Marc Holland
Senna is a herb with a laxative effect. It is the most commonly used ingredient in commercial laxative preparations. Senna stimulates the movement of the digestive system, resulting in a laxative effect. It is available in tea form and typically works in 8–12 hours. However, long-term and high-dose use of senna has been reported to cause liver damage. Other herbs with laxative effects include rhubarb, cascara sagrada (buckthorn), slippery elm, and licorice root.
| Characteristics | Values |
|---|---|
| Herb with a possible laxative effect | Senna |
| Other herbs with laxative effects | Licorice root, black cohosh, St. John's wort, holy basil |
| Rhubarb, cascara sagrada (buckthorn), slippery elm, dandelion root, elderberry, ginger, castor oil | |
| Type of laxative | Stimulant laxatives, herbal laxatives, anthraquinone-containing laxatives, herbal stimulant laxatives, bulk-forming laxatives, saline laxatives, stool softeners, lubricant laxatives, osmotic laxatives |
| Mechanism of action | Stimulating nerves in the GI tract, stimulating muscle contractions in the bowel, drawing fluid into the intestines, increasing peristalsis, reducing fluid absorption from the intestines, increasing fluid secretion in the colon |
| Side effects | Abdominal pain, electrolyte imbalance, liver injury, mild cramping, diarrhea |
| Precautions | Not recommended for long-term use, may build up tolerance, follow dosage recommendations, not safe for children, check with a doctor or pharmacist before use, do not exceed the recommended dose |
What You'll Learn
Senna
The most common side effects of taking Senna are stomach cramps and diarrhoea. Urine may also turn a red-brown colour, which is harmless and will disappear when you stop taking the medication.
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Rhubarb
Medicinal Uses
Culinary Uses
Precautions
While rhubarb is generally considered safe when consumed as food, there are some precautions to be aware of when using it medicinally. Rhubarb can cause side effects such as stomach pain, diarrhoea, and uterine contractions. Long-term use can result in muscular weakness, bone loss, potassium loss, and irregular heart rhythm. It may also worsen diarrhoea and constipation, depending on the preparation used. Rhubarb should be avoided by those with bowel obstructions, inflammatory bowel conditions, kidney disease, or liver problems. It can also interact with certain medications, including digoxin, corticosteroids, and diuretics.
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Slippery Elm
The inner bark of slippery elm contains mucilage, a sticky mixture of sugars that the human digestive tract cannot break down. When mixed with water, it forms a slick gel that coats and soothes the mouth, throat, stomach, and intestines. Slippery elm also contains antioxidants that help relieve inflammatory bowel conditions. The increased mucus production may protect the gastrointestinal tract against ulcers and excess acidity.
- Tablets and capsules
- Finely powdered bark for making teas or extracts
- Coarsely powdered bark for poultices
While slippery elm has been used traditionally to treat constipation, there is limited scientific evidence to support this claim. However, it is possible that slippery elm may help relieve constipation due to the presence of mucilage, which can work similarly to other types of fibre recommended for constipation relief.
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Cascara Sagrada
Today, cascara sagrada is available as a dietary supplement, but not as a drug. It is important to note that there is insufficient scientific evidence to support the effectiveness and safety of cascara sagrada, especially for long-term use. Side effects may include abdominal cramps, electrolyte imbalance, and dehydration. It is recommended for short-term use only (less than one week).
While cascara sagrada has been traditionally used as a laxative, its effectiveness and safety profile are uncertain. It is important to consult a healthcare professional before taking cascara sagrada or any other dietary supplement, especially if you have a medical condition or are taking medications.
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Ma Zi Ren Wan
- Fructus Cannabis (Huo Ma Ren)
- Radix et Rhizoma Rhei (Da Huang)
- Radix Paeoniae Alba (Bai Shao)
- Semen Armeniacae Amarum (Ku Xing Ren)
- Fructus Aurantii Immaturus (Zhi Shi)
- Cortex Magnoliae Officinalis (Hou Po)
MZRW is believed to have a laxative effect by softening stools, reducing water absorption, activating intestinal mucosa, and re-establishing gastrointestinal homeostasis, which strengthens colonic motility and relieves constipation.
MZRW has been studied in clinical trials for its effectiveness in treating functional constipation. In one randomized, double-blind, placebo-controlled trial, MZRW was found to be more effective than senna, a popular herbal laxative, and a placebo in increasing complete spontaneous bowel movement (CSBM). The trial also showed that MZRW significantly increased colonic transit, reduced the severity of constipation symptoms, and had durable benefits beyond the treatment period.
Another three-armed randomized trial involving 291 patients with functional constipation compared MZRW (7.5g twice daily) with senna (15mg daily) and a placebo over an 8-week treatment period. The results showed that MZRW was more effective than senna and the placebo in producing a complete response, defined as an increase of >1 CSBM per week compared to the baseline. MZRW also reduced straining and global constipation symptoms and had benefits that persisted at the 16-week follow-up.
MZRW has been generally well-tolerated in clinical trials, with side effects including cramping, bloating, nausea, vomiting, diarrhoea, difficulty urinating, and worsened rhinitis.
In summary, MZRW is a traditional Chinese herbal formula that has been shown to be effective in treating functional constipation, with potential benefits beyond those of conventional laxatives. Further research is needed to understand its mechanisms of action and effectiveness in diverse populations.
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Frequently asked questions
Senna is the herb that is most often used as an ingredient in commercial laxative preparations. Other herbs that have a possible laxative effect include rhubarb, cascara sagrada (buckthorn), slippery elm, and licorice root.
The use of herbal laxatives can lead to a range of side effects, from mild to severe. Some common side effects include mild cramping and diarrhea. In rare cases, excessive use of herbal laxatives can lead to electrolyte deficiency and even death.
No, herbal stimulant laxatives are not recommended for long-term use. Prolonged use can lead to a build-up of tolerance, requiring higher doses for effectiveness. It is important to carefully follow the recommended dosage and read labels to understand the ingredients being introduced into the body.
