Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Alexandrian senna (Cassia senna or Senna alexandrina) is widely used as a stimulant laxative for the treatment of constipation, including in pediatric populations. Its primary active components, sennosides, act by stimulating peristalsis and altering electrolyte transport in the colon, which promotes bowel movement. The use of senna for constipation is supported by both historical use and modern clinical studies.

Several clinical guidelines, such as those from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), include senna as an option for treating pediatric constipation, especially in cases where osmotic laxatives like polyethylene glycol are ineffective or not tolerated. Systematic reviews and randomized controlled trials have found that senna is effective and generally safe for short-term use in children, although side effects like abdominal cramping and diarrhea can occur.

However, it is generally recommended that senna should not be used for prolonged periods in children due to potential risks such as dependence, electrolyte imbalance, and possible damage to the colonic mucosa. The quality of evidence for short-term use is moderate to high, but there is less data on long-term safety. In summary, the use of Alexandrian senna for pediatric constipation is scientifically validated for short-term management, supported by clinical evidence and guideline recommendations.

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