Constipation is not only decreased stool frequency, but also difficulty in initiation or passage; passage of firm or small-volume feces, or a feeling of incomplete evacuation.
Although constipation has many reversible or secondary causes, including lack of dietary fiber, drugs, hormonal disturbances, neurogenic disorders, and systemic illnesses. In most cases of chronic constipation, no specific cause is found.
Clinical Trials on Senna:
A randomized, open, parallel group study was conducted to determine the efficacy of senna compared to lactulose in terminal cancer patients treated with opioids. Ninety-one terminal cancer patients were treated with either senna (starting with 0.4 mL daily) or lactulose (starting with 15 mL daily) for a 27-day period. The main outcome measures were defecation-free intervals of 72 hr., days with defecation, general health status, and treatment cost. Both treatment groups had similar scores for defecation-free intervals and in days with defecation. The final scores for general health status were similar in both groups.2
In A crossover control study of prophylactic treatment of chemotherapy induced constipationby senna extract. The effective rate of constipation by taking senna extract was 92.68% and that by the crude fiber diet was 10.93%.3
In a double-blind, active-comparator trial, 64 adults were enrolled; 56 participants (28 in each group) had baseline and follow up measures and were included in the intention to treat intention to treat (ITT) analyses. 43 participants completed the study, 21 in the active lubiprostone and 22 in the active Senna group. Both lubiprostone* and Senna improved constipation-related symptoms and Quality Of Life in opioid-induced constipation, with no significant between-group differences.4
Therapy with Senna should be the laxative treatment of choice as part of a bowel management program in children with repaired anorectal malformations and constipation.5