An evidence-based systematic review of senna (Cassia senna) by the natural standard research collaboration

Journal of Dietary Supplements

Volumn 8, Issue 2, 2011, Pages 189-238

  Ulbricht, Catherine ^a   Conquer, Julie ^b   Costa, Dawn ^c   Hamilton, William ^d   Higdon, Elizabeth R B ^c   Isaac, Richard ^c   Rusie, Erica ^c   Rychlik, Idalia ^e   Serrano, Jill M Grimes ^c   Tanguay Colucci, Shaina ^c   Theeman, Mark ^f   Varghese, Minney ^c  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

^b RGB Consulting   (United States)

^c Natural Standard   (United States)

^d CREIGHTON UNIVERSITY MEDICAL CENTER   (United States)

^e MASSACHUSETTS COLLEGE OF PHARMACY AND HEALTH SCIENCES   (United States)

^f NORTHEASTERN UNIVERSITY   (United States)

Author keywords

Adverse effects; constipation; dosing; evidence based; interactions; laxative; pharmacodynamics; pharmacokinetics; pharmacology; senna (Cassia senna); systematic review

Indexed keywords

PLANT EXTRACT;

ARTICLE; EVIDENCE BASED MEDICINE; HUMAN; PHYTOTHERAPY; SENNA; TRADITIONAL MEDICINE;

EVIDENCE-BASED MEDICINE; HUMANS; MEDICINE, TRADITIONAL; PHYTOTHERAPY; PLANT EXTRACTS; SENNA PLANT;

CASSIA SENNA; SENNA;

EID: 79955858954     PISSN: 19390211     EISSN: 1939022X     Source Type: Journal    
DOI: 10.3109/19390211.2011.573186     Document Type: Article

References (187)

1. No authors listed. Minimun information for sensible use of self-prescribed medicines. An international consensus. Lancet, 1977; 2: 1017-1019.
2. Agra Y, SacristanA, Gonzalez M, FerrariM, Portugues A, CalvoMJ. Efficacy of senna versus lactulose in terminal cancer patients treated with opioids. J Pain Symptom Manage. 1998;15:1-7. (Pubitemid 28018853)
3. American Academy of Pediatrics. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108:776-789.
4. Arezzo A. Prospective randomized trial comparing bowel cleaning preparations for colonoscopy. Surg Laparosc Endosc Percutan Tech. 2000;10:215-217. (Pubitemid 30641415)
5. Bailey SR, Tyrrell PN, Hale M. A trial to assess the effectiveness of bowel preparation prior to intravenous urography. Clin Radiol. 1991;44:335-337.
6. BaldwinWF. Clinical study of senna administration to nursing mothers: assessment of effects on infant bowel habits. Can Med Assoc J. 1963;89:566-568.
7. Beuers U, Spengler U, Pape GR. Hepatitis after chronic abuse of senna. Lancet. 1991;337:372-373.
8. Blair GK, Murphy JJ, Fraser GC. Internal sphincterotomy in post-pull-through Hirschsprung's disease. J Pediatr Surg. 1996;31:843-845. (Pubitemid 26190611)
9. Borkje B, Pedersen R, Lund GM, Enehaug JS, Berstad A. Effectiveness and acceptability of three bowel cleansing regimens. Scand J Gastroenterol. 1991;26:162-166.
10. Borowitz SM, Cox DJ, Kovatchev B, Ritterband LM, Sheen J, Sutphen J. Treatment of childhood constipation by primary care physicians: efficacy and predictors of outcome. Pediatrics. 2005;115:873-877.
11. Bossi S, Arsenio L, Bodria P, MagnatiG, Trovato R, Strata A. Clinical study of a new preparation from plantago seeds and senna pods. Acta Biomed Ateneo Parmense. 1986;57:179-186.
12. Bronder E, Klimpel A, Helmert U, Greiser E, Molzahn M, Pommer W. Analgesics and laxatives as risk factors for cancer in the efferent urinary tract-results of the Berlin Urothelial Carcinoma Study. Soz Praventivmed. 1999;44:117-125. (Pubitemid 29329341)
13. Brouwers JR, van Ouwerkerk WP, de Boer SM, Thoman L. A controlled trial of senna preparations and other laxatives used for bowel cleansing prior to radiological examination. Pharmacology. 1980;20(Suppl 1):58-64. (Pubitemid 10070556)
14. Brusick D, Mengs U. Assessment of the genotoxic risk from laxative senna products. Environ Mol Mutagen. 1997;29:1-9. (Pubitemid 27076223)
15. Buhmann S, Kirchhoff C, Wielage C, Fischer T, Mussack T, Reiser M, Lienemann A. Visualization and quantification of large bowel motility with functional cine-MRI. Rofo. 2005a;177:35-40. (Pubitemid 40126115)
16. Buhmann S, Kirchhoff C,Wielage C, Mussack T, Reiser MF, Lienemann A. Assessment of large bowel motility by cine magnetic resonance imaging using two different prokinetic agents: a feasibility study. Invest Radiol. 2005b;40:689-694. (Pubitemid 41546834)
17. Burlefinger RJ, Schmitt W. Letter to the Journal of Gastroenterology. comment on the article: "Senna or bisacodyl before lavage preparation for colonoscopy: prospective randomized comparative study," by DJ Ziegenhagen, E Zehnter, W Tacke, TH Gheorghiu, W Kruis. Z Gastroenterol. 1992;30:376.
18. Calore EE, Cavaliere MJ, Haraguchi M, Gorniak SL, Dagli ML, Raspantini PC, Perez Calore NM. Experimental mitochondrial myopathy induced by chronic intoxication by Senna occidentalis seeds. J Neurol Sci. 1997;146:1-6. (Pubitemid 27116045)
19. Cameron JC. Constipation related to narcotic therapy.Aprotocol for nurses and patients. Cancer Nurs. 1992;15:372-377.
20. Chilton AP,O'Sullivan M, CoxMA, Loft DE, Nwokolo CU.Ablinded, randomized comparison of a novel, low-dose, triple regimenwith fleet phospho-soda: a study of colon cleanliness, speed and success of colonoscopy. Endoscopy. 2000;32:37-41. (Pubitemid 30071904)
21. Chomnawang MT, Surassmo S, Nukoolkarn VS, Gritsanapan W. Effect of Garcinia mangostana on inflammation caused by Propionibacterium acnes. Fitoterapia. 2007;78:401-408. (Pubitemid 47299162)
22. Connolly P, Hughes IW, Ryan G. Comparison of "Duphalac" and "irritant" laxatives during and after treatment of chronic constipation: a preliminary study. Curr Med Res Opin. 1974;2:620-625.
23. Corman ML.Management of postoperative constipation in anorectal surgery. DisColonRectum. 1979;22:149-151. (Pubitemid 9196207)
24. Crossner CG, Birkhed D, Edwardsson S. The cariologic aspects of two laxatives-Senna (Fikonsirap) and Duphalac. Tandlakartidningen. 1982;74:284-288.
25. De SL, Borgonovo G, Ansaldo GL, Varaldo E, Floris F, Assalino M, Gianiorio F. The bowel cleansing for colonoscopy. A randomized trial comparing three methods. Ann Ital Chir. 2006;77:143-146.
26. de WP. Metabolism and pharmacokinetics of anthranoids. Pharmacology. 1993;47(Suppl 1):86-97.
27. de WP, Lemli L. The metabolism of anthranoid laxatives. Hepatogastroenterology. 1990;37:601-605.
28. DiPalma JA. Current treatment options for chronic constipation. Rev Gastroenterol Disord. 2004;4(Suppl 2):S34-S42. (Pubitemid 38811503)
29. Dubecq JP, Palmade J. Etude clinique de l'administration de Tamarine chez la mere qui allaite. Gaz Med Fr. 1974;81:5173-5175.
30. Duncan, AS. Standardized senna as a laxative in the puerperium; a clinical assessment. Br Med J. 1957;1:439-441.
31. Ewe K, Ueberschaer B, Press AG. Influence of senna, fibre, and fibre + senna on colonic transit in loperamide-induced constipation. Pharmacology. 1993;47(Suppl 1):242-248. (Pubitemid 23291038)
32. Faber P, Strenge-Hesse A. Relevance of rhein excretion into breast milk. Pharmacology. 1988;36(Suppl 1):212-220. (Pubitemid 18070178)
33. Faber P, Strenge-Hesse A. Senna-containing laxatives: excretion in the breastmilk?. Geburtshilfe Frauenheilkd. 1989;49:958-962.
34. Fernandez SJ, Pascual RP, Pato Rodriguez MA, Pereira Jorge JA, Dominguez Alvarez LM, Landeiro AE, Tesouro RI, Gonzalez Simon MC, Mendez Veloso MC, Pena PL. Comparative study of the efficacy and tolerance of 2 types of colon cleansing. Rev Esp Enferm Dig. 1995;87:785-791.
35. Fingerhut A, Hay JM. Single-dose ceftriaxone, ornidazole, and povidone-iodine enema in elective left colectomy. A randomized multicenter controlled trial. French Assoc Surg Res Arch Surg. 1993;128:228-232. (Pubitemid 23057650)
36. Fireman Z, Rozen P, Fine N, ChetritA. Reproducibility studies and effects of bowel preparations on measurements of rectal epithelial proliferation. Cancer Lett. 1989;45:59-64. (Pubitemid 19121401)
37. First international symposium on senna, May 22-23, 1987, Rottach-Egern (FRG). Proc. Pharm. 1988; 36(Suppl 1)1-240.
38. Fournier AM. Use of senna for the acceleration of small intestine transit in hospital radiology. Mars Med. 1971;108:469-474.
39. Fugh-Berman A. Herb-drug interactions. Lancet. 2000;355:134-138. (Pubitemid 30068565)
40. Gattuso JM, Kamm MA. Adverse effects of drugs used in the management of constipation and diarrhoea. Drug Saf. 1994;10:47-65. (Pubitemid 24032938)
41. Glatzel H. Senna-an old drug in a new form. Z Allgemeinmed. 1970;46:82-84.
42. Glatzel H. Results of long-term therapy of 1059 babitually constipated patients using a standardized senna preparation. Z Allgemeinmed. 1972;48:654-656.
43. Godding EW. Laxatives and the special role of senna. Pharmacology. 1988;36(Suppl 1):230-236. (Pubitemid 18070181)
44. Goppel M, Franz G. Stability control of senna leaves and senna extracts. Planta Med. 2004;70:432-436. (Pubitemid 38716476)
45. Gould SR,Williams CB. Castor oil or senna preparation before colonoscopy for inactive chronic ulcerative colitis. Gastrointest Endosc. 1982;28:6-8. (Pubitemid 12179769)
46. Greenhalf JO, Leonard HS. Laxatives in the treatment of constipation in pregnant and breastfeeding mothers. Practitioner. 1973;210:259-263.
47. Greiner AC, Warwick WE. The use of sennosides A and B in the treatment of constipation in a mental institution. Appl Ther. 1965;7:1096-1098.
48. Grossi F. Possibilities of a derivative of senna in the treatment of simple chronic constipation. Clin Ter. 1970;54:139-151.
49. Guo H, Huang Y, Xi Z, Song Y, Guo Y, Na Y. Is bowel preparation before excretory urography necessary? A prospective, randomized, controlled trial. J Urol. 2006;175:665-668. (Pubitemid 43067414)
50. Hagemann TM. Gastrointestinal medications and breastfeeding. J Hum Lact. 1998;14:259-262. (Pubitemid 128504476)
51. Han RX. Study of the cleansing effect of senna on the intestinal tract. Zhonghua Hu Li Za Zhi. 1989;24:273-275.
52. Hangartner PJ, Munch R, Meier J, Ammann R, Buhler H. Comparison of three colon cleansing methods: evaluation of a randomized clinical trial with 300 ambulatory patients. Endoscopy. 1989;21:272-275. (Pubitemid 20009921)
53. Hardcastle JD,Wilkins JL. The action of sennosides and related compounds on human colon and rectum. Gut. 1970;11:1038-1042.
54. Heaton KW, Cripps HA. Straining at stool and laxative taking in an English population. Dig Dis Sci. 1993;38:1004-1008. (Pubitemid 23175119)
55. HeldweinW, Sommerlatte T, Hasford J, Lehnert P, Littig G, Muller-Lissner S. Evaluation of the usefulness of dimethicone and/or senna extract in improving the visualization of abdominal organs. J Clin Ultrasound. 1987;15:455-458. (Pubitemid 17144343)
56. Helin T, Makinen-Kiljunen S. Occupational asthma and rhinoconjunctivitis caused by senna. Allergy. 1996;51:181-184. (Pubitemid 26183304)
57. Hensel A, Deters AM, Muller G, Stark T, Wittschier N, Hofmann T. Occurrence of Nphenylpropenoyl- L-amino acid amides in different herbal drugs and their influence on human keratinocytes, on human liver cells and on adhesion of Helicobacter pylori to the human stomach. Planta Med. 2007;73:142-150. (Pubitemid 46910432)
58. Hietala P, Lainonen H, Marvola M. New aspects on the metabolism of the sennosides. Pharmacology. 1988;36(Suppl 1):138-143. (Pubitemid 18070170)
59. Ip SW, Weng YS, Lin SY, Mei D, Tang NY, Su CC, Chung JG. The role of Ca+2 on rheininduced apoptosis in human cervical cancer Ca Ski cells. Anticancer Res. 2007;27:379-389.
60. Izzo AA, Mascolo N, Capasso F. Nitric oxide as a modulator of intestinal water and electrolyte transport. Dig Dis Sci. 1998;43:1605-1620. (Pubitemid 28381563)
61. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Controlled Clin Trials. 1996;17(1):1-12. (Pubitemid 26120810)
62. Joo JS, Ehrenpreis ED, Gonzalez L, Kaye M, Breno S,Wexner SD, Zaitman D, Secrest K. Alterations in colonic anatomy induced by chronic stimulant laxatives: the cathartic colon revisited. J Clin Gastroenterol. 1998;26:283-286. (Pubitemid 28272505)
63. Kaspi T, Royds RB, Turner P. Qualitative determination of senna in urine. Lancet. 1978;1:1162.
64. Kenny SE, Irvine T,Driver CP,NunnAT, Losty PD, JonesMO, Turnock RR, Lamont GL, Lloyd DA. Double blind randomized controlled trial of topical glyceryl trinitrate in anal fissure.Arch Dis Child. 2001;85:404-407. (Pubitemid 33702295)
65. Kinnunen O, Salokannel J. The carry-over effect on the bowel habit in elderly long-term patients of long-term bulk-forming products containing stimulant laxative. Acta Med Scand. 1987;222:477-479. (Pubitemid 18006461)
66. Kinnunen O, Winblad I, Koistinen P, Salokannel J. Safety and efficacy of a bulk laxative containing senna versus lactulose in the treatment of chronic constipation in geriatric patients. Pharmacology. 1993;47(Suppl 1):253-255. (Pubitemid 23291040)
67. KittisupamongkolW,Nilaratanakul V,KulwichitW. Near-fatal bleeding, senna, and the opposite of lettuce. Lancet. 2008;371:784. (Pubitemid 351288877)
68. Kobashi K, Nishimura T, Kusaka M, Hattori M, Namba T. Metabolism of sennosides by human intestinal bacteria. Planta Med. 1980;40:225-236. (Pubitemid 11169107)
69. Kositchaiwat S, Suwanthanmma W, Suvikapakornkul R, Tiewthanom V, Rerkpatanakit P, Tinkornrusmee C. Comparative study of two bowel preparation regimens for colonoscopy: senna tablets vs. sodium phosphate solution.World J Gastroenterol. 2006;12:5536-5539. (Pubitemid 44501816)
70. Krumbiegel G, Schulz HU. Rhein and aloe-emodin kinetics from senna laxatives in man. Pharmacology. 1993;47(Suppl 1):120-124. (Pubitemid 23291022)
71. Kumarasinghe SP, Karunaweera ND, Ihalamulla RL, Arambewela LS, Dissanayake RD. Larvicidal effects of mineral turpentine, low aromatic white spirits, aqueous extracts of Cassia alata, and aqueous extracts, ethanolic extracts and essential oil of betel leaf (Piper betle) on Chrysomya megacephala. Int J Dermatol. 2002;41:877-880. (Pubitemid 36075228)
72. Labenz J, Hopmann G, Leverkus F, Borsch G. Bowel cleansing prior to colonoscopy. A prospective, randomized, blind comparative study. Med Klin (Munich). 1990;85:581-585. (Pubitemid 20334777)
73. Laitinen L, Takala E, Vuorela H, Vuorela P, Kaukonen AM, Marvola M. Anthranoid laxatives influence the absorption of poorly permeable drugs in human intestinal cell culture model (Caco-2). Eur J Pharm Biopharm. 2007;66:135-145. (Pubitemid 46412969)
74. Langmead L, Rampton DS. Review article: herbal treatment in gastrointestinal and liver disease-benefits and dangers. Aliment Pharmacol Ther. 2001;15:1239-1252. (Pubitemid 32835530)
75. Lazarus H, Fitzmartin RD, Goldenheim PD. A multi-investigator clinical evaluation of oral controlled-release morphine (MS Contin tablets) administered to cancer patients. Hosp J. 1990;6:1-15.
76. Lemli J. Senna: chemistry and pharmacology. Verh K Acad Geneeskd Belg. 1986;48:51-62.
77. Lemli J. Metabolism of sennosides-an overview. Pharmacology. 1988a;36(Suppl 1), 126-128.
78. Lemli J. Senna-an old drug in modern research. Pharmacology. 1988b;36(Suppl 1), 3-6. (Pubitemid 18070152)
79. Lemli J. Mechanism of action of sennosides. Bull Acad Natl Med. 1995;179:1605-1611.
80. Lemli J. The mechanism of action of sennosides. Ann Gastroenterol Hepatol (Paris). 1996;32:109-112.
81. Leng-Peschlow E. Inhibition of intestinal water and electrolyte absorption by senna derivatives in rats. J Pharm Pharmacol. 1980;32:330-335. (Pubitemid 11230976)
82. Leng-Peschlow E. Acceleration of large intestine transit time in rats by sennosides and related compounds. J Pharm Pharmacol. 1986a;38:369-373. (Pubitemid 16102027)
83. Leng-Peschlow E. Dual effect of orally administered sennosides on large intestine transit and fluid absorption in the rat. J Pharm Pharmacol. 1986b;38:606-610. (Pubitemid 16060113)
84. Leng-Peschlow E. (ed.). Classification of senna as a laxative. Pharmacology. 1992a;44(SUPPL. 1):6-9.
85. Leng-Peschlow E (ed.). Identity of senna products. Pharmacology. 1992b;44(SUPPL. 1):3-5.
86. Leng-Peschlow E. (ed.). Modes of action of senna. Pharmacology. 1992c;44(SUPPL. 1):16-19.
87. Leng-Peschlow E. (ed.). Risk assessment for senna during pregnancy. Pharmacology. 1992d;44(SUPPL. 1):20-22.
88. Leng-Peschlow E. (ed.). Senna and damage of the nerve plexus of the intestinal wall. Pharmacology. 1992e;44(SUPPL. 1):26-29.
89. Leng-Peschlow E. (ed.). Senna and habituation. Pharmacology. 1992f;44(SUPPL. 1):30-32.
90. Leng-Peschlow E. (ed.). Senna and its rational use. Pharmacology. 1992g;44(SUPPL. 1):1-52.
91. Leng-Peschlow E. (ed.). Senna and pseudomelanosis coli. Pharmacology. 1992h;44(SUPPL. 1):33-35.
92. Leng-Peschlow E. (ed.). Senna in the puerperium. Pharmacology. 1992i;44(SUPPL. 1):23-25.
93. Leng-Peschlow E. (ed.). Site of senna action. Pharmacology. 1992j;44(SUPPL. 1):10-15.
94. Leng-Peschlow E. (ed.). The importance of senna products. Pharmacology. 1992k;44(SUPPL. 1):1-2.
95. Leng-Peschlow E. (ed.). The rational use of senna. Pharmacology. 1992l;44(SUPPL. 1):41-42.
96. Levine D, Goode AW, Wingate DL. Purgative abuse associated with reversible cachexia, hypogammaglobulinaemia, and finger clubbing. Lancet. 1981;1:919-920. (Pubitemid 11096294)
97. Lewis S, Bolton C, Heaton K. Lack of influence of intestinal transit on oxidative status in premenopausal women. Eur J Clin Nutr. 1996;50:565-568. (Pubitemid 26283727)
98. Lewis S, Cochrane S. Alteration of sulfate and hydrogen metabolism in the human colon by changing intestinal transit rate. Am J Gastroenterol. 2007;102:624-633. (Pubitemid 46328140)
99. Lewis SJ, Heaton KW. Increasing butyrate concentration in the distal colon by accelerating intestinal transit. Gut. 1997a;41:245-251. (Pubitemid 27395930)
100. Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997b;32:920-924. (Pubitemid 27382038)
101. Lewis SJ, Heaton KW, Oakey RE, McGarrigle HH. Lower serum oestrogen concentrations associated with faster intestinal transit. Br J Cancer. 1997;76:395-400. (Pubitemid 27308093)
102. Lewis SJ, Oakey RE, Heaton KW. Intestinal absorption of oestrogen: the effect of altering transit-time. Eur J Gastroenterol Hepatol. 1998;10:33-39. (Pubitemid 28085497)
103. Lim AK, Hooke DH, Kerr PG. Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy. Med J Aust. 2008;188:121-122.
104. MacLennanWJ, Pooler AFWM.Acomparison of sodium picosulphate ("Laxoberal") with standardised senna ("Senokot") in geriatric patients. Curr Med Res Opin. 1974;2: 641-647.
105. Maddi VI. Regulation of bowel function by a laxative/stool softener preparation in aged nursing home patients. J Am Geriatr Soc. 1979;27:464-468. (Pubitemid 10243519)
106. Maguire LC, Yon JL, Miller E. Prevention of narcotic-induced constipation. N Engl J Med. 1981;305:1651. (Pubitemid 12169199)
107. Malmquist J, Ericsson B, Hulten-Nosslin MB, Jeppsson JO, Ljungberg O. Finger clubbing and aspartylglucosamine excretion in a laxative-abusing patient. Postgrad Med J. 1980;56:862-864. (Pubitemid 11155128)
108. Marcus SN, Heaton KW. Intestinal transit, deoxycholic acid and the cholesterol saturation of bile-three inter-related factors. Gut. 1986;27:550-558. (Pubitemid 16079756)
109. Marks GB, Salome CM, Woolcock AJ. Asthma and allergy associated with occupational exposure to ispaghula and senna products in a pharmaceutical work force. Am Rev Respir Dis. 1991;144:1065-1069.
110. Marlett JA, Li BU, Patrow CJ, Bass P. Comparative laxation of psyllium with and without senna in an ambulatory constipated population. Am J Gastroenterol. 1987;82:333-337. (Pubitemid 17068692)
111. Martinez-Costa C, Palao Ortuno MJ, Alfaro PB, Nunez GF, Martinez-Rodriguez L, Ferre FI, Brines SJ. Functional constipation: prospective study and treatment response. An Pediatr (Barc.) 2005;63:418-425. (Pubitemid 43035727)
112. Marvola M, Koponen A, Hiltunen R, Hieltala P. The effect of raw material purity on the acute toxicity and laxative effect of sennosides. J Pharm Pharmacol. 1981;33:108-109. (Pubitemid 11186837)
113. McGuffin M, Hobbs C, Upton R, Goldberg A. American herbal products association's botanical safetly handbook. Boca Raton, FL: CRC Press, 1997.
114. McLaughlin AF. Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy. Med J Aust. 2008;189:348.
115. Mengs U. Reproductive toxicological investigations with sennosides. Arzneimittelforschung. 1986;36:1355-1358. (Pubitemid 16016249)
116. Mengs U. Toxic effects of sennosides in laboratory animals and in vitro. Pharmacology. 1988;36(Suppl 1):180-187. (Pubitemid 18070175)
117. Mengs U, Grimminger W, Krumbiegel G, Schuler D, Silber W, Volkner W. No clastogenic activity of a senna extract in the mouse micronucleus assay. Mutat Res. 1999;444:421-426. (Pubitemid 29469486)
118. Mengs U, Rudolph RL. Light and electron-microscopic changes in the colon of the guinea pig after treatment with anthranoid and non-anthranoid laxatives. Pharmacology. 1993;47(Suppl 1):172-177. (Pubitemid 23291029)
119. Mereto E, Ghia M, Brambilla G. Evaluation of the potential carcinogenic activity of Senna and Cascara glycosides for the rat colon. Cancer Lett. 1996;101:79-83. (Pubitemid 26060196)
120. MilesCL, FellowesD, GoodmanML,Wilkinson S. Laxatives for the management of constipation in palliative care patients. Cochrane Database Syst Rev. 2006;CD003448.
121. Milner P, Belai A, Tomlinson A, Hoyle CH, Sarner S, Burnstock G. Effects of long-term laxative treatment on neuropeptides in rat mesenteric vessels and caecum. J Pharm Pharmacol. 1992;44:777-779.
122. MishalanyH. Seven years' experience with idiopathic unremitting chronic constipation. J Pediatr Surg. 1989;24:360-362. (Pubitemid 19099677)
123. Mitchell JM, Mengs U, McPherson S, Zijlstra J, Dettmar P, Gregson R, Tigner JC. An oral carcinogenicity and toxicity study of senna (Tinnevelly senna fruits) in the rat. Arch Toxicol. 2006;80:34-44. (Pubitemid 41830993)
124. Monias MB. Standardized senna concentrate in postpartum bowel rehabilitation. Md StateMed J. 1966;15:32-33.
125. Morris AI, Turnberg LA. Surreptitious laxative abuse. Gastroenterology. 1979;77:780-786. (Pubitemid 9235793)
126. Nazif NM, Rady MR, el-Nasr MM. Stimulation of anthraquinone production in suspension cultures of Cassia acutifolia by salt stress. Fitoterapia. 2000;71:34-40. (Pubitemid 30012014)
127. Nielsen GD, Olsen O, Larsen ST, LovikM, Poulsen LK, Glue C, Brandorff NP, Nielsen PJ. IgEmediated sensitisation, rhinitis and asthma from occupational exposures. Smoking as a model for airborne adjuvants? Toxicology. 2005;216:87-105. (Pubitemid 41715119)
128. Njoroge GN, Bussmann RW. Ethnotherapeautic management of skin diseases among the Kikuyus of Central Kenya. J Ethnopharmacol. 2007;111:303-307. (Pubitemid 46528076)
129. Nusko G, Schneider B, Schneider I, Wittekind C, Hahn EG. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut. 2000;46:651-655. (Pubitemid 30305782)
130. Otero R, Nunez V, Barona J, Fonnegra R, Jimenez SL, Osorio RG, Saldarriaga M, Diaz A. Snakebites and ethnobotany in the northwest region of Colombia. Part III: neutralization of the haemorrhagic effect of Bothrops atrox venom. J Ethnopharmacol. 2000;73:233-241.
131. Padumanonda T, Gritsanapan W. Barakol contents in fresh and cooked Senna siamea leaves. Southeast Asian J Trop Med Public Health. 2006;37:388-393. (Pubitemid 44074342)
132. Padumanonda T, Suntornsuk L, Gritsanapan W. Quantitative analysis of barakol content in Senna siamea leaves and flowers by TLC-densitometry. Med Princ Pract. 2007;16:47-52. (Pubitemid 44924457)
133. Pahor M, Mugelli A, Guralnik JM, Manto A, Carosella L, Sgadari A, Carbonin PU. Age and laxative use in hospitalized patients. A report of the "Gruppo Italiano di Farmacovigilanza nell' Anziano-GIFA." Aging (Milano) 1995;7:128-135.
134. Palsson K, Jaenson TG. Plant products used as mosquito repellents in Guinea Bissau, West Africa. Acta Trop. 1999;72:39-52. (Pubitemid 29062922)
135. Passmore AP, Davies KW, Flanagan PG, Stoker C, Scott MG. A comparison of Agiolax and lactulose in elderly patients with chronic constipation. Pharmacology. 1993;47(Suppl 1):249-252. (Pubitemid 23291039)
136. Patanwala AE, Abarca J, Huckleberry Y, Erstad BL. Pharmacologic management of constipation in the critically ill patient. Pharmacotherapy. 2006;26:896-902.
137. Perkin JM. Constipation in childhood: a controlled comparison between lactulose and standardized senna. Curr Med Res Opin. 1977;4:540-543. (Pubitemid 8093779)
138. Pers M, Pers B. A crossover comparative study with two bulk laxatives. J Int Med Res. 1983;11:51-53. (Pubitemid 13179758)
139. Pockros PJ, Foroozan P. Golytely lavage versus a standard colonoscopy preparation. Effect on normal colonic mucosal histology. Gastroenterology. 1985;88:545-548. (Pubitemid 15194722)
140. Prather CM. Pregnancy-related constipation. Curr Gastroenterol Rep. 2004;6:402-404. (Pubitemid 39480912)
141. Prior J, White I. Tetany and clubbing in patient who ingested large quantities of senna. Lancet. 1978;2:947. (Pubitemid 9059497)
142. Putalun W, Pimmeuangkao S, De-Eknamkul W, Tanaka H, Shoyama Y. Sennosides A and B production by hairy roots of Senna alata (L.) Roxb. Z Naturforsch C. 2006;61:367-371. (Pubitemid 44073428)
143. Radaelli F, Meucci G, Imperiali G, Spinzi G, Strocchi E, Terruzzi V, Minoli G. High-dose senna compared with conventional PEG-ES lavage as bowel preparation for elective colonoscopy: a prospective, randomized, investigator-blinded trial.AmJ Gastroenterol. 2005;100:2674-2680.
144. Radaelli F, Minoli G. Colonoscopy preparation: is there still room for senna? Gastrointest Endosc. 2002;56:463.
145. Raimondi F, Santoro P, Maiuri L, Londei M, Annunziata S, Ciccimarra F, Rubino A. Reactive nitrogen species modulate the effects of rhein, an active component of senna laxatives, on human epithelium in vitro. J Pediatr Gastroenterol Nutr. 2002;34:529-534. (Pubitemid 34596222)
146. Ramesh PR, Kumar KS, Rajagopal MR, Balachandran P, Warrier PK. Managing morphineinduced constipation: a controlled comparison of an Ayurvedic formulation and senna. J Pain Symptom Manage. 1998;16:240-244. (Pubitemid 28478237)
147. Ramkumar D, Rao SS. Efficacy and safety of traditional medical therapies for chronic constipation: systematic review. Am J Gastroenterol. 2005;100:936-971. (Pubitemid 40592390)
148. Remes-Troche JM. Constipation: initial evaluation and diagnostic approach. Rev Gastroenterol Mex. 2005;70:312-322.
149. Rodrigues E. Plants of restricted use indicated by three cultures in Brazil (Caboclo-river dweller, Indian and Quilombola). J Ethnopharmacol. 2007;111:295-302. (Pubitemid 46541627)
150. RogersHJ, House FR, Morrison PJ, Bradbrook ID. Comparison of the effect of drugs upon some commonly used measures of bowel transit time. Br J Clin Pharmacol. 1978;6:493-497. (Pubitemid 9087332)
151. Sanders RC, Wright FW. Colonic preparation: a controlled trial of Dulcodos, Dulcolax and Senokot DX. Br J Radiol. 1970;43:245-247.
152. Sansores-Peraza P, Rosado-Vallado M, Brito-LoezaW, Mena-Rejon GJ, Quijano L. Cassine, an antimicrobial alkaloid from Senna racemosa. Fitoterapia. 2000;71:690-692.
153. Seybold U, Landauer N, Hillebrand S, Goebel FD. Senna-induced hepatitis in a poor metabolizer. Ann Intern Med. 2004;141:650-651.
154. Shelton JH, Santa Ana CA, Thompson DR, Emmett M, Fordtran JS. Factitious diarrhea induced by stimulant laxatives: accuracy of diagnosis by a clinical reference laboratory using thin layer chromatography. Clin Chem. 2007;53:85-90. (Pubitemid 46047766)
155. Shelton MG. Standardized senna in themanagement of constipation in the puerperium: a clinical trial. S Afr Med J. 1980;57:78-80. (Pubitemid 10152949)
156. Slanger A. Comparative study of a standardized senna liquid and castor oil in preparing patients for radiographic examination of the colon. Dis Colon Rectum. 1979;22:356-359. (Pubitemid 10142564)
157. Sogni P, Chaussade S, Akue-Gohe K, Nepveux P, HomerinM, CouturierD, Guerre J. Comparative effects of ricinoleic acid and senna on orocecal and oroanal transit time in healthy subjects. Application of the salacylazosulfapyridine method. Gastroenterol Clin Biol. 1992;16:21-24.
158. Sondheimer JM, Gervaise EP. Lubricant versus laxative in the treatment of chronic functional constipation of children: a comparative study. J Pediatr Gastroenterol Nutr. 1982;1:223-226. (Pubitemid 12013438)
159. Sonmez A, Yilmaz MI,Mas R, Ozcan A, Celasun B, Dogru T, Taslipinar A, Kocar IH. Subacute cholestatic hepatitis likely related to the use of senna for chronic constipation.Acta Gastroenterol Belg. 2005;68:385-387. (Pubitemid 41474750)
160. Soyuncu S, Cete Y, NokayAE. Portal vein thrombosis related to Cassia angustifolia. Clin Toxicol (Phila). 2008;46:774-777.
161. Sriphong L, Sotanaphun U, Limsirichaikul S, Wetwitayaklung P, Chaichantipyuth C, Pummangura S. Cytotoxic alkaloids from the flowers of Senna spectabilis. Planta Med. 2003;69:1054-1056. (Pubitemid 38064699)
162. Staumont G, Frexinos J, Fioramonti J, Bueno L. Sennosides and human colonic motility. Pharmacology. 1988;36(Suppl 1):49-56. (Pubitemid 18070158)
163. Stickel F, Schuppan D. Herbal medicine in the treatment of liver diseases. Dig Liver Dis. 2007;39:293-304. (Pubitemid 46432239)
164. Sykes NP. A volunteer model for the comparison of laxatives in opioid-related constipation. J Pain Symptom Manage. 1996;11:363-369. (Pubitemid 26157416)
165. Taylor SA, Slater A, Burling DN, Tam E, Greenhalgh R, Gartner L, Scarth J, Pearce R, Bassett P, Halligan S. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging. Eur Radiol. 2008;18:32-42.
166. Thorpe DM. Management of opioid-induced constipation. Curr Pain Headache Rep. 2001;5:237-240.
167. Tooson JD, Gates LK, Jr. Bowel preparation before colonoscopy. Choosing the best lavage regimen. Postgrad Med. 1996;100:203-212, 214.
168. Tshikalange TE, Meyer JJ, Hussein AA. Antimicrobial activity, toxicity and the isolation of a bioactive compound from plants used to treat sexually transmitted diseases. J Ethnopharmacol. 2005;96:515-519. (Pubitemid 41556603)
169. Tyson RM, Shrader EA, Perlman HH. Drugs transmitted through breast milk. Part I: laxatives. JPediatr. 1937;11:824-832.
170. Unal S, Dogan UB, Ozturk Z, Cindoruk M. A randomized prospective trial comparing 45 and 90-ml oral sodium phosphate with X-Prep in the preparation of patients for colonoscopy.Acta Gastroenterol Belg. 1998;61:281-284. (Pubitemid 28473319)
171. Vaidyanathan S, Soni BM. Bluish discolouration of urine drainage tube and bag in a female patient with spina bifida, paraplegia, and suprapubic cystostomy. ScientificWorld J. 2007;7:1070-1072. (Pubitemid 47036154)
172. Valverde A, Hay JM, Fingerhut A, Boudet MJ, Petroni R, Pouliquen X, Msika S, Flamant Y. Senna vs. polyethylene glycol for mechanical preparation the evening before elective colonic or rectal resection: a multicenter controlled trial. French Association for surgical research. Arch Surg. 1999;134:514-519. (Pubitemid 29218122)
173. Valverde A, Msika S, Kianmanesh R, Hay JM, Couchard AC, Flamant Y, Fingerhut A, Fagniez PL. Povidone-iodine vs. sodium hypochlorite enema for mechanical preparation before elective open colonic or rectal resection with primary anastomosis: a multicenter randomized controlled trial. Arch Surg. 2006;141:1168-1174. (Pubitemid 44956626)
174. Van Der Jagt EJ, Thijn CJ, Taverne PP. Colon cleansing prior to roentgenologic examination. Adouble blind comparative study. J Belge Radiol. 1986;69:167-170.
175. van GorkomBA, Karrenbeld A, LimburgAJ, Kleibeuker JH. The effect of sennosides on colonic mucosal histology and bowel preparation. Z Gastroenterol. 1998;36:13-18. (Pubitemid 28108894)
176. van GorkomBA, Karrenbeld A,VanDer ST,Koudstaal J, de VriesEG, Kleibeuker JH. Influence of a highly purified senna extract on colonic epithelium. Digestion. 2000;61:113-120. (Pubitemid 30114078)
177. Vanderperren B, Rizzo M, Angenot L, Haufroid V, Jadoul M, Hantson P.Acute liver failure with renal impairment related to the abuse of senna anthraquinone glycosides.Ann Pharmacother. 2005;39:1353-1357. (Pubitemid 40943194)
178. Waller SL. Proceedings: comparative effects of codeine and senna on the motor activity of the left colon. Gut. 1975;16:407-408.
179. Waltenberger B, Avula B, Ganzera M, Khan IA, Stuppner H, Khan SI. Transport of sennosides and sennidines from Cassia angustifolia and Cassia senna across Caco-2 monolayers-an in vitro model for intestinal absorption. Phytomedicine. 2008;15:373-377. (Pubitemid 351508390)
180. Watson R. Senna-pod and wintergreen. Nurs Times. 1992;88:64.
181. Werthmann MW, Jr, Krees SV. Quantitative excretion of Senokot in human breast milk. Med Ann Dist Columbia. 1973;42:4-5.
182. Wildgrube HJ, Lauer H. Combination intestinal lavage: a conservative procedure for colonoscopy. Bildgebung. 1991;58:63-66.
183. Wilkins JL, Hardcastle JD. The mechanism by which senna glycosides and related compounds stimulate peristalsis in the human colon. Br J Surg. 1970;57:864.
184. Xing JH, Soffer EE. Adverse effects of laxatives. Dis Colon Rectum. 2001;44:1201-1209. (Pubitemid 32758279)
185. Yang B, Ni HK.Diagnosis and treatment of spontaneous colonic perforation: analysis of 10 cases. World J Gastroenterol. 2008;14:4569-4572.
186. Ziegenhagen DJ, Zehnter E, Tacke W, Gheorghiu T, Kruis W. Senna vs. bisacodyl in addition to Golytely lavage for colonoscopy preparation-a prospective randomized trial. Z Gastroenterol. 1992;30:17-19.
187. Ziegenhagen DJ, Zehnter E, TackeW, Kruis W.Addition of senna improves colonoscopy preparation with lavage: a prospective randomized trial. Gastrointest Endosc. 1991;37:547-549.