Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Hydroxyanthracene derivatives, found in plants such as senna, cascara, and aloe, have a long history of traditional use as stimulant laxatives. Their primary action is to increase intestinal motility and promote bowel movements, which has led to their use in the management of constipation and, by extension, some cases of "spastic colon" (an older term often used to describe symptoms of irritable bowel syndrome with constipation, IBS-C). Historical texts and herbal pharmacopeias document their use for this purpose across various cultures.

However, the evidence supporting their use specifically for "spastic colon" is limited. Most clinical studies have focused on their efficacy in treating acute or chronic constipation, not specifically the symptom complex of spastic colon. Some patients with IBS-C may benefit from the laxative effect, but hydroxyanthracene derivatives do not address the underlying dysmotility or visceral hypersensitivity of the colon characteristic of IBS. Furthermore, long-term use is discouraged due to potential adverse effects such as electrolyte imbalance, dependency, and possible carcinogenic risk. Regulatory bodies like the European Medicines Agency have also restricted their use due to safety concerns.

In summary, the use of hydroxyanthracene derivatives for spastic colon is primarily justified by tradition, with limited and indirect scientific evidence, and contemporary guidelines generally do not recommend them for this condition.

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