Are Senna based laxatives safe when used as long term treatment for constipation in children?

Vilanova-Sánchez, Alejandra; Gasior, Alessandra C.; Toocheck, Nicole; Weaver, Laura; Wood, Richard J.; Reck, Carlos A.; Wagner, Andrea; Hoover, Erin; Gagnon, Renae; Jaggers, Jordon; Maloof, Tassiana; Nash, Onnalisa; Williams, Charae; Levitt, Marc A.

doi:10.1016/j.jpedsurg.2018.01.002

Cited by 63 publications

(41 citation statements)

References 31 publications

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“…Pediatric caregivers should advise families of the rare side effect of skin blistering and educate them to change the diaper frequently in children who are not toilet- trained to reduce stool to skin exposure. Senna is a safe treatment option for constipation in children [ 106 ]. Until more data are available, the use of probiotics for the treatment of constipation should be considered investigational.…”

Section: Constipationmentioning

confidence: 99%

Alternative Treatments for Minor GI Ailments

Mohiuddin

2019

Innov Pharm

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About 80% of the population worldwide use a variety of traditional medicine, including herbal medicines, for the diagnosis, prevention and treatment of illnesses, and for the improvement of general well-being. Total consumer spending on herbal dietary supplements in the United States reached an estimated $8.085 billion in 2017. In addition, the 8.5% increase in total sales from 2016 is the strongest growth for these products in more than 15 years. The main reason to use herbal products in these countries is the assumption of a better tolerability compared to synthetic drugs. Whereas in developing countries herbal medicines are mostly the only available and affordable treatment option. Surveys from industrialized countries reveal as main health areas in which herbal products are used for upper airway diseases including cough and common cold; other leading causes are gastrointestinal, nervous and urinary complaints up to painful conditions such as rheumatic diseases, joint pain and stiffness. Gastrointestinal disorders are the most widespread problems in health care. Many factors may upset the GI tract and its motility (or ability to keep moving), including: eating a diet low in fiber; lack of motion or sedentary lifestyle; frequent traveling or changes in daily routine; having excessive dairy products; anxiety and depression; resisting the urge to have a bowel movement habitually or due to pain of hemorrhoids; misuse of laxatives (stool softeners) that, over time, weaken the bowel muscles; calcium or aluminum antacids, antidepressants, iron pills, narcotics; pregnancy. About 30% to 40% of adults claim to have frequent indigestion, and over 50 million visits are made annually to ambulatory care facilities for symptoms related to the digestive system. Over ten million endoscopies and surgical procedures involving the GI tract are performed each year. Community-based studies from around the world demonstrate that 10% to 46% of all children meet the criteria for RAP. Gastrointestinal disorders such as chronic or acute diarrhea, malabsorption, abdominal pain, and inflammatory bowel diseases can indicate immune deficiency, present in 5% to 50% of patients with primary immunodeficiencies. The gastrointestinal tract is the largest lymphoid organ in the body, so it is not surprising that intestinal diseases are common among immunodeficient patients. Gastroenterologists therefore must be able to diagnose and treat patients with primary immunodeficiency. Further, pathogens do influence the gut function. On the other hand, dietary habits and specific food types can play a significant role in the onset, treatment, and prevention of many GI disorders. Many of these can be prevented or minimized by maintaining a healthy lifestyle, and practicing good bowel habits. Article Type: Review

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Section: Constipationmentioning

confidence: 99%

Alternative Treatments for Minor GI Ailments

Mohiuddin

2019

Innov Pharm

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“…This may be explained by the fact that senna is a laxative that stimulates the movement of the intestinal tract and can induce abdominal pain [24]. Some previous studies on children also reported a high incidence of abdominal pain by senna [25][26][27][28]. Empirically, even though both polyethylene glycol and senna have been safely used for children and no serious adverse events were noted, we should be careful about abdominal pain as induced by senna.…”

Section: Discussionmentioning

confidence: 99%

Polyethylene Glycol Versus Senna for Bowel Preparation for Colonoscopy in Children: Updated Evidence by a Systematic Review and Meta-Analysis

Watanabe

Kotani

2021

Cureus

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For colonoscopy, bowel preparation, especially that using polyethylene glycol (PEG) or senna, is performed among children with gastrointestinal disorders; however, it is not fully grounded in evidence. This study reviewed via meta-analyses the approaches to bowel preparation for colonoscopy in children.Electronic databases and trial registries were searched until April 2021. Quality assessment was conducted using the Grading of Recommendations, Assessment, Development, and Evaluation method.In total, three randomized controlled trials (318 patients) were identified. PEG was observed as a preferred protocol of bowel preparation compared with senna (risk ratio [RR] 1.35, 95% confidence interval [CI] 1.05-1.74; I 2 = 15%). It was less painful than senna (RR 0.62, 95% CI 0.44-0.87; I 2 = 0%). No serious adverse events were noted. Overall, the certainty of the evidence was low to moderate.PEG might be a preferred preparation agent for colonoscopy in children. Given the limited data, more studies are recommended.

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“…The pathogenesis of the skin reaction to Senna overdose is unclear. It may be that the high concentration of digestive enzymes in the diarrheal stool due to the increased gut transit time may cause a chemical contact burn to the skin [201].…”

Section: Limitationsmentioning

confidence: 99%