Synopsis

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

Alexandrian senna (Cassia senna) has a long history of traditional use as a stimulant laxative, primarily for the treatment of constipation. Its active compounds, known as sennosides, act on the colon to enhance peristalsis and promote bowel movements. In the context of Irritable Bowel Syndrome (IBS), senna has been traditionally used to help manage the constipation-predominant subtype (IBS-C). There is historical precedent for this use in both traditional medicine and in older Western herbal pharmacopoeias, where senna is recommended as a remedy for occasional constipation, including in IBS when constipation is the main symptom.

However, scientific evidence supporting senna’s use specifically for IBS is limited. Most clinical studies of senna focus on its efficacy as a short-term remedy for simple constipation rather than IBS per se. While senna is effective at inducing bowel movements, it can cause cramping, discomfort, and, with long-term use, potential dependency or electrolyte imbalance. Major guidelines for IBS management recommend osmotic laxatives or fiber as first-line therapies for constipation, with stimulant laxatives like senna being reserved for refractory cases due to their side effect profile.

In summary, while Alexandrian senna is traditionally used to support bowel regularity in individuals with constipation, including those with IBS-C, there is insufficient scientific validation for its use specifically in IBS. Its role is primarily as a traditional remedy rather than a scientifically endorsed treatment for IBS.

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