An Evidence-Based Systematic Review of Senna (Cassia senna) by the Natural Standard Research Collaboration

REFERENCES

• No authors listed. Minimun information for sensible use of self-prescribed medicines. An international consensus. Lancet. 1977;2:1017–1019.
   PubMed Web of Science ®Google Scholar
• Agra Y, Sacristan A, Gonzalez M, Ferrari M, Portugues A, Calvo MJ. Efficacy of senna versus lactulose in terminal cancer patients treated with opioids. J Pain Symptom Manage. 1998;15:1–7.
   PubMed Web of Science ®Google Scholar
• American Academy of Pediatrics. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108:776–789.
   PubMed Web of Science ®Google Scholar
• Arezzo A. Prospective randomized trial comparing bowel cleaning preparations for colonoscopy. Surg Laparosc Endosc Percutan Tech. 2000;10:215–217.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Baldwin WF. Clinical study of senna administration to nursing mothers: assessment of effects on infant bowel habits. Can Med Assoc J. 1963;89:566–568.
   PubMed Web of Science ®Google Scholar
• Beuers U, Spengler U, Pape GR. Hepatitis after chronic abuse of senna. Lancet. 1991;337:372–373.
   PubMed Web of Science ®Google Scholar
• Blair GK, Murphy JJ, Fraser GC. Internal sphincterotomy in post-pull-through Hirschsprung's disease. J Pediatr Surg. 1996;31:843–845.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Bossi S, Arsenio L, Bodria P, Magnati G, Trovato R, Strata A. Clinical study of a new preparation from plantago seeds and senna pods. Acta Biomed Ateneo Parmense. 1986;57:179–186.
   PubMedGoogle Scholar
• 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.
   PubMedGoogle Scholar
• 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.
   PubMedGoogle Scholar
• Brusick D, Mengs U. Assessment of the genotoxic risk from laxative senna products. Environ Mol Mutagen. 1997;29:1–9.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Cameron JC. Constipation related to narcotic therapy. A protocol for nurses and patients. Cancer Nurs. 1992;15:372–377.
   PubMed Web of Science ®Google Scholar
• Chilton AP, O'Sullivan M, Cox MA, Loft DE, Nwokolo CU. A blinded, randomized comparison of a novel, low-dose, triple regimen with fleet phospho-soda: a study of colon cleanliness, speed and success of colonoscopy. Endoscopy. 2000;32:37–41.
   PubMed Web of Science ®Google Scholar
• Chomnawang MT, Surassmo S, Nukoolkarn VS, Gritsanapan W. Effect of Garcinia mangostana on inflammation caused by Propionibacterium acnes. Fitoterapia. 2007;78:401–408.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• Corman ML. Management of postoperative constipation in anorectal surgery. Dis Colon Rectum. 1979;22:149–151.
   PubMed Web of Science ®Google Scholar
• Crossner CG, Birkhed D, Edwardsson S. The cariologic aspects of two laxatives—Senna (Fikonsirap) and Duphalac. Tandlakartidningen. 1982;74:284–288.
   PubMedGoogle Scholar
• 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.
   PubMedGoogle Scholar
• de WP. Metabolism and pharmacokinetics of anthranoids. Pharmacology. 1993;47(Suppl 1):86–97.
   PubMedGoogle Scholar
• de WP, Lemli L. The metabolism of anthranoid laxatives. Hepatogastroenterology. 1990;37:601–605.
   PubMedGoogle Scholar
• DiPalma JA. Current treatment options for chronic constipation. Rev Gastroenterol Disord. 2004;4(Suppl 2):S34–S42.
   PubMedGoogle Scholar
• Dubecq JP, Palmade J. Etude clinique de l'administration de Tamarine chez la mere qui allaite. Gaz Med Fr. 1974;81:5173–5175.
   Google Scholar
• Duncan, AS. Standardized senna as a laxative in the puerperium; a clinical assessment. Br Med J. 1957;1:439–441.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Faber P, Strenge-Hesse A. Relevance of rhein excretion into breast milk. Pharmacology. 1988;36(Suppl 1):212–220.
   PubMed Web of Science ®Google Scholar
• Faber P, Strenge-Hesse A. Senna-containing laxatives: excretion in the breast milk?. Geburtshilfe Frauenheilkd. 1989;49:958–962.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• Fireman Z, Rozen P, Fine N, Chetrit A. Reproducibility studies and effects of bowel preparations on measurements of rectal epithelial proliferation. Cancer Lett. 1989;45:59–64.
   PubMed Web of Science ®Google Scholar
• First international symposium on senna, May 22–23, 1987, Rottach-Egern (FRG). Proc. Pharm. 1988;36(Suppl 1):1–240.
   Google Scholar
• Fournier AM. Use of senna for the acceleration of small intestine transit in hospital radiology. Mars Med. 1971;108:469–474.
   PubMedGoogle Scholar
• Fugh-Berman A. Herb–drug interactions. Lancet. 2000;355:134–138.
   PubMed Web of Science ®Google Scholar
• Gattuso JM, Kamm MA. Adverse effects of drugs used in the management of constipation and diarrhoea. Drug Saf. 1994;10:47–65.
   PubMed Web of Science ®Google Scholar
• Glatzel H. Senna—an old drug in a new form. Z Allgemeinmed. 1970;46:82–84.
   PubMedGoogle Scholar
• Glatzel H. Results of long-term therapy of 1059 babitually constipated patients using a standardized senna preparation. Z Allgemeinmed. 1972;48:654–656.
   PubMedGoogle Scholar
• Godding EW. Laxatives and the special role of senna. Pharmacology. 1988;36(Suppl 1):230–236.
   PubMedGoogle Scholar
• Goppel M, Franz G. Stability control of senna leaves and senna extracts. Planta Med. 2004;70:432–436.
   PubMed Web of Science ®Google Scholar
• Gould SR, Williams CB. Castor oil or senna preparation before colonoscopy for inactive chronic ulcerative colitis. Gastrointest Endosc. 1982;28:6–8.
   PubMed Web of Science ®Google Scholar
• Greenhalf JO, Leonard HS. Laxatives in the treatment of constipation in pregnant and breast-feeding mothers. Practitioner. 1973;210:259–263.
   PubMedGoogle Scholar
• 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.
   PubMedGoogle Scholar
• Grossi F. Possibilities of a derivative of senna in the treatment of simple chronic constipation. Clin Ter. 1970;54:139–151.
   PubMedGoogle Scholar
• 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.
   PubMedGoogle Scholar
• Hagemann TM. Gastrointestinal medications and breastfeeding. J Hum Lact. 1998;14:259–262.
   PubMedGoogle Scholar
• Han RX. Study of the cleansing effect of senna on the intestinal tract. Zhonghua Hu Li Za Zhi. 1989;24:273–275.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Hardcastle JD, Wilkins JL. The action of sennosides and related compounds on human colon and rectum. Gut. 1970;11:1038–1042.
   PubMed Web of Science ®Google Scholar
• Heaton KW, Cripps HA. Straining at stool and laxative taking in an English population. Dig Dis Sci. 1993;38:1004–1008.
   PubMed Web of Science ®Google Scholar
• Heldwein W, 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.
   PubMed Web of Science ®Google Scholar
• Helin T, Makinen-Kiljunen S. Occupational asthma and rhinoconjunctivitis caused by senna. Allergy. 1996;51:181–184.
   PubMed Web of Science ®Google Scholar
• Hensel A, Deters AM, Muller G, Stark T, Wittschier N, Hofmann T. Occurrence of N-phenylpropenoyl-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.
   PubMed Web of Science ®Google Scholar
• Hietala P, Lainonen H, Marvola M. New aspects on the metabolism of the sennosides. Pharmacology. 1988;36(Suppl 1):138–143.
   PubMedGoogle Scholar
• Ip SW, Weng YS, Lin SY, Mei D, Tang NY, Su CC, Chung JG. The role of Ca+2 on rhein-induced apoptosis in human cervical cancer Ca Ski cells. Anticancer Res. 2007;27:379–389.
   PubMed Web of Science ®Google Scholar
• Izzo AA, Mascolo N, Capasso F. Nitric oxide as a modulator of intestinal water and electrolyte transport. Dig Dis Sci. 1998;43:1605–1620.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Kaspi T, Royds RB, Turner P. Qualitative determination of senna in urine. Lancet. 1978;1:1162.
   PubMed Web of Science ®Google Scholar
• Kenny SE, Irvine T, Driver CP, Nunn AT, Losty PD, Jones MO, 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• Kittisupamongkol W, Nilaratanakul V, Kulwichit W. Near-fatal bleeding, senna, and the opposite of lettuce. Lancet. 2008;371:784.
   PubMed Web of Science ®Google Scholar
• Kobashi K, Nishimura T, Kusaka M, Hattori M, Namba T. Metabolism of sennosides by human intestinal bacteria. Planta Med. 1980;40:225–236.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Krumbiegel G, Schulz HU. Rhein and aloe-emodin kinetics from senna laxatives in man. Pharmacology. 1993;47(Suppl 1):120–124.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Langmead L, Rampton DS. Review article: herbal treatment in gastrointestinal and liver disease—benefits and dangers. Aliment Pharmacol Ther. 2001;15:1239–1252.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• Lemli J. Senna: chemistry and pharmacology. Verh K Acad Geneeskd Belg. 1986;48:51–62.
   PubMedGoogle Scholar
• Lemli J. Metabolism of sennosides—an overview. Pharmacology. 1988a;36(Suppl 1), 126–128.
   Google Scholar
• Lemli J. Senna—an old drug in modern research. Pharmacology. 1988b;36(Suppl 1), 3–6.
   PubMedGoogle Scholar
• Lemli J. Mechanism of action of sennosides. Bull Acad Natl Med. 1995;179:1605–1611.
   PubMedGoogle Scholar
• Lemli J. The mechanism of action of sennosides. Ann Gastroenterol Hepatol (Paris). 1996;32:109–112.
   PubMedGoogle Scholar
• Leng-Peschlow E. Inhibition of intestinal water and electrolyte absorption by senna derivatives in rats. J Pharm Pharmacol. 1980;32:330–335.
   PubMed Web of Science ®Google Scholar
• Leng-Peschlow E. Acceleration of large intestine transit time in rats by sennosides and related compounds. J Pharm Pharmacol. 1986a;38:369–373.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Leng-Peschlow E. (ed.). Classification of senna as a laxative. Pharmacology. 1992a;44(Suppl. 1):6–9.
   PubMedGoogle Scholar
• Leng-Peschlow E (ed.). Identity of senna products. Pharmacology. 1992b;44(Suppl. 1):3–5.
   PubMedGoogle Scholar
• Leng-Peschlow E. (ed.). Modes of action of senna. Pharmacology. 1992c;44(Suppl. 1):16–19.
   PubMedGoogle Scholar
• Leng-Peschlow E. (ed.). Risk assessment for senna during pregnancy. Pharmacology. 1992d;44(Suppl. 1):20–22.
   PubMedGoogle Scholar
• Leng-Peschlow E. (ed.). Senna and damage of the nerve plexus of the intestinal wall. Pharmacology. 1992e;44(Suppl. 1):26–29.
   Google Scholar
• Leng-Peschlow E. (ed.). Senna and habituation. Pharmacology. 1992f;44(Suppl. 1):30–32.
   PubMedGoogle Scholar
• Leng-Peschlow E. (ed.). Senna and its rational use. Pharmacology. 1992g;44(Suppl. 1):1–52.
   Google Scholar
• Leng-Peschlow E. (ed.). Senna and pseudomelanosis coli. Pharmacology. 1992h;44(Suppl. 1):33–35.
   Google Scholar
• Leng-Peschlow E. (ed.). Senna in the puerperium. Pharmacology. 1992i;44(Suppl. 1):23–25.
   PubMedGoogle Scholar
• Leng-Peschlow E. (ed.). Site of senna action. Pharmacology. 1992j;44(Suppl. 1):10–15.
   PubMedGoogle Scholar
• Leng-Peschlow E. (ed.). The importance of senna products. Pharmacology. 1992k;44(Suppl. 1):1–2.
   Google Scholar
• Leng-Peschlow E. (ed.). The rational use of senna. Pharmacology. 1992l;44(Suppl. 1):41–42.
   Google Scholar
• Levine D, Goode AW, Wingate DL. Purgative abuse associated with reversible cachexia, hypogammaglobulinaemia, and finger clubbing. Lancet. 1981;1:919–920.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Lewis SJ, Heaton KW. Increasing butyrate concentration in the distal colon by accelerating intestinal transit. Gut. 1997a;41:245–251.
   PubMed Web of Science ®Google Scholar
• Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997b;32:920–924.
   PubMed Web of Science ®Google Scholar
• Lewis SJ, Heaton KW, Oakey RE, McGarrigle HH. Lower serum oestrogen concentrations associated with faster intestinal transit. Br J Cancer. 1997;76:395–400.
   PubMed Web of Science ®Google Scholar
• Lewis SJ, Oakey RE, Heaton KW. Intestinal absorption of oestrogen: the effect of altering transit-time. Eur J Gastroenterol Hepatol. 1998;10:33–39.
   PubMed Web of Science ®Google Scholar
• Lim AK, Hooke DH, Kerr PG. Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy. Med J Aust. 2008;188:121–122.
   PubMed Web of Science ®Google Scholar
• MacLennan WJ, Pooler AFWM. A comparison of sodium picosulphate (“Laxoberal”) with standardised senna (“Senokot”) in geriatric patients. Curr Med Res Opin. 1974;2:641–647.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Maguire LC, Yon JL, Miller E. Prevention of narcotic-induced constipation. N Engl J Med. 1981;305:1651.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Marcus SN, Heaton KW. Intestinal transit, deoxycholic acid and the cholesterol saturation of bile—three inter-related factors. Gut. 1986;27:550–558.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• McGuffin M, Hobbs C, Upton R, Goldberg A. American herbal products association's botanical safetly handbook. Boca Raton, FL: CRC Press, 1997.
   Google Scholar
• McLaughlin AF. Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy. Med J Aust. 2008;189:348.
   PubMed Web of Science ®Google Scholar
• Mengs U. Reproductive toxicological investigations with sennosides. Arzneimittelforschung. 1986;36:1355–1358.
   PubMed Web of Science ®Google Scholar
• Mengs U. Toxic effects of sennosides in laboratory animals and in vitro. Pharmacology. 1988;36(Suppl 1):180–187.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Miles CL, Fellowes D, Goodman ML, Wilkinson S. Laxatives for the management of constipation in palliative care patients. Cochrane Database Syst Rev. 2006; CD003448.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Mishalany H. Seven years’ experience with idiopathic unremitting chronic constipation. J Pediatr Surg. 1989;24:360–362.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Monias MB. Standardized senna concentrate in postpartum bowel rehabilitation. Md State Med J. 1966;15:32–33.
   PubMedGoogle Scholar
• Morris AI, Turnberg LA. Surreptitious laxative abuse. Gastroenterology. 1979;77:780–786.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Nielsen GD, Olsen O, Larsen ST, Lovik M, Poulsen LK, Glue C, Brandorff NP, Nielsen PJ. IgE-mediated sensitisation, rhinitis and asthma from occupational exposures. Smoking as a model for airborne adjuvants? Toxicology. 2005;216:87–105.
   PubMed Web of Science ®Google Scholar
• Njoroge GN, Bussmann RW. Ethnotherapeautic management of skin diseases among the Kikuyus of Central Kenya. J Ethnopharmacol. 2007;111:303–307.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Padumanonda T, Gritsanapan W. Barakol contents in fresh and cooked Senna siamea leaves. Southeast Asian J Trop Med Public Health. 2006;37:388–393.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• Palsson K, Jaenson TG. Plant products used as mosquito repellents in Guinea Bissau, West Africa. Acta Trop. 1999;72:39–52.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Patanwala AE, Abarca J, Huckleberry Y, Erstad BL. Pharmacologic management of constipation in the critically ill patient. Pharmacotherapy. 2006;26:896–902.
   PubMed Web of Science ®Google Scholar
• Perkin JM. Constipation in childhood: a controlled comparison between lactulose and standardized senna. Curr Med Res Opin. 1977;4:540–543.
   PubMed Web of Science ®Google Scholar
• Pers M, Pers B. A crossover comparative study with two bulk laxatives. J Int Med Res. 1983;11:51–53.
   PubMed Web of Science ®Google Scholar
• Pockros PJ, Foroozan P. Golytely lavage versus a standard colonoscopy preparation. Effect on normal colonic mucosal histology. Gastroenterology. 1985;88:545–548.
   PubMed Web of Science ®Google Scholar
• Prather CM. Pregnancy-related constipation. Curr Gastroenterol Rep. 2004;6:402–404.
   PubMedGoogle Scholar
• Prior J, White I. Tetany and clubbing in patient who ingested large quantities of senna. Lancet. 1978;2:947.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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. Am J Gastroenterol. 2005;100:2674–2680.
   PubMed Web of Science ®Google Scholar
• Radaelli F, Minoli G. Colonoscopy preparation: is there still room for senna? Gastrointest Endosc. 2002;56:463.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Ramesh PR, Kumar KS, Rajagopal MR, Balachandran P, Warrier PK. Managing morphine-induced constipation: a controlled comparison of an Ayurvedic formulation and senna. J Pain Symptom Manage. 1998;16:240–244.
   PubMed Web of Science ®Google Scholar
• Ramkumar D, Rao SS. Efficacy and safety of traditional medical therapies for chronic constipation: systematic review. Am J Gastroenterol. 2005;100:936–971.
   PubMed Web of Science ®Google Scholar
• Remes-Troche JM. Constipation: initial evaluation and diagnostic approach. Rev Gastroenterol Mex. 2005;70:312–322.
   PubMedGoogle Scholar
• Rodrigues E. Plants of restricted use indicated by three cultures in Brazil (Caboclo-river dweller, Indian and Quilombola). J Ethnopharmacol. 2007;111:295–302.
   PubMed Web of Science ®Google Scholar
• Rogers HJ, 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.
   PubMed Web of Science ®Google Scholar
• Sanders RC, Wright FW. Colonic preparation: a controlled trial of Dulcodos, Dulcolax and Senokot DX. Br J Radiol. 1970;43:245–247.
   PubMed Web of Science ®Google Scholar
• Sansores-Peraza P, Rosado-Vallado M, Brito-Loeza W, Mena-Rejon GJ, Quijano L. Cassine, an antimicrobial alkaloid from Senna racemosa. Fitoterapia. 2000;71:690–692.
   PubMed Web of Science ®Google Scholar
• Seybold U, Landauer N, Hillebrand S, Goebel FD. Senna-induced hepatitis in a poor metabolizer. Ann Intern Med. 2004;141:650–651.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Shelton MG. Standardized senna in the management of constipation in the puerperium: a clinical trial. S Afr Med J. 1980;57:78–80.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Sogni P, Chaussade S, Akue-Gohe K, Nepveux P, Homerin M, Couturier D, 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.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Soyuncu S, Cete Y, Nokay AE. Portal vein thrombosis related to Cassia angustifolia. Clin Toxicol (Phila). 2008;46:774–777.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Staumont G, Frexinos J, Fioramonti J, Bueno L. Sennosides and human colonic motility. Pharmacology. 1988;36(Suppl 1):49–56.
   PubMedGoogle Scholar
• Stickel F, Schuppan D. Herbal medicine in the treatment of liver diseases. Dig Liver Dis. 2007;39:293–304.
   PubMedGoogle Scholar
• Sykes NP. A volunteer model for the comparison of laxatives in opioid-related constipation. J Pain Symptom Manage. 1996;11:363–369.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Thorpe DM. Management of opioid-induced constipation. Curr Pain Headache Rep. 2001;5:237–240.
   PubMedGoogle Scholar
• Tooson JD, Gates LK, Jr. Bowel preparation before colonoscopy. Choosing the best lavage regimen. Postgrad Med. 1996;100:203–212, 214.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Tyson RM, Shrader EA, Perlman HH. Drugs transmitted through breast milk. Part I: laxatives. J Pediatr. 1937;11:824–832.
   Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMedGoogle Scholar
• Van Der Jagt EJ, Thijn CJ, Taverne PP. Colon cleansing prior to roentgenologic examination. A double blind comparative study. J Belge Radiol. 1986;69:167–170.
   PubMedGoogle Scholar
• van Gorkom BA, Karrenbeld A, Limburg AJ, Kleibeuker JH. The effect of sennosides on colonic mucosal histology and bowel preparation. Z Gastroenterol. 1998;36:13–18.
   PubMed Web of Science ®Google Scholar
• van Gorkom BA, Karrenbeld A, Van Der ST, Koudstaal J, de Vries EG, Kleibeuker JH. Influence of a highly purified senna extract on colonic epithelium. Digestion. 2000;61:113–120.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Waller SL. Proceedings: comparative effects of codeine and senna on the motor activity of the left colon. Gut. 1975;16:407–408.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Watson R. Senna-pod and wintergreen. Nurs Times. 1992;88:64.
   PubMedGoogle Scholar
• Werthmann MW, Jr, Krees SV. Quantitative excretion of Senokot in human breast milk. Med Ann Dist Columbia. 1973;42:4–5.
   PubMedGoogle Scholar
• Wildgrube HJ, Lauer H. Combination intestinal lavage: a conservative procedure for colonoscopy. Bildgebung. 1991;58:63–66.
   PubMedGoogle Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Xing JH, Soffer EE. Adverse effects of laxatives. Dis Colon Rectum. 2001;44:1201–1209.
   PubMed Web of Science ®Google Scholar
• Yang B, Ni HK. Diagnosis and treatment of spontaneous colonic perforation: analysis of 10 cases. World J Gastroenterol. 2008;14:4569–4572.
   PubMed Web of Science ®Google Scholar
• 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.
   PubMed Web of Science ®Google Scholar
• Ziegenhagen DJ, Zehnter E, Tacke W, Kruis W. Addition of senna improves colonoscopy preparation with lavage: a prospective randomized trial. Gastrointest Endosc. 1991;37:547–549.
   PubMed Web of Science ®Google Scholar