encyclopedia

Senna Leaf

Scientific Names:
Cassia angustifolia VAHL [Fam. Caesalpiniaceae

Forms:
Senna leaf tea; Liquid or dry extract of senna leaf

Traditional Usage:
– Anal fissures

– Anti-diarrheal

– Antinflammatory

– Cellular Regeneration

– Cleansing

– Constipation

– Detoxifying

– Hemorrhoids

– Laxative

– Pre and Post Operative Cleansing

Overview:
The leaves of senna, Cassia angustifolia VAHL [Fam. Caesalpiniaceae], have been used traditionally as a laxative for centuries. The sweetish bitter tea is rich in sennosides and anthraquinones glycosides, including aloe-emodin and rhein (similar to Turkish rhubarb root) and functions as a safe and effective laxative. The German Pharmacopoeia recommends senna leaf against general and acute constipation, for emptying the bowels before X-rays, before and after abdominal operations and for all disorders in which defecation with a soft stool is desired, e.g. anal fissures, hemorrhoids and after rectal operations. The active glycosides are hydrolyzed in the gut into their aglycones at least in part by the action of bacterial enzymes; by influencing the water and electrolyte transport in the colon, these aglycones are responsible for the laxative action. Emodin at different concentrations has many therapeutic benefits including: anti-inflammatory at 15mg/kg; antiseptic; antispasmodic; antiulcer, cathartic; vasorelaxant and viricidal. Anthraquinones are also cytotoxic and stimulate cellular regeneration, detoxification and cleansing. Chronic use of sennoside laxatives, however, often causes pseudomelanosis coli and therefore should be avoided. A recent study suggested that pseudomelanosis coli is associated with an increased risk of abnormal colorectal growths.

Active Ingredients:
Senna leaf contains: Approximately 3% dianthrone glycosides (sennosides A, A1, B, C, D, E, F & G ); and small amounts of anthraquinones including aloe-emodin and rhein 8-glucoside; approximately 10% mucilage; tannins; and flavonoids.

Suggested Amount:
Unless otherwise prescribed: The finely chopped or powdered leaf, or powdered dry extract is used for making an infusion or decoction. Hot water (approximately 150ml) is poured over 0.5-2 g of finely chopped senna leaf and after 10-15 minutes passed through a strainer. For constipation, a cup of the freshly prepared infusion is drunk in the morning and/or at night before going to bed. The average daily dosage as a laxative contains 20-60mg hydroxyanthracene.

Drug Interactions:

In large dosages, the anthraquinones-type laxative compounds may increase the action of other laxatives and should not be taken at the same time. With chronic use/abuse, a potassium deficiency may develop that may potentiate the effects of cardiotonic glycosides.

Contraindications:
Laxatives are contraindicated in the case of impacted bowel (serious bowel obstruction) or ileus of any origin (danger of intestinal rupture). Stimulant laxatives are also not recommended for the treatment of chronic constipation. Senna leaf should also not be taken during pregnancy due to reflex stimulation of the uterus or during lactation because a proportion of the active aglycones reach the mother’s milk.

Side Effects:

If used as prescribed, there may be a harmless reddening of the urine. Overdose can lead to painful stomach cramps and diarrhea. Like all other anthracene-glycoside laxatives, senna leaf should not be used continuously over a prolonged period as this disturbs the water and electrolyte balance of the body. An increased loss of water and salts, especially potassium salts, may occur and ultimately a dangerous electrolyte imbalance can develop that can be fatal if it persists. Large doses of senna leaf tea may cause gastric disturbance, nausea and diarrhea due to anthraquinones-type laxative compounds. Chronic use of sennoside laxatives often causes pseudomelanosis coli and therefore should be avoided for this reason as well. A recent study suggested that pseudomelanosis coli is associated with an increased colorectal cancer risk.

References:

Dreessen M, Eyssen H, and Lemli J. 1981. The metabolism of sennosides A and B by the intestinal microflora: in vitro and in vivo studies on rat and mouse. J Pharm Pharmacol 33: 678-681.

Driscoll JS, Hazard JrHB, Wood Jr, and Goldin A. 1974. Structure-antitumor activity relationships among quinone derivatives. Cancer Chem Rep, Part 2 4: 1-27.

van Gorkom BA, Karrenbeld A, van Der Sluis T, Koudstaal J, de Vries EG, Kleibeuker JH. 2000. Influence of a highly purified senna extract on colonic epithelium. Digestion. 2000; 61(2): 113-20.

Wichtl M (ed). 1994. Sennae folium – Senna Leaf (English translation by Norman Grainger Bisset). In Herbal Drugs and Phytopharmaceuticals. CRC Press, Stuttgart, pp. 463-466.

Yagi T, Yamauchi K, and Kuwano S. 1997. The synergistic purgative action of aloe-emodin anthrone and rhein anthrone in mice: synergism in large intestinal propulsion and water secretion. J Pharm Pharmacol 49: 22-25.