laxative abuse

Introduction

Associated with chronic use of stimulant laxatives.

Clinical manifestations

• chronic constipation progressing to chronic diarrhea
• continuous feeling of need to defecate
• sensation of incomplete evacuation
• anthracene-containing laxatives cause the colonic mucosa to darken

Laboratory

• normal anion gap metabolic acidosis
  • NEJM asserts symptomatic hypokalemia without metabolic alkalosis
• serum potassium: hypokalemia
• urinalysis:
  • negative urinary anion gap consistent with GI loss of HCO3=
  • urine chloride low

Management

• decrease laxative use
• retrain to normal bowel schedule
• often frustrating to both patient & physician

More general terms

• intestinal disease
• substance abuse

Additional terms

• laxative