Is Senna (generic name: Sennoside) a stimulant laxative?

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From the Guidelines

Yes, senna is a stimulant laxative. It contains compounds called sennosides that work by irritating the lining of the bowel, which stimulates intestinal contractions and promotes bowel movements 1. Senna typically begins working within 6-12 hours after ingestion, making it useful for short-term relief of constipation. The typical adult dose ranges from 8.6–17.2 mg daily 1. However, senna should only be used short-term (less than 1 week) as prolonged use can lead to dependence, electrolyte imbalances, and potentially damage to the colon's nerve cells. Side effects may include abdominal cramping, diarrhea, and discoloration of urine.

Key Points

  • Senna is a stimulant laxative that works by increasing intestinal motility and fluid secretion in the colon 1.
  • The typical adult dose ranges from 8.6–17.2 mg daily 1.
  • Senna should only be used short-term (less than 1 week) due to the risk of dependence, electrolyte imbalances, and potential damage to the colon's nerve cells.
  • Side effects may include abdominal cramping, diarrhea, and discoloration of urine.

Mechanism of Action

Senna works because the sennosides are converted by gut bacteria into active compounds that increase intestinal motility and fluid secretion in the colon 1. This leads to an increase in bowel movements and relief of constipation.

Clinical Use

Senna is available over-the-counter in various forms, including tablets, capsules, and teas, under brand names like Senokot, Ex-Lax, and Fletcher's Castoria. It is recommended for short-term use or rescue therapy, with a recommended maximum dose of 4 tablets twice per day 1. However, the long-term safety and efficacy of senna are unknown.

From the FDA Drug Label

Active ingredient (in each 5 mL = 1 teaspoonful) Sennosides 8.8 mg The FDA drug label does not answer the question.

From the Research

Definition and Classification of Senna

  • Senna, also known as Sennoside, is classified as a stimulant laxative 2, 3, 4, 5, 6.
  • Stimulant laxatives work by increasing the amount of fluid in the intestines and stimulating the intestinal muscles to move stool through the digestive system more quickly 3, 4, 5.

Mechanism of Action

  • Senna produces contractions that improve colonic motility without affecting the stool consistency 6.
  • It is commonly used to treat constipation in children and adults 2, 4, 5, 6.

Efficacy and Safety

  • Studies have shown that Senna is effective in treating constipation in children and adults 2, 4, 5, 6.
  • Senna has been found to be safe for long-term use, with no evidence of tolerance or serious side effects 2, 3, 4, 5.
  • Common side effects of Senna include abdominal cramping, vomiting, and diarrhea, which are usually mild and resolve on their own 2, 4, 5.

Comparison with Other Laxatives

  • Senna has been compared to other laxatives, such as polyethylene glycol and magnesium oxide, and has been found to be equally or more effective in treating constipation 4, 5, 6.
  • Senna is often recommended as a first-line treatment for constipation, along with polyethylene glycol 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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