs.
    Constipation
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    Senna contains hydroxyanthracene glycosides known as sennosides. These glycosides stimulate colon activity and thus have a laxative effect. Also, these glycosides increase fluid secretion by the colon, with the effect of softening the stool and increasing its bulk.1 Double-blind trials have confirmed the benefit of senna in treating constipation.6,7Constipation induced by drugs such as the anti-diarrhea medicine loperamide (Imodium) has also been shown to be improved by senna in a clinical trial.8

    The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating.

    Bulk-forming laxatives come from plants with a high fiber and mucilage content that expand when they come in contact with water; examples include psyllium, flaxseed, and fenugreek. As the volume in the bowel increases, a reflex muscular contraction occurs, stimulating a bowel movement. These mild laxatives are best suited for long-term use in people with constipation.

    Many doctors recommend taking 7.5 grams of psyllium seeds or 5 grams of psyllium husks, mixed with water or juice, one to two times per day. Some doctors use a combination of senna (18%) and psyllium (82%) for the treatment of chronic constipation. This has been shown to work effectively for people in nursing homes with chronic constipation.9

    Stimulant laxatives are high in anthraquinone glycosides, which stimulate bowel muscle contraction. The most frequently used stimulant laxatives are senna leaves, cascara bark, and aloe latex. While senna is the most popular, cascara has a somewhat milder action. Aloe is very potent and should be used with caution. Other stimulant laxatives include buckthorn, alder buckthorn (Rhamnus frangula), and rhubarb (Rheum officinale, R. palmatum).

    Bowel Surgery

    A double-blind trial found that senna may be an effective treatment for preparing the bowel for colon and rectal surgery, though people undergoing surgery should ask their doctor before using supplements.
    Bowel Surgery
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    A double-blind trial found senna an effective treatment for preparing the bowel for colon and rectal surgery.10 A double-blind trial showed that senna was more effective as a preparatory agent for bowel surgery than the commonly used polyethylene glycol (PEG). Patients scheduled to undergo bowel surgery received either 120 mg of senna in a glass of water or 118 mg of PEG in about 2–3 quarts of water the night before surgery. Surgeons rated the efficacy of senna at clearing the bowels at 70%, compared to 58% efficacy for PEG. Supplementation with senna for this purpose should always be supervised by the surgeon. 
What Are Star Ratings?
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Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

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Traditional Use (May Not Be Supported by Scientific Studies)

People in northern Africa and southwestern Asia have used senna as a laxative for centuries. It was considered a “cleansing” herb because of its cathartic effect. In addition, the leaves were sometimes made into a paste and applied to various skin diseases. Ringworm and acne were both treated in this way.

References

1. Leng-Peschlow E. Dual effect of orally administered sennosides on large intestinal transit and fluid absorption in the rat. J Pharm Pharmacol 1986;38:606-10.

2. Passmore AP, Davies KW, Flanagan PG, et al. A comparison of Agiolax and Lactulose in elderly patients with chronic constipation. Pharmacol 1993;47(suppl 1):249-52.

3. Kinnunen O, Winblad I, Koistinen P, Salokannel J. Safety and efficacy of a bulk laxative containing senna versus lactulose in the treatment of chronic constipation in geriatric patients. Pharmacol 1993;47(suppl 1):253-5.

4. Ewe K, Ueberschaer B, Press AG. Influence of senna, fibre, and fibre+senna on colonic transit in loperamide-induced constipation. Pharmacol 1993;47(suppl 1):242-8.

5. Valverde A, Hay JM, Fingerhut A, et al. Senna vs polyethylene glycol for mechanical preparation the evening before elective colonic or rectal resection: a multicenter controlled trial. French Association for Surgical Research. Arch Surg 1999;134:514-9.

6. Passmore AP, Davies KW, Flanagan PG, et al. A comparison of Agiolax and Lactulose in elderly patients with chronic constipation. Pharmacol 1993;47(suppl 1):249-52.

7. Kinnunen O, Winblad I, Koistinen P, Salokannel J. Safety and efficacy of a bulk laxative containing senna versus lactulose in the treatment of chronic constipation in geriatric patients. Pharmacol 1993;47(suppl 1):253-5.

8. Ewe K, Ueberschaer B, Press AG. Influence of senna, fibre, and fibre+senna on colonic transit in loperamide-induced constipation. Pharmacol 1993;47(suppl 1):242-8.

9. Passmore AP, Wilson-Davies K, Flanagan PG, et al. Chronic constipation in long stay elderly patients: a comparison of lactulose and senna-fiber combination. BMJ 1993; 307:769-71.

10. Valverde A, Hay JM, Fingerhut A, et al. Senna vs polyethylene glycol for mechanical preparation the evening before elective colonic or rectal resection: a multicenter controlled trial. French Association for Surgical Research. Arch Surg 1999;134:514-9.

11. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. Montvale, NJ: Medical Economics, 1998, 722-4.

12. Mengs U. Reproductive toxicological investigations with sennosides. Arzneimittelforschung 1986;36:1355-8.

13. Faber P, Strenge-Hesse A. Relevance of rhein excretion into breast milk. Pharmacol 1988;36(suppl 1):212-20.

14. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 204-8.

15. Vanderperren B, Rizzo M, Angenot L, et al. Acute liver failure with renal impairment related to the abuse of senna anthraquinone glycosides. Ann Pharmacother 2005;39:1353-7.

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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2025.