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PubMed1999

The effect of sennosides on bacterial translocation and survival in a model of acute hemorrhagic pancreatitis.

Bacterial translocation leading to subsequent infectious complications is a significant determinant of outcome in acute hemorrhagic pancreatitis (AHP). The colonic ileus and impaired intestinal barrier function that often accompany AHP may predispose to translocation. Sennoside is a naturally occurring cathartic and choleretic agent that stimulates intestinal mucous secretion and has potent promotility effects. The impact of sennoside-induced intestinal motility and secretory function on bacterial translocation and survival was studied in a rat model of AHP. Severe acute pancreatitis was induced in rats by the intraductal infusion of 2% sodium deoxycholate (DCA, 0.4 ml/kg). A group of sham-operated rats (group A) received intraductal saline, whereas experimental animals were subsequently administered distilled water (group B) or sennoside solution (group C) by gavage every 8 h. After 48 h, intestinal transit of fluorescein isothiocyanate-labeled dextran, serum endotoxin, and amylase levels, and bacterial translocation to mesenteric lymph nodes (MLNs) and pancreatic tissue were determined. The pancreas and intestine were sampled for histologic study. All group A animals survived and did not develop pancreatitis or endotoxemia, whereas groups B and C all demonstrated severe hemorrhagic pancreatitis with evidence of necrosis. Mortality at 48 h was 55% in group B versus 12.5% in group C. Inhibition of intestinal motility was noted in 40% versus 20%, and endotoxin levels were 61.36+/-28.26 pg/L versus 5.41+/-3.58 pg/L in group B versus group C rats, respectively (p<0.001). Pancreatic tissue and MLN cultures were positive in 100% of group B survivors versus 14% of group C survivors (p<0.05). Histologic examination of the intestine in group C animals showed increased mucous secretion, proliferation of goblet cells, and evidence of rapid turnover/renewal of enterocytes. Treatment with the cathartic agent, sennoside, reduced translocation of endotoxin and bacteria, restored intestinal motility, increased mucous secretion, and reduced mortality in a model of acute hemorrhagic pancreatitis in the rat. Other cathartics may have similar properties and may be useful in preventing infectious complications in acute pancreatitis.

Acute Disease↗
PubMed2005

Assessment of large bowel motility by cine magnetic resonance imaging using two different prokinetic agents: a feasibility study.

OBJECTIVES: We sought to assess large bowel motility, induced by 2 prokinetic agents, senna tea and erythromycin, using functional cine magnetic resonance imaging (MRI). MATERIALS AND METHODS: Twelve volunteers underwent functional cine MRI before and after the administration of senna tea or erythromycin. The protocol consisted of 2 sets of repeated measurements using coronal T2-weighted HASTE sequences, adjusted to the course of the colon. For the assessment of large bowel motility, the changes of the luminal diameter were measured at 5 defined locations in the ascending, transverse, and descending colon. RESULTS: In all examined volunteers after senna tea, the mean number of significant changes in the ascending colon was 8.6 and after erythromycin, 7.2. In the transverse colon, 9.6 diameters changed significantly for senna tea and 7.2 for erythromycin. In the descending colon, 6.6 diameters changed after senna tea and 7.2 after erythromycin. CONCLUSION: Senna tea and erythromycin proved to induce large bowel motility; senna tea was more effective. Functional cine MRI is a reliable, noninvasive method for the assessment of colonic motility.

Administration, Oral↗
PubMed1987

The carry-over effect on the bowel habit in elderly long-term patients of long-term bulk-forming products containing stimulant laxative.

This study was undertaken to investigate the possible carry-over effect on elderly long-term patients of bulk-forming products containing stimulant type laxatives. Thirty-six patients received magnesium hydroxide daily for a mean period of 10 months prior to the study, and 23 patients received bulk laxatives containing cassiae senna daily for a mean period of 13 months prior to the study. The pre-study laxatives were randomly changed either to magnesium hydroxide or to bulk laxatives. In the patient group receiving a bulk-forming product containing stimulant type laxative long-term prior to the study, the need for additional stimulant laxatives during the pure bulk laxative (3.0 vs. 3.8/4 weeks, NS) or magnesium hydroxide treatment (2.6 vs. 2.7/4 weeks, NS) was not more frequent and the frequency of defaecation was not lower than in the patients (during bulk laxative 11.2 vs. 9.3/4 weeks, NS and during magnesium hydroxide 12.0 vs. 13.7/4 weeks, NS) who received long-term magnesium hydroxide treatment prior to the study. Thus, our data indicated no carry-over effect after the use of bulk-forming laxatives containing senna for 13 months in elderly long-term patients.

Aged↗
PubMed1994

Comparative effects of intraduodenal psyllium and senna on canine small bowel motility.

BACKGROUND/AIM: To define the possible contribution of altered small intestinal motor activity to side-effects of bulking fibres, we sought to compare the relative effects of intraduodenal and intracolonic administration of the bulking fibre psyllium and the anthraquinone laxative senna on canine small intestinal motor activity. METHODS: Motor activity was recorded by serosal strain gauges implanted along the small intestine in 6 dogs. In random order, the motor responses to the instillation of psyllium (in doses of 5 or 10 g), senna (10 mg/kg) or appropriate vehicle (200 ml water infusion or saline 5 ml bolus) into either the proximal duodenum or proximal colon were assessed. RESULTS: The intra-duodenal administration of psyllium in either dose consistently induced a prolonged burst of 'clustered' contractions; in contrast, clusters were infrequent and of short duration following instillation of either vehicle or senna (P < 0.05). Intraduodenal instillation of psyllium inhibited migrating motor complex (MMC) migration and consistently delayed the onset of the next MMC cycle; a similar inhibition occurred with vehicle, however. Neither senna nor its vehicle inhibited MMC migration. None of these agents had any effect on small intestinal motor activity when instilled directly into the colon. CONCLUSIONS: Psyllium administered directly into the duodenum inhibits MMC activity and consistently induces 'clustered' contractions. Whilst the MMC-inhibitory effect appears to be a non-specific volume-related phenomenon, the induction of clusters is independent of volume or laxation. These motor effects of psyllium may contribute to the gastrointestinal symptomatology related to such agents and could be avoided by the preferential release of psyllium in the colon.

Animals↗
PubMed1978

Comparison of the effect of drugs upon some commonly used measures of bowel transit time.

1 To study the effect of drugs on methods of assessment of gut transit time a double-blind study of the effect of single doses of placebo, oxyphenisatin, anthracene purgatives, (+)-norpseudoephedrine and a combined preparation of (+)-norpseudophedrine and senna was carried out in ten normal volunteers. Gut transit time was assessed by dye and radio-opaque marker methods. 2 It was possible to demonstrate the effect of the anthracenes but not oxyphenisatin on gut transit time. 3 More sophisticated statistical techniques were required to demonstrate the retarding effect of the sympathomimetic amine and its reversal by senna. 4 Statistical analysis shows that assessment of intestinal transit time by dye or pellet methods gives identical information.

Adult↗
PubMed1996

Occupational asthma and rhinoconjunctivitis caused by senna.

Occupational sensitization to senna is seldom reported. We describe a 21-year-old male atopic factory worker who developed IgE-mediated asthma and rhinoconjunctivitis 5 months after exposure to senna while he was working for a company manufacturing hair dyes. In the bronchial challenge test with senna, he exhibited a strong reaction. The skin prick test gave a 12-mm wheal reaction. The radioallergosorbent test (RAST) with senna was highly positive (33.6 PRU/ml, class 4), and could not be inhibited with pollens or foods. In protein staining with SDS-PAGE, two heavy bands were detected in senna at about 14 and 25 kDa, and two faint bands were visible at 19 and 21 kDa, In IgE immunoblotting with the patient's serum, one heavy band was detected at about 16 and four faint bands at 23, 25, 28, and 38 kDa. The patient became symptom free after he had changed his job within the same company.

Adult↗
PubMed1983

A controlled trial of 'Senokot' in faecal soiling treated by behavioural methods.

A double-blind randomly controlled trial of one particular laxative, Senokot, used in moderate dosage, was carried out on a group of 40 children with severe and persistent soiling and often with a history of faecal retention. Significant improvement occurred following three months of outpatient treatment using a behavioural approach and either Senokot, placebo or no medication. However, there was no evidence either during the trial or subsequently when Senokot was employed to supplement behavioural treatment in every child who continued with therapy that this laxative contributed in any way to relieving the problem in this group of cases.

Behavior Therapy↗
PubMed1979

Regulation of bowel function by a laxative/stool softener preparation in aged nursing home patients.

A 12-week program for 42 chronically constipated patients in a nursing home involved a graduated dosage regimen of standardized senna concentrate with dioctyl sodium sulfosuccinate (Senokot-S Tablets), a high-fiber diet, and an increased fluid intake. The program achieved a satisfactory pattern of bowel evacuation in 36 (86 percent) of these patients. This pattern, as observed during a 4-week follow-up period while therapy was continued, was characterized by absence of fecal impactions, regular comfortable bowel movements of appropriate consistency, minimal or no straining at stool, and minimal or no resort to enemas. In the initial 2-week control period, none of the 42 patients had responded adequately to only dietary modification and increased hydration. Six additional patients whose response to the control regimen was equivocal, also appeared to benefit from the medication program. Two of these were able to discontinue the laxative tablets completely by the end of the 12-week test period. None of the 48 patients who completed the course experienced any adverse effects related to this rehabilitative program.

Aged↗
PubMed2005

High-dose senna compared with conventional PEG-ES lavage as bowel preparation for elective colonoscopy: a prospective, randomized, investigator-blinded trial.

OBJECTIVE: To compare the efficacy and patient acceptance of an oral high dose of senna to conventional polyethylene glycol-electrolyte lavage solution (PEG-ES) in adults undergoing elective colonoscopy. METHODS: Consecutive outpatients referred for elective colonoscopy were prospectively randomly assigned to receive, the day before the procedure, either 24 tablets of 12 mg senna, divided into two doses at 1 p.m. and 9 p.m. (senna group, n=191), or standard 4-L PEG-ES (PEG-ES group, n=92). The overall quality of colon cleansing (primary outcome measure) and cleansing in the right colon were evaluated using the Aronchick scoring scale (1=excellent to 4=inadequate) by the investigator/endoscopist who was blinded to the treatment assignment. Patient acceptance and the safety of the preparation were assessed by a nurse, using a structured questionnaire covering compliance with the dosing, overall tolerance of the preparation (1=none or mild discomfort to 4=severely distressing), and adverse events. RESULTS: The quality of colon cleansing, overall tolerance of the preparation, and compliance were significantly better with senna; overall cleansing was excellent or good in 90.6% of patients in the senna group and in 79.7% in the PEG-ES group (p= 0.003). The percentage of procedures rescheduled because of insufficient colon cleansing was 7.3% in the PEG-ES group and 2.6% in the senna group (p=0.035). Multivariate logistic regression modeling showed the PEG-ES preparation as negative independent predictor of unsuccessful bowel cleansing. The incidence of adverse reactions was similar in the two groups; patients who received senna experienced significantly less nausea and vomiting, but more abdominal pain. CONCLUSIONS: An oral high dose of senna is a valid alternative to standard PEG-ES for outpatient colonoscopy preparation.

Administration, Oral↗
PubMed1988

The effect of different storage conditions on the chemical stability, laxative effect and acute toxicity of sennoside solutions.

This paper investigates the effect of different storage conditions on the chemical stability, laxative effect and acute toxicity of sennoside solutions. The variables in storage conditions were pH, time and temperature (room temperature or 100 degrees). The chemical stability of sennosides in aqueous solutions was found to be pH-dependent, with the best stability at pH 6.5 (t90. = 8.4 months) and the poorest at pH 8.0 (t90. = 2.5 months). Two years of storage at room temperature did not reduce the laxative potency in mice, regardless of the pH. After 4.25 years of storage the potency declined in alkaline solutions only. The degradation products with laxative potencies are chemically unknown. The acute toxicity of sennoside solutions increased with time during storage, the acid solution being more toxic than either the neutral or alkaline ones.

Animals↗