Senna

What Is Senna?

Senna can be found all over the tropics. Although they are usually different species, the uses are almost always the same. The leaves and seed pods have powerful purgative and laxative actions, which have been used to treat constipation, infection, and in traditional Chinese medicine for conditions involving too much heat.

The uses of this herb are somewhat limited, and it’s no longer used for purging the body as it was in the past. This action is uncomfortable and can be dangerous if misused.

Now Senna is almost exclusively used for treating constipation short term. Long term use is not recommended under any circumstance.

What Is Senna Used For?

Senna is primarily used to treat constipation.

Traditional Uses

Senna is indigenous to many different countries, and for the most part each individual country’s native species have all been used for much the same purposes ^{4Reference 4A Modern Herbal · 1931A Modern Herbal. (1931). Senna. Retrieved from http://www.botanical.com/botanical/mgmh/s/senna-42.htmlView study →}. Most of senna’s traditional usage involves its laxative action, as described in various ways. In traditional Chinese medicine, it’s described as downward draining, and purges heat ^{7Reference 7Hempen et al. · 2009A Materia Medica for Chinese Medicine, Churchill Livingstone, Edinburgh}.

Senna is also a valuable medicinal plant for constipation in the Ayurvedic traditional medical system ^{11Reference 11Das PN et al. · 2003A handbook of medicinal plants}.

Ellingwood suggested senna for the treatment of temporary constipation ^{5Reference 5Hoffmann · 2003Medical herbalism: The science and practice of herbal medicine}.

Traditional Chinese Medicine

(Leaves used)

Pinyin: Fan Xie Ye

Taste: Sweet and bitter ^{2,3,7Reference 2Yang et al. · 2013Introduction to chinese materia medica (3rd ed.). (Pg 158-160)Reference 3Wu · 2005An illustrated Chinese materia medicaReference 7Hempen et al. · 2009A Materia Medica for Chinese Medicine, Churchill Livingstone, Edinburgh}

Energy: Cold ^{2,3,7Reference 2Yang et al. · 2013Introduction to chinese materia medica (3rd ed.). (Pg 158-160)Reference 3Wu · 2005An illustrated Chinese materia medicaReference 7Hempen et al. · 2009A Materia Medica for Chinese Medicine, Churchill Livingstone, Edinburgh}

Channel: Large intestine ^{3,7Reference 3Wu · 2005An illustrated Chinese materia medicaReference 7Hempen et al. · 2009A Materia Medica for Chinese Medicine, Churchill Livingstone, Edinburgh}

Actions: Purging (aggressive), drains heat, removes stagnation, promotes defecation and urination, relaxes the bowels. This herb drains downwards. ^{2,3,7Reference 2Yang et al. · 2013Introduction to chinese materia medica (3rd ed.). (Pg 158-160)Reference 3Wu · 2005An illustrated Chinese materia medicaReference 7Hempen et al. · 2009A Materia Medica for Chinese Medicine, Churchill Livingstone, Edinburgh}.

Indications: Heat accumulation and binding, constipation with abdominal pain, edema, fullness, distention ^{2,7Reference 2Yang et al. · 2013Introduction to chinese materia medica (3rd ed.). (Pg 158-160)Reference 7Hempen et al. · 2009A Materia Medica for Chinese Medicine, Churchill Livingstone, Edinburgh}.

Combinations:

1. To break up stagnation: Zhi shi + huo po ^{7Reference 7Hempen et al. · 2009A Materia Medica for Chinese Medicine, Churchill Livingstone, Edinburgh}.
2. Constipation due to heat accumulation in the intestines: huo xiang + mu xiang ^{7Reference 7Hempen et al. · 2009A Materia Medica for Chinese Medicine, Churchill Livingstone, Edinburgh}.

Botanical Information

Senna is a member of the Leguminosae family, which is the third largest family of flowering plants, containing roughly 19,000 species and 751 genera.

The Cassia genera contains between 250 and 350 different species (a lot of debate about the actual number).

Harvesting, Collection & Preparation

Senna comes in a variety of species, but all are used for the same general purposes. The preferred species for medicinal benefit however, is Cassia acutifolia ^{4Reference 4A Modern Herbal · 1931A Modern Herbal. (1931). Senna. Retrieved from http://www.botanical.com/botanical/mgmh/s/senna-42.htmlView study →}. The leaves and pods are commonly used with all of these species. The leaves are more powerful, however the pods are much less griping. The griping action is suggested to be mainly caused by the resin content of the leaves.

Alcohol and water combination is best used to extract the medicinal constituents of both senna pods and leaves rather than just one or the other ^{4Reference 4A Modern Herbal · 1931A Modern Herbal. (1931). Senna. Retrieved from http://www.botanical.com/botanical/mgmh/s/senna-42.htmlView study →}.

Phytochemistry

Senna’s purgative action is the work of its dianthrone anthraquinone glycosides — collectively the sennosides. The two principal markers are sennoside A and sennoside B, a pair of optical isomers built from two molecules of rhein anthrone; sennosides C and D (rhein–aloe-emodin heterodianthrones) occur in smaller amounts. These glycosides pass intact to the colon, where bacterial enzymes liberate the active rhein-anthrone that stimulates peristalsis ^{1,8Reference 1Barnes et al. · 2007Herbal medicines (3rd ed.)Reference 8Vitalone et al. · 2011In vitroCassia angustifolia Extract Is Not Hepatotoxic in an in vitro and in vivo StudyView study →}. Pharmacopoeial material is standardised to not less than ~2.5% total hydroxyanthracene glycosides (calculated as sennoside B), with leaves typically carrying ~2–3% and pods ~3–4% ^{12Reference 12European Medicines Agency · 2018Assessment report on Cassia senna L. and Cassia angustifolia Vahl, folium and fructus}.

Senna also contains a class of naphthalene glycosides that serve as a botanical fingerprint: tinnevellin glycoside † marks Indian (Tinnevelly) senna, while 6-hydroxymusizin glycoside characterises Alexandrian senna — the two are used to tell the commercial varieties apart ^{13Reference 13Lemli et al. · 1981Naphthalene glycosides in Cassia senna and Cassia angustifoliaView study →}. Yellow flavonol pigments, chiefly kaempferol and its glycosides, round out the leaf chemistry ^{13Reference 13Lemli et al. · 1981Naphthalene glycosides in Cassia senna and Cassia angustifoliaView study →}.

Constituent Summary

Figures are share of dried leaf or pod (total hydroxyanthracene glycosides, expressed as sennoside B); content varies with species, plant part, and harvest. † Tinnevellin glycoside is a chemotaxonomic marker distinguishing Indian (Tinnevelly) senna from Alexandrian senna. Browse a class to see related compounds, or any compound for its full profile.

Pharmacology & Medical Research

Purgative (Cathartic)

The purgative action of senna is reported to act mainly on the lower bowel, through an increase in bulking and increasing peristalsis ^{4,5,7Reference 4A Modern Herbal · 1931A Modern Herbal. (1931). Senna. Retrieved from http://www.botanical.com/botanical/mgmh/s/senna-42.htmlView study →Reference 5Hoffmann · 2003Medical herbalism: The science and practice of herbal medicineReference 7Hempen et al. · 2009A Materia Medica for Chinese Medicine, Churchill Livingstone, Edinburgh}.

The majority of senna’s laxative actions are from its sennoside content. It works through a release of endogenous substances in the colon, such as autacoids, and nitric oxide. Sennosides also alter the absorption and secretion of water and electrolytes into the lumen of the colon. ^{8,9Reference 8Vitalone et al. · 2011In vitroCassia angustifolia Extract Is Not Hepatotoxic in an in vitro and in vivo StudyView study →Reference 9Capasso F et al. · 1983AnimalEffect of indomethacin on aloin and 1,8 dioxianthraquinone-induced production of prostaglandins in rat isolated colon}.

Clinical Applications

Senna is a reliable laxative. It’s purgative in higher doses, however, this action is no longer used in modern herbal medicine. Topically, senna is useful for treating wounds and skin irritations.

Cautions & Safety

Never take senna for more than 10 days at a time.

Be very careful about the list of contraindications with this herb (see above).

Senna may turn the urine red during use.

Contraindications

• Intestinal obstruction
• Abdominal pain of unknown origin
• Inflammatory bowel disease
• Stomach inflammation due to griping
• Appendicitis
• Colitis
• Irritable bowel syndrome
• Ulcerative colitis
• Crohn’s disease
• Pregnancy and lactation
• Haemorrhoids
• Prolapsus
• Chronic constipation (because it can lead to dependency issues)

Synergy

Senna may have synergistic effects with carminatives in order to combat the negative side effect of griping pain and nausea. Some good herbs to combine for this are ginger, cloves, cinnamon or other aromatics.

References

1. Barnes, J., Anderson, L. A., & Phillipson, J. D. (2007). Herbal medicines (3rd ed.). London, United Kingdom: Pharmaceutical Press. (Pg. 537-538).
2. Yang, J., Huang, H., Zhu, Li-Jiang, & Chen, Y. (2013). Introduction to chinese materia medica (3rd ed.). (Pg 158-160).
3. Wu, J. N. (2005). An illustrated Chinese materia medica. New York: Oxford University Press. (Pg. 164-165).
4. A Modern Herbal. (1931). Senna. Retrieved from http://www.botanical.com/botanical/mgmh/s/senna-42.html
5. Hoffmann, D. (2003). Medical herbalism: The science and practice of herbal medicine. Rochester, VT: Healing Arts Press. (Pg. 582-583)
6. Wren RC. (N.D). Potters new Cyclopedia of Botanical Drugs and Preparations, 8th Ed.
7. Hempen, C.H., Fischer, T., (2009). A Materia Medica for Chinese Medicine, Churchill Livingstone, Edinburgh.
8. Vitalone, A., Di Giacomo, S., Di Sotto, A., Franchitto, A., Mammola, C., Mariani, P., Mastrangelo, S., Mazzanti, G. (2011). Cassia angustifolia Extract Is Not Hepatotoxic in an in vitro and in vivo Study. Pharmacology, 88(5-6), 252-259. doi:10.1159/000331858
9. Capasso F, Mascolo N, Autore G, Duraccio MR. (1983). Effect of indomethacin on aloin and 1,8 dioxianthraquinone-induced production of prostaglandins in rat isolated colon. Prostaglandins. 26:557–562.
10. Marazzi, B.; et al. (2006). Phylogenetic relationships within Senna(Leguminosae, Cassiinae) based on three chloroplast DNA regions: patterns in the evolution of floral symmetry and extrafloral nectaries. American Journal of Botany.93 (2): 288–303. doi:10.3732/ajb.93.2.288
11. Das PN, Purohit SS, Sharma AK and Kumar T. (2003). A handbook of medicinal plants. Agrobios, Jodhpur, India, 118.
12. European Medicines Agency, Committee on Herbal Medicinal Products. (2018). Assessment report on Cassia senna L. and Cassia angustifolia Vahl, folium and fructus. EMA/HMPC/. (Leaves/pods not less than 2.5% hydroxyanthracene glycosides, expressed as sennoside B; leaf ~2–3%, pod ~3–4%.)
13. Lemli, J., Toppet, S., Cuveele, J., & Janssen, G. (1981). Naphthalene glycosides in Cassia senna and Cassia angustifolia. Studies in the field of drugs containing anthracene derivatives, Part 32. Planta Medica, 43(1), 11–17. doi:10.1055/s-2007-971465 (Tinnevellin glycoside in Indian/Tinnevelly senna vs 6-hydroxymusizin glycoside in Alexandrian senna; kaempferol flavonols also reported.)