Laxative abuse.

Department of Medicine, Hope Hospital, University of Manchester School of Medicine, Salford, UK.

Two types of laxative abuse are described, namely habitual abuse and surreptitious abuse. Phenolphthalein and the anthraquinone derivatives have been most abused in this respect. Long-term anthraquinone use may lead to melanosis coli and cathartic colon, with typical histological and radiological features. Surreptitious abuse presents as a factitious illness with diarrhoea, hypokalaemia, abdominal pain and thirst, as well as melanosis coli. Over 90% of cases occur in women, many of whom work in a paramedical situation. Wider recognition of the range of normal bowel habit and a cultural change with rejection of Victorian mores and concepts of 'intestinal auto-intoxication' have led to a decrease in inappropriate laxative consumption. However, they are still widely prescribed and bought. Although it was as long ago as 1937 that Witts [108] drew attention to the dangers associated with the use of laxatives, his lesion still needs to be preached today.

PMID: 3280173 [PubMed - indexed for MEDLINE]