Laxative abuse: epidemiology, diagnosis and management

Area of Science:

• Gastroenterology and Internal Medicine

Background:

• Laxative misuse has a long history, with abuse occurring for over 2000 years.
• Abuse patterns vary, with the largest group involving individuals with eating disorders like anorexia or bulimia nervosa.

Purpose of the Study:

• To categorize laxative abuse patterns.
• To outline the physiological impact of laxative abuse.
• To describe diagnostic and treatment strategies for laxative misuse.

Main Methods:

• Categorization of laxative abusers into four main groups.
• Description of normal bowel function and laxative types.
• Identification of medical complications and treatment approaches.

Main Results:

• Prevalence of laxative abuse in eating disorders ranges from 10% to 60%.
• Stimulant laxatives are the most frequently abused type.
• Medical problems include life-threatening electrolyte and acid/base disturbances.

Conclusions:

• Laxative abuse requires high clinical suspicion, especially with gastrointestinal complaints.
• Treatment involves addressing underlying causes, discontinuing abused laxatives, and patient education.
• Referral for psychiatric treatment is crucial for individuals with eating disorders misusing laxatives.