Author: Gary Jackson

Laxative abuse: epidemiology, diagnosis and management

Originally a medicine to ease constipation, laxatives can be misused as part of purging behavior to get rid of unwanted calories. There’s a belief that laxatives help to expel food before it’s absorbed, which isn’t the case. Laxatives can effectively treat various medical conditions but may cause adverse effects such as abdominal pain, nausea, and urinary retention.

• Laxatives are a common over-the-counter medication often used to treat constipation.
• Over time, laxative misuse can cause depression, chronic constipation, laxative dependency, organ damage, and an increased risk of colon cancer.
• Laxative abuse is a dangerous practice that can significantly damage a person’s health and even lead to potentially fatal consequences.

Laxatives are categorized based on the mechanism of action they exert, including bulk-forming laxatives, osmotic and prokinetic agents, lubricants, stimulants, and other types. Initial management should involve lifestyle changes, including consuming increased fluids and fiber-rich foods, such as asparagus, broccoli, Brussels sprouts, cabbage, and spinach, into their diet. If constipation persists despite lifestyle modifications, the use of laxatives becomes a viable consideration. The comprehensive approach to treating chronic constipation encompasses patient education, behavior modification, dietary adjustments, and, if necessary, the inclusion of laxative therapy. Stimulant laxatives are a common class of laxatives that is abused by patients with eating disorders.

Getting Help for Excessive Laxative Use

When a patient presents with electrolyte abnormalities, treatment should focus on repleting electrolyte abnormalities as well as symptom improvement. A loop diuretic was used as our patient had normal potassium and bicarbonate and did not meet the criteria for pseudo-Bartter syndrome. The patient’s laxative use should be quantified upon initial encounter and they should be monitored closely for symptom development after cessation. Treatment duration was ill-defined in previous literature; however, it is recommended that treatment should be started at the onset of the first identification of peripheral edema. In our case, treatment persisted until the patient stated symptoms had resolved. Excessive laxative occurs when you take laxatives to lose or control weight.

A nutritionist can also help you set healthy goals in terms of eating habits,” she adds. Abrupt cessation of high dose laxatives can cause edema and rapid weight gain due to fluid shifts and electrolyte disturbances. Our case report highlights a significant amount of weight gain, which has been reported rarely. The optimal treatment approach remains ill-defined at this time but is centered around diuretic use in patients with significant fluid overload. According to research, extreme weight loss efforts like laxatives and diuretics do not work. Although there may be some initial loss due to purging, the gains are typically reversed with most people increasing their body mass index (BMI) over time.

Bupropion for weight loss (Wellbutrin, Zyban)

When a person has diarrhea, electrolytes are lost at abnormally high rates, leading to weakness, irregular heartbeats, and, on rare occasions, death. Here, we will go further into what laxative abuse is, what the side effects are, how to recognize laxative abuse in a loved one, and what treatments can help. Eating disorders can severely affect the quality of life of people living with these conditions and those close to them. Early intervention and treatment greatly improve the likelihood of recovery. Continue reading to learn more about laxative misuse, including the consequences and how to find help.

Or, if they have a colon infection, the team will administer antibiotics to clear up the infection. The treatment for excessive laxative use usually involves psychotherapy, such as dialectical behavior therapy (DBT) or cognitive behavioral therapy (CBT). Early treatment not only helps address the core emotional issues that fuel eating disorders but also prevents short- and long-term damage to your physical health. Your healthcare provider can refer you to a psychiatrist or therapist who specializes in treating eating disorders. Studies have shown that the overuse of laxatives, including stimulant and osmotic laxatives, increases the risk of colon cancer by twofold.

Naltrexone for weight loss (Revia, Vivitrol)

They may purge without binging to rapidly lose weight (to fit into a wedding dress, for example). Michelle Coleman, a Grow Therapy licensed professional counselor, emphasizes that early detection and treatment for laxative abuse is important for physical and mental health conditions. Laxative misuse can lead to severe health consequences, including dehydration, organ damage, and dependence.

Other signs of BN include frequent trips to the bathroom or hidden stashes of food in the house. The excessive use of laxatives can lead to many colon-related complications, including colon distension (the abnormal enlargement of the large intestine) and colon infections. Not only are they ineffective in maintaining a healthy weight over the long term, but they can also cause potentially severe health complications.

At that time, her dyspnea had resolved; however, she had persistent edema and minimal weight loss. Her physical exam showed abdominal distension and pitting edema of the lower extremities. She had no elevated jugular venous pressure, S3 or displaced point of maximal impulse (PMI) on the exam.

• This can lead to an increased risk of infection and bleeding during bowel movements.
• An interprofessional approach involving clinicians, gastroenterologists, pharmacists, and nurses can enhance patient outcomes while reducing the occurrence of adverse drug reactions.
• Originally a medicine to ease constipation, laxatives can be misused as part of purging behavior to get rid of unwanted calories.
• In our case, treatment persisted until the patient stated symptoms had resolved.

In order to compensate for the increased gut motility, these organs have to work overtime to keep up. Excessive laxative use occurs when someone uses laxatives habitually, frequently, or in higher-than-recommended doses for weight loss or control. The aim of laxative abuse is to stimulate bowel movements so that foods are “purged” from the body before fat and calories can be absorbed. However, weight loss and binge eating don’t always mean an eating disorder is to blame. “The first symptom [of laxative abuse] that you may recognize or look for is weight loss or consuming lots of food but still losing weight. Many would say that it’s down to anorexia or bulimia, but laxative abuse could often be a common cause as well,” advises Williams.