Senna leaf, powder

Herb:  Senna Leaf

Botanical Name:  Cassia species, Senna alexandrina type species

Common Names:  Khartoum Senna, India Senna, Egyptian Senna, Alexandrian Senna, Tinnevelly Senna. Note that senna is sometimes referred to in texts as “Cassia Officinalis,” but capitalization of the second part of the name indicates this is an apothecary term and not a botanical name as governed by the International Code of Botanical Nomenclature.

Habitat/Range: India, Egypt, Somalia, North, Central and South America.

Description:  There are roughly between 250 and 300 species of plants in the senna family, but S. alexandrina is attributed as the source of senna leaf and senna pods used in herbal medicine. With the exception of Europe, the plant thrives in the tropical and subtropical regions of every continent in the world. It is grown extensively as a commercial crop in southern Egypt and northern Sudan, where the herb is a significant source of income to farmers and distributors. The plant is harvested twice each year, dried in the sun and transported to ports along the Red Sea via camel caravans.

Parts Used:  Leaves, flowers and fruit.


Chemical Composition:  Senna contains senna glycosides, which are derivatives of an organic compound with known laxative properties called anthracenedione. These anthracene derivatives are collectively referred to as sennosides and further identified as sennosides A, A1, B, C and D. (1)

Pharmacological Actions:  Sennosides and a metabolite called rhein anthrone inhibit the absorption of water and electrolytes in the large intestine, which results in more pressure and volume of material in the intestines. In response, the colon produces contractions to relieve the pressure. At the same time, the amount of water and electrolytes in the intestine increases due to greater production of prostaglandin E2, a lipid that relaxes smooth muscles.

Senna is a short-term therapy for constipation that has been used in “mainstream” medicine since the 1950s. Studies show that sennosides improve transit time in the gut, which translates to more frequent and productive bowel movements. In terms of clinical practice, this is significant because it is often necessary to introduce laxatives to prevent or treat constipation in what is known as a “bowel protocol.” In short, this means coming up with a plan that includes therapeutic agents that will be both effective and well tolerated. According to a study published in the May 11, 2008 issue of the “Journal of Palliative Medicine,” senna therapy effectively provided relief for patients undergoing cancer treatment, even without the addition of a stool softener. Another study published in the May 2010 issue of the “American Journal of Obstetrics and Gynecology” showed that senna effectively stimulated bowel movements in patients recovering from pelvic reconstructive surgery.

Side Effects/Drug Interactions

Some people may experience an allergic reaction or cramps and diarrhea from ingesting senna leaf. Long-term use or high dosages can lead to potassium depletion and, in rare cases, an increased risk of fluid retention (edema), bone loss, and irregular heart rhythm. Do not use senna preparations if you are pregnant or nursing. This herb should not be given to young children or the elderly without medical supervision.

Senna should not be combined with licorice, which also depletes the body of potassium with long-term use. Due to an increased risk of toxicity, senna should not be used concurrently with digoxin, a heart medication made from digitalis (foxglove).