Effectiveness of senna vs polyethylene glycol as laxative therapy in children with constipation related to anorectal malformation

Santos-Jasso, Karla Alejandra; Arredondo-Garcı́a, José Luis; Maza-Vallejos, Jorge; Valle, Pablo Lezama-Del

doi:10.1016/j.jpedsurg.2016.10.021

Cited by 38 publications

(16 citation statements)

References 10 publications

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“…Oral laxatives are the most commonly prescribed treatments for fecal disimpaction and maintenance therapy, but their long-term use has not been adequately evaluated. 14 - 17 The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) guidelines recommend polyethylene glycol (PEG) with or without electrolytes, dosed orally (1-1.5 g/kg/d) for 3 to 6 days as the first-line treatment for children presenting with fecal impaction. 16 If PEG is unavailable, lactulose is recommended as the first-line maintenance treatment, whereas milk of magnesia, mineral oil, and stimulant laxatives may be considered as additional or second-line treatment.…”

Section: Resultsmentioning

confidence: 99%

“… 16 While significant improvements in constipation symptoms have been reported with both osmotic (eg, PEG) and stimulant (eg, senna) laxatives in RCTs, approximately 40% to 50% of children with functional constipation experience at least 1 episode of relapse within the first 5 years after initial recovery. 14 , 16 , 18 Dietary fibers, traditional medicine, and probiotics are commonly used; however, the clinical evidence supporting their use is not clear. 16 , 19 - 22 Prebiotics and probiotics may be effective at improving clinical symptoms, but data from RCTs are limited.…”

Section: Resultsmentioning

confidence: 99%

“…In a recent RCT conducted in constipated children with anorectal malformations, senna demonstrated greater efficacy than PEG on the endpoints assessed, including presence of daily bowel movements, absence of fecal soiling, and a clean abdominal X-ray obtained after passing stool. 14 However, in previous studies senna was less effective than lactulose or mineral oil, and was associated with worsened fecal incontinence. 28 Taken together, existing studies do not provide conclusive evidence favoring any particular treatment option for PFC.…”

Section: Resultsmentioning

confidence: 99%

“…29 These findings highlight the need for well-designed clinical studies of sufficient duration that permit investigation of current treatments on constipation outcomes over an extended period (6-12 months). [8][9][10] • Growing use of probiotics/ fiber 10,[12][13][14][15] Randomized controlled trials: 22…”

Section: Clinical Researchmentioning

confidence: 99%

See 3 more Smart Citations

Unmet Needs in Pediatric Functional Constipation

Sood

Lichtlen²,

Pérez

2018

Clin Pediatr (Phila)

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Clinical Researchmentioning

confidence: 99%

See 2 more Smart Citations

Unmet Needs in Pediatric Functional Constipation

Sood

Lichtlen²,

Pérez

2018

Clin Pediatr (Phila)

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“…Another study by Yenidogan et al reported that same-day administration of senna was safe and effective for bowel cleansing before colonoscopy and that patients were positive about using the same product in the future [16]. Another study conducted in the pediatric population showed that a three-day regimen of senna was comparable to a one-day regimen of PEG-bisacodyl [17]. A clinical trial conducted by Santos-Jasso et al compared the effects of senna vs. PEG in constipated pediatric patients with anorectal malformation; the trial suggested that senna should be the laxative of choice for bowel management in pediatric patients [18].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy and Safety of Combined Senna and Probiotic-Based Bowel Preparation for Colonoscopy in Children

Kesavelu¹

2020

Cureus

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Background and objective Bowel preparation (BP) is a major determinant of accurate and successful colonoscopy and its outcomes in children and adults. The present study aimed to evaluate the effectiveness and safety of a senna alkaloid and probiotic-based BP in children undergoing elective colonoscopy. Methods Children aged 2-15 years who underwent esophagogastroduodenoscopy (OGD) and colonoscopy for various indications from December 2018 to May 2019 at the Apollo Children's Hospital who were prescribed a senna and probiotic-based [Bacillus coagulans (B. coagulans)] preparation before the procedure were included in the study. The effectiveness of the bowel preparation was assessed using the Boston Bowel Preparation Scale (BBPS). Safety assessment was performed by recording adverse events in the study. Results Successful bowel preparation was observed in all patients according to BBPS, and the mean BBPS score was 2.93 ±0.25, indicating good bowel clearance. About 29 (96.67%) patients showed accessible terminal ileum. There were no major side effects reported in the study. The formulation was found to be palatable and acceptable by 100% of patients. Conclusion The study revealed the administration of the novel BP to be effective and safe in children undergoing elective colonoscopy for various indications.

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Novel Natural Candidates for Replacing Synthetic Additives in Nutraceutical and Pharmaceutical Areas: Two Senna Species (S. alata (L.) Roxb. and S. occidentalis (L.) Link)

Yagi,

Cetiz,

Zengin

et al. 2024

Food Science & Nutrition

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Senna alata (L.) Roxb. and Senna occidentalis (L.) Link (family Fabaceae) are commonly used in different systems of traditional medicine to treat ailments. The present study was designed to determine the phytoconstituents, antioxidant, enzyme inhibition, and antimicrobial activities of the methanolic extract from the leaves of these two Senna species. A total of 75 phenolic compounds belonging to dihydroxybenzoic acids, dihydroxycinnamic acids, flavonoid C‐glycosides, flavonoid O‐glycosides, flavonoid aglycones, anthraquinone glycosides, and anthraquinone aglycones were identified. Flavonoid C‐glycosides were only found in S. occidentalis while sennosides A, B, and C were only detected in S. alata. In line with its higher total phenolic and flavonoids contents, S. alata exerted significantly (p < 0.05) higher antiradical (2,2‐diphenyl‐1‐picrylhydrazy (DPPH) = 58.36 mg trolox equivalent (TE)/g; 2,2′‐azino‐bis(3‐ethylbenzothiazoline‐6‐sulfonic acid (ABTS) = 118.86 mg TE/g), ions reducing (cupric reducing antioxidant capacity (CUPRAC) = 93.85 mg TE/g; ferric reducing antioxidant power (FRAP) = 50.42 mg TE/g), and total antioxidant (1.39 mmol TE/g) activities than S. occidentalis. S. alata revealed significantly (p < 0.05) higher inhibitory effect against butyrylcholinesterase (1.67 mg galantamine equivalent (GALAE)/g), tyrosinase (45.07 mg KAE/g) 45.07 mg kojic acid equivalent (KAE)/g), α‐glucosidase (0.73 mmol acarbose equivalent (ACAE)/g), and α‐amylase (2.95 mmol ACAE/g) enzymes. Both species showed high antibacterial and antifungal activities with remarkable antifungal activity exerted by S. alata against Trichoderma viride (minimum inhibition concentration (MIC) 1 mg/mL), similar to that of Ketoconazole. The study utilized molecular docking, molecular mechanics Poisson–Boltzmann surface area (MM/PBSA) free energy calculations, and molecular dynamics simulations to evaluate the binding interactions between anthraquinone glycosides and various bacterial enzymes, including targets from Escherichia coli and Staphylococcus aureus. The findings suggest that compounds like sennoside A, sennoside B, and chrysophanol exhibit strong binding affinities, stable interactions, and potential as antimicrobial inhibitors, especially against vital bacterial proteins such as MurE and 30S ribosome S3. In conclusion, our findings underscore the biopharmaceutical potential of these two Senna species, suggesting their significance as sources of bioactive agents for health‐related applications.

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Effectiveness of senna vs polyethylene glycol as laxative therapy in children with constipation related to anorectal malformation

Cited by 38 publications

References 10 publications

Unmet Needs in Pediatric Functional Constipation

Unmet Needs in Pediatric Functional Constipation

The Efficacy and Safety of Combined Senna and Probiotic-Based Bowel Preparation for Colonoscopy in Children

Novel Natural Candidates for Replacing Synthetic Additives in Nutraceutical and Pharmaceutical Areas: Two Senna Species (S. alata (L.) Roxb. and S. occidentalis (L.) Link)

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