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The leaf is a very effective laxative and purgative and is a particularly useful remedy for the occasional bout of constipation and is useful for evacuation relief in cases of fissures, haemorrhoids, after rectoanal operations, and in preparation of diagnostic intervention in the gastrointestinal tract. It irritates the lining of the large intestine, causing the muscles to contract strongly resulting in bowel movement in about 10 to 12 hours after ingestion and also stops fluid being absorbed from the large bowel helping to keep the stool soft. It is sure and safe even for children (over 12 years of age) and weak and elderly persons. To prevent griping pains in the intestines, it is best when combined with a smaller amount of a warming stimulant and antispasmodic such as ginger or some other suitable herb. Too frequent usage can lead to laxative dependency. Senna leaf is approved by the World Health Organization (WHO) for short-term use in occasional constipation. Senna is also approved in the United States and in European countries as an ingredient in over-the-counter and prescription laxative preparations. The herb is approved by the German government for any condition in which alleviating constipation or softening stools is desirable.

Clinical studies in the United States and abroad involving various age groups suggest that senna is effective in managing constipation associated with a number of causes including surgery, childbirth, and use of narcotic pain relievers. A study in the medical journal Diseases of the Colon and Rectum showed that senna was able to prevent or treat postoperative constipation after proctologic surgery. The South African Medical Journal shows that treatment with senna was successful in 93%-96% of women suffering from postpartum constipation. By comparison, only 51%-59% of women in the placebo group experienced relief. Senna is considered to be one of the more effective agents for relieving constipation caused by such narcotic pain relievers as morphine. In another study published in the Journal of Pain and Symptom Management, researchers recommended the use of senna in terminal cancer patients with opiate-induced constipation, citing the effectiveness of the herb and its relatively low cost. A study published in the medical journal Pharmacology suggests that a combination of senna and bulk laxatives can alleviate chronic constipation in geriatric patients.

Also useful in intestinal worms, rheumatism, sciatica, gout, hip pain and lumbago.