Addition of senna improves quality of colonoscopy preparation with magnesium citrate

World J Gastroenterol. 2009 Apr 14;15(14):1759-63. doi: 10.3748/wjg.15.1759.


Aim: To prospectively investigate the effectiveness and patient's tolerance of two low-cost bowel cleansing preparation protocols based on magnesium citrate only or the combination of magnesium citrate and senna.

Methods: A total of 342 patients who were referred for colonoscopy underwent a colon cleansing protocol with magnesium citrate alone (n = 160) or magnesium citrate and senna granules (n = 182). The colonoscopist rated the overall efficacy of colon cleansing using an established score on a 4-point scale. Patients were questioned before undergoing colonoscopy for side effects and symptoms during bowel preparation.

Results: The percentage of procedures rescheduled because of insufficient colon cleansing was 7% in the magnesium citrate group and 4% in the magnesium citrate/senna group (P = 0.44). Adequate visualization of the colonic mucosa was rated superior under the citramag/senna regimen (P = 0.004). Both regimens were well tolerated, and did not significantly differ in the occurrence of nausea, bloating or headache. However, abdominal cramps were observed more often under the senna protocol (29.2%) compared to the magnesium citrate only protocol (9.9%, P < 0.0003).

Conclusion: The addition of senna to the bowel preparation protocol with magnesium citrate significantly improves the cleansing outcome.

MeSH terms

  • Adult
  • Aged
  • Cathartics / administration & dosage*
  • Citric Acid / administration & dosage*
  • Citric Acid / adverse effects
  • Colonoscopy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Organometallic Compounds / administration & dosage*
  • Organometallic Compounds / adverse effects
  • Prospective Studies
  • Senna Extract / administration & dosage*
  • Senna Extract / adverse effects


  • Cathartics
  • Organometallic Compounds
  • Citric Acid
  • Senna Extract
  • magnesium citrate