SENNA LEAF SKIN
All of the cases described had a long period of exposure of the skin to stool. Senna induced dermatitis is rare, but may occur when patients need a higher dose. There is a paucity of information in the literature regarding side effects of sennosides as a long-term therapy, and to our knowledge, this is the first review of Senna side effects in children. We found no evidence of tolerance to Senna in our review. There were no other long-term side effects from Senna found in the pediatric literature for long-term treatment besides abdominal cramping or diarrhea during the first weeks of administration. The doses of Senna was not significantly different in these patients 15mg/day vs. 83 (13%) patients presented minor side effects such as abdominal cramping, vomiting or diarrhea which resolved once the type of laxatives were changed or enemas were started. All of the blistering episodes were related to night-time accidents, with a long period of stool to skin contact. Patients who developed blisters had higher doses 60mg/day 60 vs. During the study period, 17 patients (2.2%) developed blisters during their treatment. At our institution, from 2014 to 2017, we prescribed Senna and have recorded data to 640 patients. All of the blistering episodes were related to high dose, night-time accidents, or intense diarrhea with a long period of stool to skin contact.
Of those occurrences, 18 patients (64%) had accidental administration of Senna and 10 (36%) had Senna prescribed as a long term treatment. We also reviewed the charts of our patients who had previously taken Senna or are currently taking Senna, looking for adverse reactions.Įight articles in the literature reported perineal blisters after administration of Senna laxatives in 28 patients. We looked for articles with information regarding perineal blisters related to Senna as well as other secondary effects of Senna laxatives in children when used on a long-term basis. We performed a literature review (MEDLINE, PUBMED) using the keywords of Senna, sen, sennosides and children, and pediatric and functional (idiopathic) constipation. Because of this we chose to review the literature to identify side effects in children taking this medication as well as to analyze our Center's experience with Senna's secondary effects. We recently found several patients we were caring for developed perineal blistering during the course of Senna treatment. Many clinicians avoid Senna for reasons such as tolerance or side effects but this has little scientific justification.
2017 6(2): 349-353.Senna is a stimulant laxative commonly used by pediatricians, pediatric gastroenterologists, and pediatric surgeons. Journal of Pharmacognosy and Phytochemistry. Recent Advances on Senna as a Laxative: A Comprehensive Review. Effect of dietary fiber on constipation: a meta analysis. Senna treatment in pregnant women and congenital abnormalities in their offspring-a population-based case-control study. Acute liver failure with renal impairment related to the abuse of senna anthraquinone glycosides. Vanderperren B, Rizzo M, Angenot L, Haufroid V, Jadoul M, Hantson P. Evidence-based clinical practice guidelines for irritable bowel syndrome 2020. Anti-inflammatory, laxative and intestinal motility effects of Senna macranthera leaves. Guarize L, Costa JC, Dutra LB, Mendes RF, Lima IV, Scio E. Addition of senna improves quality of colonoscopy preparation with magnesium citrate. Vradelis S, Kalaitzakis E, Sharifi Y, et al. Chronic constipation: current treatment options. Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review.
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