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Surreptitious laxative abuse: keep it in mind.

¹Mayo Clinic and Medical School, Rochester, MN 55905, USA.

Seminars in Gastrointestinal Disease

|November 5, 1999

Summary

Chronic diarrhea, even after extensive investigation, may be self-induced by laxative abuse. Fecal magnesium levels can help diagnose this condition, often linked to depressive illness.

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Area of Science:

Gastroenterology
Clinical Medicine
Psychiatry

Background:

Chronic diarrhea presents a diagnostic challenge, particularly when initial investigations are inconclusive.
Laxative abuse is an underrecognized cause of unexplained watery diarrhea.

Observation:

A case study of a 45-year-old man with a 3-year history of undiagnosed diarrhea and depressive illness.
Clinical features included symptoms suggestive of laxative abuse, despite initial denial.

Findings:

Abnormally high fecal magnesium concentrations supported the diagnosis of laxative abuse.
The case highlights typical and atypical features of surreptitious laxative ingestion.

Implications:

Unexplained chronic diarrhea warrants consideration of self-induced causes, such as laxative abuse.
Awareness of laxative abuse syndrome aids in efficient diagnosis, especially in specific patient populations.
Early diagnosis can prevent unnecessary investigations and guide appropriate management.

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