Am J Med. 1995 Nov;99(5):513-8.
Correlates of regular laxative use by frail elderly persons.
Harari D, Gurwitz JH, Avorn J, Choodnovskiy I, Minaker KL.
Division on Aging, Harvard Medical School, Boston, Massachusetts, USA.
PURPOSE: To examine the demographic, clinical, and pharmacological correlates of regular laxative use in elderly persons residing in a long-term care setting. METHODS: This was a cross-sectional study using retrospective record review undertaken in an academically affiliated long-term care facility in the United States. All individuals residing in the institution for at least 1 month (n = 694) were characterized regarding use of laxatives. Regular laxative use was defined as more than 30 doses of laxatives, stool softeners, or enemas taken over the most recent 1-month period. RESULTS: Residents with regular laxative use (n = 349) were compared with those who received no laxatives (n = 227). Factors significantly associated with regular laxative use at the P < 0.05 significance level were simultaneously included in a multiple logistic regression model. Factors associated with regular laxative use were immobility, Parkinson's disease, diabetes mellitus, and use of iron supplements, calcium channel blockers, and antidepressants with moderate to strong anticholinergic properties. CONCLUSION: Regular laxative use is often associated with neurologic dysfunction that directly or indirectly affects the gut, or medications known to depress colonic motility. Identification of potentially modifiable correlates of regular laxative use in older individuals may suggest management strategies to avoid or reduce laxative, stool softener, and enema requirements, improve constipation symptoms, and enhance quality of life for the frail elderly population.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7485209&dopt=Abstract constipation laxative
Arch Pediatr Adolesc Med. 1995 Dec;149(12):1330-5.
Body dissatisfaction and unhealthy weight-control practices among adolescents with and without chronic illness: a population-based study.
Neumark-Sztainer D, Story M, Resnick MD, Garwick A, Blum RW.
Division of General Pediatrics and Adolescent Health, School of Public Health, University of Minnesota, Minneapolis, USA.
OBJECTIVE: To compare body dissatisfaction and unhealthy weight-loss practices among adolescents with and without chronic illness. DESIGN: Survey. PARTICIPANTS: The sample consisted of 2149 adolescent boys and girls with diabetes, asthma, attention deficit disorder, physical disabilities, or seizure disorders; and a comparison group of 1381 adolescents without chronic illness. MAIN OUTCOME MEASURES: Body concerns, binge eating, frequent dieting, vomiting, and laxative or diuretic use among adolescents. RESULTS: Adolescents with chronic illness reported higher body dissatisfaction and engaged in more high-risk weight-loss practices than adolescents without chronic illness. This trend was consistent across the different conditions and was not limited to those with a nutrition-related condition such as diabetes. The trend remained after conducting logistic regression and controlling for age, race, socioeconomic status, and body mass index. CONCLUSIONS: Adolescents with chronic illness are at high risk for engaging in unhealthy weight-loss practices and should be screened and targeted for prevention and treatment.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7489069&dopt=Abstract constipation laxative
Pediatrics. 1995 Nov;96(5 Pt 2):999-1000.
Constipation and dietary fiber intake in children.
McClung HJ, Boyne L, Heitlinger L.
Department of Pediatrics, Ohio State University College of Medicine, Columbus Children's Hospital, USA.
OBJECTIVE. Severe constipation in children is associated with rectal overdistension and insensitivity. Treatment typically involves three phases: disimpaction (days to weeks), laxative use (months), and a high-fiber diet (lifelong). The purpose of this survey is a discussion of therapies that recognize the unique problems that children with severe constipation have. METHODS. Four-day diet logs were obtained from children who had no history of chronic bowel disease. Their intake of dietary fiber was determined from the logs and was compared with the dietary fiber ingested by children who had chronic constipation. These data sets were compared in light of our current understanding of the need for dietary fiber. RESULTS. Approximately half of the children from families who were health conscious enough to request dietary evaluation still fell below the age + 5 guidelines for grams of dietary fiber intake per day. The children referred to use with chronic constipation had all been instructed "to eat a high-fiber diet." Those constipated patients were consuming less than one fourth of the recommended fiber intake. CONCLUSIONS. This survey underscored the difficulties in beginning and in maintaining high-fiber diets in children. When families receive advice to administer a high-fiber diet, they are unable to accomplish this unless they receive intensive and ongoing dietary counseling. Even among health-conscious families, only half of the children received the recommended amounts of dietary fiber. Further public education in this regard is warranted.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7494681&dopt=Abstract constipation laxative
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