Image source: http://en.wikipedia.org/wiki/File:Senna_alexandrina_-_Köhler–s_Medizinal-Pflanzen-264.jpg
Cassia angustifolia
Common name Senna
Plant family Fabaceae
Parts used Dried leaflets, pods (Grieve, 1971).
Qualities Bitter, dry, hot with a secondary cooling effect (Holmes, 2007).
Constituents
Anthraquinone glycosides, hydrocolloids (Johns Cupp, 2000). Flavonoids (particularly kaempferol derivatives), and mucilage (Wichtl, 2004).
Actions
Purgative (Grieve, 1971), laxative (Braun & Cohen, 2010).
Indications
Grieve states that cassia acts on the walls of the lower colon, simulating peristalsis (Grieve, 1971).
It is the gentlest of the stimulating laxatives and is considered suitable for children (Wichtl, 2004), but some have cautioned that it should not be used in children under 10 years (Mueller & Mechler, 2005).
It is indicated for short-term use, longer than 2 weeks use is not recommended (Mueller & Mechler, 2005).
A 2015 study showed that cellular changes in the small intestine and epidermis of rats occurred with long-term senna treatment, with a tendency for peristalsis to be inhibited after repeated senna administration. The number of Langerhans immune cells in the epidermis decreased after repeated administration (Yamate, Hiramoto, Yokoyama & Ooi, 2015).
It has been suggested the herb be avoided in pregnancy and lactation; Grieve notes that the active principle passes through breastmilk and will cause purging in the infant (Grieve, 1971). However, a 1963 study found no effect on nursing infants whose mothers were given regular doses of a commercial laxative product made from senna compound (Yamate, Hiramoto, Yokoyama & Ooi, 2015). Avoidance of the herb during pregnancy may sometimes still be advisable on the basis of it containing anthraquinone glycosides, (Schaefer, Peters & Miller, 2014).
The herb has hepatotoxic potential (Rakel, 2012) and there have been cases of chronic abuse of the herb causing acute liver failure (Vanderperren, 2005) and portal vein thrombosis (Soyuncu, Cete & Nokay, 2008); the amounts used by the patients effected were extreme and long term (high daily dose for over two years).
Possible Digoxin interactions have been noted (Braun & Cohen, 2010).
Dosage
200 ml cold water should be poured over one teaspoon of the dried, cut leaves (0.6-1.5g), left to steep during the day, then sieved and drunk before bed (Mueller & Mechler, 2005).
Combinations
Grieve notes that the taste of senna is nauseating and can cause griping pains, and recommends that the addition of cloves, ginger, cinnamon can alleviate these effects (Grieve, 1971).
Has been combined with psyllium (bulking laxative), fennel, buckthorn and anise in a commercial laxative preparation (Innerclean Herbal) (Johns Cupp, 2000).
References
Braun, L., & Cohen, M. (2010). Herbs & natural supplements. Sydney: Elsevier Australia.
Grieve, M. (1971). A modern herbal. New York: Dover Publications.
Holmes, P. (2007). The energetics of Western herbs. Cotati, Calif.: Snow Lotus Press.
Mueller, M., & Mechler, E. (2005). Medicinal plants in tropical countries. Stuttgart: Thieme.
Johns Cupp, M. (2000). Toxicology and Clinical Pharmacology of Herbal Products. Humana Press.
Rakel, D. (2012). Integrative medicine (3rd ed.). Saunders.
Schaefer, C., Peters, P., & Miller, R. (2014). Drugs during pregnancy and lactation (2nd ed.). Amsterdam: Elsevier.
Soyuncu, S., Cete, Y., & Nokay, A. (2008). Portal vein thrombosis related to Cassia angustifolia *. Clinical Toxicology, 46(8), 774-777. doi:10.1080/15563650701682097
Vanderperren, B. (2005). Acute Liver Failure with Renal Impairment Related to the Abuse of Senna Anthraquinone Glycosides. Annals Of Pharmacotherapy, 39(7), 1353-1357.
Wichtl, M. (2004). Herbal drugs and phytopharmaceuticals. Stuttgart: Medpharm.
Yamate, Y., Hiramoto, K., Yokoyama, S., & Ooi, K. (2015). Immunological changes in the intestines and skin after senna administration. Pharmaceutical Biology, 53(6), 913-920.