From the Research
Yes, senna can irritate the small intestine. Senna is a stimulant laxative that works primarily in the colon by increasing intestinal contractions, but it can affect the entire gastrointestinal tract including the small intestine. When taken orally, senna's active compounds (sennosides) are converted by gut bacteria into rhein anthrone, which stimulates intestinal motility and can cause irritation of the intestinal mucosa. This irritation may manifest as abdominal cramping, pain, or diarrhea. For this reason, senna should be used at the lowest effective dose and only for short-term use (typically no more than 1-2 weeks) 1.
Key Considerations
- Common senna preparations include tablets (typically 8.6 mg sennosides per tablet) or tea forms.
- Long-term use can lead to more serious issues including dependency, electrolyte imbalances, and potentially damage to intestinal nerves.
- People with inflammatory bowel conditions, intestinal obstruction, or abdominal pain of unknown origin should avoid senna.
- If constipation is chronic, it's better to try gentler approaches like increasing dietary fiber, hydration, and physical activity before resorting to stimulant laxatives like senna 2.
Evidence-Based Recommendations
- The most recent and highest quality study suggests that senna is effective for short-term use, but its long-term use is associated with potential risks 1.
- Another study found that fiber supplementation is effective at improving constipation, particularly with higher fiber doses and longer treatment durations 2.
- The American Journal of Gastroenterology study found good evidence to recommend polyethylene glycol or senna as first-line laxatives, but also noted that senna can cause irritation to the small intestine 1.
Important Notes
- Senna should be used with caution and under medical supervision, especially in patients with underlying gastrointestinal conditions.
- Patients should be advised to report any adverse effects, such as abdominal cramping, pain, or diarrhea, to their healthcare provider.
- Alternative treatments, such as fiber supplementation, should be considered before resorting to stimulant laxatives like senna 2.