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Dependence-related screening positivity among regular stimulant-laxative users with chronic constipation: a
Yo Ishihara1,2,3, Eikichi Ihara2,4, Mitsuru Esaki4
1Department of Palliative Medicine, International University of Health and Welfare Narita Hospital, 852, Hatakeda, Narita, Chiba, 286-8520, Japan.
Journal of Gastroenterology
|May 29, 2026
Summary
Long-term stimulant laxative use in chronic constipation patients is linked to increased substance use symptoms and habituation. This study highlights potential dependence concerns with regular use.
Area of Science:
- Gastroenterology
- Addiction Medicine
- Pharmacology
Background:
- Chronic constipation affects many, with stimulant laxative use posing challenges.
- Habitual stimulant laxative use is linked to dependence, but long-term effects require further study.
Purpose of the Study:
- To characterize clinical features and substance use symptoms in chronic constipation patients using stimulant laxatives.
- To investigate the association between regular stimulant laxative use and substance use-related issues.
Main Methods:
- A multicenter prospective observational study included 280 chronic constipation patients.
- Patients were categorized by stimulant laxative use: None, Short-term/Rescue, and Regular (≥3/week for >1 year).
- Substance use symptoms were assessed using CAGE-AID, ICD-11, and DSM-5-TR criteria.
Main Results:
- Regular stimulant laxative users showed significantly higher CAGE-AID positivity (90.6%) compared to other groups.
- ICD-11 and DSM-5-TR criteria for substance use disorders were markedly higher in the Regular use group (65.6%).
- The Regular use group consistently exhibited higher positive screening rates across all assessment tools.
Conclusions:
- Long-term stimulant laxative use in chronic constipation is associated with increased substance use-related symptoms.
- Findings suggest features of habituation and potential dependence with regular stimulant laxative consumption.
- Further research is warranted to fully elucidate the long-term effects of stimulant laxative use.
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