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A screening method for establishing laxative abuse.

F A de Wolff, E J de Haas, M Verweij

    Clinical Chemistry
    |June 1, 1981
    PubMed
    Summary
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    Early toxicological screening for laxative abuse is now possible with a new urine test. This method detects common phenolic and anthraquinone laxatives, aiding in faster diagnosis and avoiding extensive medical workups.

    Area of Science:

    • Toxicology
    • Analytical Chemistry
    • Pharmacology

    Background:

    • Laxative abuse, particularly of colonic stimulants and cathartics, can lead to various health disorders.
    • Extensive diagnostic procedures are often required to identify laxative abuse.
    • A need exists for a rapid and reliable screening method for laxative ingestion.

    Purpose of the Study:

    • To develop and validate a sensitive and specific screening method for detecting phenolic and anthraquinone laxatives in human urine.
    • To establish a method that can aid in the early diagnosis of laxative abuse.

    Main Methods:

    • Development of a urine screening procedure utilizing high-performance thin-layer chromatography (HPTLC) in two distinct chromatographic systems.
    • Sample preparation involved pretreatment with beta-glucuronidase and subsequent column extraction of a 20-mL urine sample.

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  • Analysis focused on the detection of phenolic and anthraquinone laxatives, excluding sodium picosulfate.

    • Main Results:

    • The developed method demonstrated high sensitivity, detecting bisacodyl, danthron, phenolphthalein, and sennoside in urine up to 32 hours post-ingestion.
    • Bisoxatin and oxyphenisatin were detectable for up to 18 hours after intake.
    • The method exhibited high specificity, with no interference observed from 73 other tested drugs in either chromatographic system.

    Conclusions:

    • A novel, sensitive, and specific HPTLC-based method for detecting common laxatives in urine has been successfully developed.
    • This screening procedure can significantly aid in the early diagnosis of laxative abuse, potentially reducing the need for more extensive diagnostic investigations.
    • The method offers a valuable tool for clinicians to identify patients misusing laxatives.