Synopsis

Source of validity: Traditional
Rating (out of 5): 3

Hydroxyanthracene derivatives, such as those found in senna, cascara, and aloe, have a long history of use as stimulant laxatives for the treatment of constipation, including conditions described as "atonic colon" (colon with reduced muscle tone). Traditional medicine systems, particularly in Europe and Asia, have relied on preparations containing these compounds for centuries to stimulate bowel movements. The mechanism involves their conversion by colonic bacteria into active metabolites that increase peristalsis and inhibit water and electrolyte absorption in the colon, thereby softening stool and promoting evacuation. While there is substantial historical and clinical use supporting their efficacy for short-term relief of constipation, modern scientific evidence is more cautious due to potential side effects, including dependency, electrolyte imbalance, and concerns about long-term safety. Regulatory agencies such as the European Medicines Agency recognize their use for short-term constipation but advise against prolonged use. There is limited direct scientific evidence specifically addressing "atonic colon," as most studies focus on general constipation rather than atonic pathology. In summary, hydroxyanthracene derivatives are justified by strong traditional use and supported by moderate clinical evidence for short-term constipation, but their use in atonic colon specifically is based more on tradition than on robust scientific studies targeting this condition.

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