Cassia fistula (Casse muette): benefits, dosage, contraindications

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Cassia fistula or Casse muette is a tree that grows in tropical Asia, reaching up to 6 m. It is notably present in Pakistan and India. Its fruit is a brown pod that contains several seeds and emits a strong odor considered unpleasant. Its fruit has a high content of anthraquinones. Indeed, the fruits contain derivatives of 1,8-dihydroxy-3-anthraquinone, rhein, fistulin, oxyanthraquinones, tannins, glycosides including sennosides A and B, volatile oils, as well as resinous and waxy derivatives. The leaves, bark and fruits are used in traditional medicine for the treatment of skin infections and the elimination of toxins from the blood. The pulp of Cassia fistula is widely used as a laxative in Traditional Chinese Medicine (TCM) and in Ayurveda, to treat constipation.

Other name(s) 

Canéficier, false carob tree

Scientific name(s)

Cassia fistula

Family or group: 

Plants

Active ingredients:

Tannins

Anthraquinones


Indications

Scoring methodology

EFSA approval.

Several randomized, double-blind, controlled clinical trials (> 2), including a significant number of patients (>100), with consistently positive conclusions for the indication.
Several randomized, double-blind, controlled clinical trials (> 2), including a significant number of patients (>100), with positive conclusions for the indication.
One or more randomized studies, or several cohorts or epidemiological studies, with positive conclusions for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or conflicting.
No clinical studies to date that can demonstrate the indication.


Constipation
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A systematic review examined the efficacy of Cassia fistula emulsion in the treatment of constipation. Two studies were included, both of which presented a high risk of bias. nnAnalyses showed greater treatment success and an increased frequency of defecation with Cassia fistula emulsion compared with the control treatment. In addition, Cassia fistula proved more effective than mineral oil and as effective as polyethylene glycol (PEG is an osmotic laxative used for the treatment of constipation). nnThe most frequent side effects were diarrhea.nn

Posologie

posologieOral administration: bark, fruit

posologie4 - 8 g

populationAdults


Properties


Laxative

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The fruit of Cassia fistula is used for its laxative effect. Indeed, the pulp is included in preparations indicated for the management of constipation. It is a relatively mild intestinal stimulant thanks to its high content of sennosides. This laxative effect manifests in two ways: on one hand, by modifying colonic motility to accelerate intestinal transit, and on the other hand, by altering colonic absorption and secretion, causing an accumulation of fluid and consequently diarrhea.

Usages associés

Constipation

Antipyretic

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The bud extract of C. fistula as well as the pod extract prepared in methanol show significant antipyretic properties in rat studies. The doses used ranged from 200 to 400 mg/kg of body weight.nnThe results of this study are consistent with those obtained with acetaminophen, a medication known for its antipyretic effects, used to treat fever.nn


Antifungal

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Extracts of fruits, leaves, and flowers of Cassia fistula have demonstrated significant antifungal properties. Methanol and ethyl acetate extracts, in particular, showed notable activity against various fungi, including Candida albicans and Alternaria solani. nnThe efficacy is comparable to that of standard antifungals such as clotrimazole.nn


Safe dosage

Adults 12 years and older: 4 g - 8 g (pulp)

Some sources recommend between 4 and 8 g of the fruit pulp. Prolonged use is not recommended.


Precautions

Pregnant women: avoid

The use of Cassia fistula is not recommended for pregnant and breastfeeding women.

Children up to 12 years: avoid

The use of Cassia fistula is not recommended for children under 12 years of age.

Breastfeeding women: avoid

The use of Cassia fistula is not recommended for pregnant and breastfeeding women.