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Laxative Abuse

Matthew E. Bryant, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A chronic watery diarrhea caused by intentional or unintentional misuse of laxatives due to self-medication or provider error

  • System(s) affected: gastrointestinal, nervous, psychiatri...

DIAGNOSIS

HISTORY

  • Suspect in patients with undiagnosed, refractory chronic diarrhea.

  • Assess over-the-counter medication use, and take thorough dietary history (2).

  • Signs and symptoms: increasing frequenc...

TREATMENT

GENERAL MEASURES

  • Behavioral support is essential in intentional use.

  • Wean patient off laxatives and supplements; substitute high-fiber diet and bulk preparations or short-term saline enemas.

  • Tr...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Ongoing behavioral counseling

  • Careful medical support; frequent visits as needed

  • Assess serum electrolytes.

DIET

Ensure good nutritional habits. 
  • Inc...

REFERENCES

1
Thomas PD, Forbes A, Green J, et al. Guidelines for the investigation of chronic diarrhoea, 2nd edition. Gut.  2003;52(Suppl 5):v1–v15. [View Abstract on OvidMedline]
2
Schiller LR. Def...

ADDITIONAL READING

  • Abraham BP, Sellin JH. Drug-induced, factitious, & idiopathic diarrhoea. Best Pract Res Clin Gastroenterol.  2012;26(5):633–648.

  • Fine KD, Santa Ana CA, Fordtran JS. Diagnosi...

SEE ALSO

Algorithm: Diarrhea, Chronic 

CODES

ICD10

F55.2 Abuse of laxatives 

ICD9

  • 305.90 Other, mixed, or unspecified drug abuse, unspecified use

SNOMED

  • 280982009 Abuse of laxatives (disorder)

  • 27051000119102 Chronic abuse of laxatives (disorder)

  • ...

CLINICAL PEARLS

  • Laxative abuse may be intentional or unintentional.

  • When associated with eating disorders, laxative abuse is associated with more severe disease.

  • Consider laxative abuse in patients with...

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