Hydroxyanthracene derivatives (HADs), found in plants such as senna (Senna alexandrina), cascara sagrada, and aloe, have a long history of traditional use as stimulant laxatives. Their primary mechanism is to increase intestinal motility and promote water secretion into the bowel, leading to laxative effects. In cases of "spastic colon" (an older term often used for irritable bowel syndrome or IBS with predominant constipation), these agents have been used traditionally to relieve constipation. However, the evidence base for their use in "spastic colon" specifically is limited. Most scientific research focuses on their efficacy in treating simple constipation, not directly on spastic colon or IBS subtypes. Additionally, spastic colon can involve alternating constipation and diarrhea, and stimulant laxatives can worsen symptoms in some cases due to increased bowel irritation or cramping. Regulatory agencies, such as the European Medicines Agency (EMA), recognize the traditional use of HADs for short-term relief of occasional constipation but caution against prolonged use due to potential adverse effects, including electrolyte imbalance and dependency. There is little high-quality clinical trial data supporting their use specifically for IBS or "spastic colon," and their use is generally based on historical practices rather than robust modern evidence. In summary, while hydroxyanthracene derivatives have a traditional role in managing constipation, evidence supporting their use for "spastic colon" is weak and mostly anecdotal.