Senna-Based Laxatives for Kids’ Constipation: Are They Safe?

Senna-based laxatives are commonly prescribed to children by pediatricians, pediatric gastroenterologists and pediatric surgeons to treat constipation. In recent years, however, parents have had growing concerns that senna is not safe. Some believe these types of laxatives have dangerous side effects. A study recently conducted at Nationwide Children’s Hospital and published in the Journal of Pediatric Surgery shows that senna is in fact a safe, long-term treatment for children suffering from constipation.

What Is Senna?

Senna is a natural laxative made from the leaves and fruit of the senna plant. It works by increasing activity in the intestines to cause a bowel movement.

Senna-based laxatives are usually prescribed to children with constipation. This constipation could be the result of functional constipation (persistent symptoms of difficult or infrequent bowel movements), anorectal malformations or other gastrointestinal conditions such as irritable bowel syndrome (IBS). It’s also sometimes given before a child undergoes anal or rectal surgery.

What Are the Side Effects?

Side effects of the medicine can include:

• Abdominal cramping
• Diarrhea
• Vomiting
• Perineal blisters*

*The perineum is the area between the anus and scrotum in males or vulva in females.

What Does the Research Tell Us?

Researchers at Nationwide Children’s looked at data from 640 patients treated with senna-based laxatives at the Center for Colorectal and Pelvic Reconstruction (CCPR) from April 2014 to April 2017. More than 84%, including some patients taking the laxatives for more than two years, had no side effects. About 13% had some abdominal pain/cramps or diarrhea, but these symptoms went away on their own within two weeks or went away when the child switched to a different laxative.

They found that just 2.2% of the patients studied experienced perineal blisters or severe perineal rash, the most serious side effect. However, all of these patients had a long period of stool-to-skin contact because they were diapered or wearing training underwear overnight. To combat this, researchers suggest giving children the medicine at a time when they are less likely to have a bowel movement during sleep. A cream can also be applied to the skin to act as a barrier while they are diapered.  

If your child suffers from constipation, be sure to ask your primary care physician about what treatments may be appropriate for your child. If senna-based laxatives are recommended and work well for your child, know that the research shows that they can be safe and effective.