* Please Note: This information is based partly on Traditional Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
Description
Name
Senna alexandrina Miller, or Cassia senna L. [C. Acutifolia Delile], (Fabaceae), commonly called Senna, but also Alexandrian Senna Pods, Khartoum senna, and Tinnevelly senna. In German it is Sennesfrüchte.
Source
Senna is prepared from the dried leaves or fruits from either Cassia senna or C. Angustifolia. Cassia senna is a small shrub that grows in Somalia and on the Arabian peninsula. C. Angustifolia is native to India and Pakistan, but is now grown commercially in California. Senna pods are sold separately from leaves and fetch a greater price. Both parts of the plant contain the same active ingredients, but more of the active ingredient is contained in the pods than in the leaves.
History
Senna has been in use at least since the ninth century, when Arabian physicians first began treating constipation with preparations made from Senna leaves and the pods.
Traditional Claims
Senna is used as a laxative.
Commission E Recommendations
Laxative.
Proven Effects
Like aloe, senna contains molecules called anthroquinones (Sennoside A and Sennoside B). In their natural state, when still in the plant, these molecules are tightly bound to a sugar molecule. The presence of the sugar molecule makes the complex inert, and prevents the molecule from being absorbed in the stomach and small intestine. But when the anthraquinone-sugar complex finally gets to the large intestine, bacteria in the gut remove the sugar molecule. Once that happens, the unbound anthraquinone (now called rheinanthrone) reacts with cells on the wall of the large intestine causing the cells to transport water and electrolytes into the intestinal tract.
The latest data suggest that the senna works by increasing production of nitric oxide, a local neurotransmitter within the intestinal wall.Whatever the molecular mechanism, the resulting increase in volume stimulates the walls of the colon, causing it to contract. Bowel movements usually occur 6-10 hours after aloe or senna are taken.
Dosage
Ground leaves can be taken in capsules, but whatever form of the drug that is used, it should state the anthrone content. The average daily dose is between 10 and 60 milligrams. Tea can be made from Tinnevelly senna fruit, or senna leaf, by adding one level teaspoonful of product to boiling water, letting it steep for 10 minutes, and then pouring it through a strainer before drinking.
References
Brusick D, Mengs U. Assessment of the genotoxic risk from laxative senna products. Environ Mol Mutagen 1997;29(1):1-9.
de Witte P, Lemli L. The metabolism of anthranoid laxatives. Hepatogastroenterology 1990;37(6):601-5.
Franz G. The senna drug and its chemistry. Pharmacology 1 993;4 7 Suppi 1:2-6.
Izzo AA, Sautebin L, Rombola L, Capasso E The role of constitutive and inducible nitric oxide synthase in senna- and cascara-induced diarrhoea in the rat. EurJ Pharmacol 1997;323(1):93-7.
Mereto E, Ghia M, Brambilla G. Evaluation of the potential carcinogenic activity of Senna and Cascara glycosides for the rat colon. Cancer Lett 1996;101(1):79-83.
Morton J. The detection of laxative abuse. Ann Clin Biochem 1987;24(Pt 1):107-8.
Siegers CP, von Hertzberg-Lottin E, Otte M, Schneider B. Anthranoid laxative abuse-a risk for colorectal cancer? Gut 1993;34(8):1099-101.
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Directions
Take 1 capsule, 3 times daily, with meals.
Cautions
Concerns
Senna does not produce nearly as much cramping as aloe, and not nearly as much of the active ingredients are absorbed into the bloodstream. For that reason,senna does not change the color of the urine. Still, some is absorbed, and small amounts still might appear in mother's milk, so nursing mothers should use another product.
The biggest cause for concern is that long-term exposure, at least in laboratory animals, caused tumors of the colon, liver, and kidneys. Worse still, epidemiologic studies of long-term users suggest that they do, in fact, develop colon cancer at a higher rate than the general population. The colon cancer rate for individuals who develop melanosis coli (see below) is even higher.
Warnings
Chronic use of any laxative can deplete the body of potassium, and low levels of potassium can cause dangerous irregularities in the way the heart beats. Chronic use can result in a benign condition called melanosis coli. Brownish pigment accumulates in the wall of the large intestine, where it apparently does no harm, although doctors consider it a marker for laxative abuse. Even though the pigment disappears if senna is discontinued, chronic senna users appear to develop bowel cancer at a higher rate than the rest of the community. Virtually every scientific body that has reviewed the problem recommends that none of the anthrone-containing laxatives be used for more than 10 days.
Drug Testing
Using senna will not change the color of urine and will not interfere with standard workplace urine tests.
Additional Information
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These statements have not been evaluated by the Food and Drug Administration (FDA). Products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor. The essence of the current American rule on Traditional Uses is, as stated by FTC, "Claims based on historical or traditional use should be substantiated by confirming scientific evidence, or should be presented in such a way that consumers understand that the sole basis for the claim is a history of use of the product for a particular purpose."
