Alexandria leaves (senna): an herb for constipation!

The intestine is considered by many as “the king of the organs”, as diseases caused by the irregular functioning of the intestine are capable of affecting the lives of individuals in many ways.

One of these diseases is constipation, which is the most common gastrointestinal disorder in the Mediterranean countries of Europe, even from a very young age. Specifically, after epidemiological research, the occurrence of constipation ranged from 2% to 30% in the general population and is more common in women, as their age gradually increases. [1]

For this reason, many people over the years have resorted to the search for ways, mainly herbs for constipation, to relieve the symptoms of occasional constipation, in a more natural way than any other product with a laxative effect. One of these ways is senna, or Alexandria leaves.

Alexandria leaves: what are they?

Senna is a medicinal herb that comes from the Senna plant and has been used as a decoction since ancient times, mainly for its laxative effect. The most common species for its preparation are Cassia acutifolia or Cassia angustifolia. [2]

Senna plants are small shrubs grown in Somalia, the Arabian Peninsula and near the Nile River and their trade names are senna alexandrina or Egypt leaves or Alexandria leaves. Plants are also found in smaller areas in southern India and Pakistan. The active principle for the beneficial properties of senna was first made by Stoll, in 1941. [3]

Alexandria leaves: Properties

The properties of the senna plant are as follows:

• Treatment of constipation

The most common application of senna tea, or tea for constipation, is to enhance intestinal motility. This is achieved because senna leaves or cinnamon leaves contain active compounds known as senna glycosides or sennosides, which cannot be absorbed by the digestive system, but can be broken down by gut bacteria. This breakdown irritates the lining of the colon and more contractions are created. At the same time, senna prevents the reabsorption of water and electrolytes in the colon, making the stools softer and easier to expel. [4] It is an FDA-approved drug for use in adults and children two years of age and older. [5]

• Bowel preparation for colonoscopy

In particular, research has shown that taking the herb senna, along with other agents (diuretics or stool softeners) for bowel cleansing, seems to be more effective than taking each of them individually. They should be taken before bed as they take 6-12 hours to work. However, further research is needed to prove whether senna alone can have the same effect on the gut for this process. [2]

• Hemorrhoid treatment

Hemorrhoids are swollen veins and tissues located at the bottom of the rectum accompanied by symptoms of bleeding pain and itching. Chronic constipation is the main cause, but occasional bouts of constipation may also irritate pre-existing hemorrhoids. So, the herb senna in some of these cases seems to have alleviated the aforementioned symptoms, but further studies are necessary for the validity of this claim. [5]

• Weight loss

The seeds from the senna plant contain compounds such as anthraquinones, naphthopyrones, volatile oils and oils, which bring about the slimming effects. Specifically, the ways in which these substances ensure weight loss are identified [6]:

1. in the reduced absorption of lipids, through the inhibition of pancreatic lipase
2. in increasing the feeling of satiety, by activating glucagon-like peptide-1 (GLP-1)
3. in the reduced absorption of carbohydrates, through the suppression of pancreatic alpha-amylase

• Antiparasitic

It is very effective in destroying parasites from the intestinal tract and more so when combined with other anthelmintic herbs such as ginger and fennel. [7]

• Digestive health

Senna contains enzymes that help restore the secretions of gastric fluid in the stomach. It also contains the compound resveratrol, which acts as an anti-inflammatory in the gastrointestinal tract. [7]

There is particular interest in the use of senna for other purposes as well, but there is not enough reliable information about its usefulness.

Alexandria leaves: Dosage

The United States Food and Drug Administration (FDA) has approved senna as an over-the-counter drug for the treatment of constipation. The most common dosage is:

• Children: 8.5 milligrams (mg) per day to induce a single bowel movement
• Children over twelve years of age and adults: 17.2 mg per day, but not more than 34.4 mg per day
• Older adults: 17 mg per day
• After childbirth: 28 mg per day, divided into two doses (in case of breastfeeding, the consent of a midwife or pediatrician is necessary for the use of senna products).

It is not recommended to use senna for more than two weeks at a time. [8]

Uses

The forms in which senna is available for consumption are:

• Tea: Known as tea for constipation, is not particularly aromatic itself but is described as a mild, sweet and slightly bitter brew. However, many commercial teas combine senna with other herbs, which changes the final aroma and taste. It can be prepared either by putting 1-2g of dried senna leaves in hot water for 10 minutes, or by using tea bags or herbal mixtures, but the amount of senna they contain is not exact. [4]
• Tincture: take 2-3ml of tincture two to three times a day or as directed by a doctor or herbalist. [7]
• Supplement: Senna has laxative effects and can be obtained by anyone, without a prescription, in pharmacies, grocery stores and food stores. However, it should be noted that taking such a supplement requires the consent of a doctor, the recommendation of a specific preparation, so that he knows how much sennosides are taken and also any interaction with medications. [2]

Alexandrian leaves: side effects

The most common side effects of senna are [4]:

• Motion sickness
• Vomiting
• Diarrhea
• Cramps
• Bloating
• Stomach discomfort

However, these side effects are usually mild and last for a short time.

The above symptoms may appear when senna is used for more than a week, without the supervision of a treating physician, or when the consumption of senna exceeds 34.4 mg twice a day.

As for the part of pregnancy, among maternal diseases during pregnancy, constipation is one of the most common pathologies affecting 11-38% of pregnant women. Senna glycosides are only minimally absorbed from the gut and excreted in the bile (in this way the function of the small intestine may be impaired). Therefore, prolonged use of senna can cause fluid and electrolyte disturbances mainly potassium loss. Also, research showed that sennosides did not show any stimulation of uterine contractions in pregnant women. In contrast, a slight inhibition of the normal contraction frequency was observed in some cases. [9]

Further studies, however, are necessary to reveal more information.

Contraindications

People on medication, suffering from Irritable Bowel Syndrome (IBS) or inflammatory bowel disease (Crohn’s disease, appendicitis), ulcerative colitis, ileus, nausea, colic should consult their doctor before using senna preparations. The use of senna during pregnancy, breastfeeding and in children under 7 should also be done on the recommendation of a doctor, due to a lack of data on safe use. In particular, senna may interact with preparations for antiarrhythmic, diuretic and antihypertensive purposes. People with kidney disorders should be aware of the possibility of disturbances in electrolyte balance. Senna, like all laxatives, may reduce the absorption of fat-soluble vitamins A, D, K & E. [4]

From what was mentioned above, it can be seen that senna or cinnamon is a milder way to improve intestinal motility and relieve occasional constipation. Of course, the method of administration and the amount consumed by each person should be determined by a supervising physician, as the uncontrolled use of the herb causes side effects, milder or more serious, with results contrary to those initially desired.

At Vita4you.gr you will find a variety of supplements with senna!

Sources

[1] Constipation: Evaluation and Management

[2] What is Senna?

[3] The Senna Drug and Its Chemistry

[4] What Is Senna Tea, and Is It Safe?

[5] Senna: Uses, Side Effects, and More 

[6] EVALUATION OF THE SLIMMING EFFECTS OF DIET TEA IN BIOCHEMICAL AND MOLECULAR MEANING

[7] A REVIEW ON SENNA: AN EXCELLENT PROPHETIC HERBAL MEDICINE

[8] Sennagen

[9] Risk Assessment for Senna during Pregnancy