Bhumivalli (Markandika, Markandi)

About

Bhumivalli, known as Senna alexandrina, is traditionally used in Ayurveda as a mild purgative. Modern research supports its effectiveness for short-term constipation relief and bowel preparation.

Properties

Irritates the lining of the bowel, causing a laxative effect., Gut bacteria break down sennosides, stimulating bowel movements.

Dosage

General Use: Senna is typically used for short-term relief of occasional constipation. It is generally effective 6 to 12 hours after oral administration. Adults: Leaves or pods: 0.6 to 2 grams per day. Sennosides: 15-30 mg once daily in the evening. Doses above 34.4 mg sennosides twice daily are not recommended. Powdered drug: 0.5-3 grams Liquid extract: 0.5-3 ml Children: Senna is approved for children ages 2 years and older. Ages 2-5: Not more than 8.6 mg sennosides twice daily. Ages 6-11: Not more than 17.2 mg sennosides twice daily. Ages 12 and older: Not more than 34.4 mg sennosides twice daily. Oral powder: Adults and children 12 years of age and older: 1/2 to 1 teaspoonful once or twice a day. Children 6 to 11 years of age: 1/4 to 1/2 teaspoonful once or twice a day. Children younger than 6 years of age: 1/4 to 1/2 teaspoonful once or twice a day. Tablets: Adults and children 12 years of age and older: At first, 2 tablets once a day, up to 4 tablets two times a day. Children 6 to 11 years of age: At first, 1 tablet once a day, up to 2 tablets two times a day. Children 2 to 5 years of age: At first, 1/2 tablet once a day, up to 1 tablet two times a day. Oral liquid: Adults and children 12 years of age and older: At first, 2 to 3 teaspoonfuls once a day, up to 3 teaspoonfuls two times a day. Children 6 to 11 years of age: At first, 1 to 1 1/2 teaspoonfuls once a day, up to 1 1/2 teaspoonfuls two times a day. Children 2 to 6 years of age: At first, 1/2 to 3/4 teaspoonfuls once a day, up to 3/4 teaspoonfuls once a day. Chewable tablets: Adults and children 12 years of age and older: 2 tablets one or two times a day. Children 6 to 11 years of age: 1 tablet one or two times a day. Duration: Senna should not be used for more than 1 week without medical supervision. If constipation persists after three days, consult a healthcare professional.

Classical attributes

• Rasa: Bitter, astringent
• Virya: ["Cold"]
• Vipaka: ["Pungent"]

Benefits

• Purgative
• Rejuvenative

Traditional uses

• Constipation
• Skin diseases
• Typhoid
• Epilepsy
• Hemorrhoids

Dosha effects

• vata: balancing
• kapha: balancing
• pitta: balancing

Preparation methods

• Herbal Tea (Infusion/Decoction): Steep 1/4 to 1/2 teaspoon of senna leaves in a cup of boiling water for 10 minutes. Alternatively, use cold water and steep for 10-12 hours. For herbal tea consumption, decoction of 1.5 mg powder of senna in 300 mL water for 10 minutes (pod) and 30 minutes (leaf). Strain and drink while hot, preferably before bedtime. Fresh ginger can be added. A bitter tea can be made containing senna 0.5 to 2 g (0.5 to 1 teaspoon).
• Other Forms: Senna is also available in liquid extracts, capsules, granules, powder, and tablets.
• Traditional Use: Historically, senna pods were used, or herbal tea was made from the leaves.
• Leaf Paste: In some regions, the leaf is ground into a paste for skin diseases.

Contraindications

• Inflammatory Colon Diseases & Intestinal Obstruction
• Ulcerative colitis
• Appendicitis
• Crohn's disease
• Severe Dysentery
• Abdominal Pain of Unknown Origin
• Severe Dehydration
• Pregnancy
• Lactation
• Children under 2 years
• Stomach inflammation
• Anal prolapse
• Hemorrhoids
• Heart Disease
• Allergies to plants of the parsley family

Side effects

• Stomach cramps
• Diarrhea
• Nausea
• Stomach upset
• Urine may turn reddish-brown
• Stool may turn yellowish
• Severe diarrhea leading to fluid and electrolyte loss
• Long-term use can lead to laxative dependence, liver damage, and loss of normal bowel function
• Electrolyte imbalance (low potassium), which can increase the risk of heart arrhythmias
• Severe allergic reaction (anaphylaxis)
• Long-term use may cause pigmentation of the colon
• Severe diaper rash in infants if accidentally ingested

Interactions

• Digoxin (Lanoxin): Senna can decrease potassium levels, increasing the risk of digoxin toxicity and heart arrhythmias.
• Diuretics (Water Pills): Increased risk of potassium loss.
• Antiarrhythmic Drugs: Increased risk of heart arrhythmias due to potassium loss; avoid simultaneous use.
• Corticosteroids: Increased and unwanted potassium loss.
• Warfarin (Coumadin): Senna can cause diarrhea, which may affect the effectiveness of warfarin.
• Estrogens: Senna might decrease the effects of estrogen.
• Tacrolimus: May increase blood concentrations of tacrolimus, potentially leading to side effects.
• Other Laxatives: Additive effects can occur; avoid concurrent use.
• Senna can decrease the absorption of drugs.
• Avoid use with disulfiram.
• The action of Jimson weed is increased in cases of chronic use or abuse of Senna.

Active compounds

• Sennosides
• Anthraquinones
• Flavonoids

Clinical evidence

Meta-analyses of up to 5 RCTs and databases tracking 27+ studies show effectiveness for constipation and colonoscopy preparation. Further research is needed to validate other traditional uses.

Ayurvedic karmas

• Purgative
• Rejuvenative

Classical clinical indications

• Constipation
• Skin diseases
• Typhoid
• Epilepsy
• Hemorrhoids

Frequently asked questions