laxative



References: Laxative






S Afr Med J. 1990 Dec 1;78(11):631-6.
Chronic laxative abusers with pseudo-idiopathic oedema and autonomous pseudo-Bartter's syndrome. A spectrum of metabolic madness, or new lights on an old disease?

Meyers AM, Feldman C, Sonnekus MI, Ninin DT, Margolius LP, Whalley NA.

Department of Medicine, Johannesburg Hospital.

The numerous metabolic abnormalities encountered in chronic purgative abusers were investigated and the new concept of autonomous pseudo-Bartter's syndrome documented. Detailed metabolic screening tests were performed in 9 women aged 17-54 years. Two patients underwent further studies, including serum renin and aldosterone, blood volume, total body potassium, urinary chloride and prostaglandin determinations, and each underwent renal biopsy on admission and after 1 year free from laxative abuse. Clinical complications included confusion, convulsions, coma, skeletal muscle weakness with or without paralysis or rhabdomyolysis, cardiac failure, urinary tract infections and bone disease (osteomalacia, secondary hyperparathyroidism and osteoporosis). Hypokalaemia, hypomagnesaemia, hypocalcaemia and hypophosphataemia were frequent findings. Serum creatine kinase correlated inversely with the product of the potassium and serum phosphate (r = -0.86; P less than 0.03), suggesting that hypokalaemia and hypophosphataemia act synergistically to produce muscle damage. After laxative withdrawal, oedema and weight gain, followed by diuresis, ensued in 7 patients. In the other 2, ongoing chloruresis, kaliuresis, hyper-reninaemia and raised urinary prostaglandin secretion persisted. Renal biopsies in these 2 patients showed the features of juxtaglomerular apparatus hyperplasia as well as medullary interstitial cell hyperplasia. In conclusion, pseudo-Bartter's syndrome was documented in 9 chronic laxative abusers. Because patients often indulged in more than one aberrant habit, e.g. laxative and/or diuretic abuse or bulimia, the clinical syndrome produced a myriad of confounding metabolic dera



Am Fam Physician. 1984 Aug;30(2):141-6.
Complications of hazardous weight-loss methods.

Sansone RA.

Individuals who are overly conscious of their weight and those with eating disorders may induce vomiting and abuse laxatives and diuretics in order to lose weight. Self-induced vomiting may result in dental erosion, parotid and submandibular gland enlargement, oral and perioral trauma, pharyngeal and esophageal inflammation, aspiration and esophageal-gastric tears. Laxative abuse leads to digestive system complications such as cathartic colon and melanosis coli. All three purging methods lead to dehydration and electrolyte disturbances.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6147075&dopt=Abstract constipation laxative



Ann Intern Med. 1983 Jul;99(1):14-7.
Purging and calorie absorption in bulimic patients and normal women.

Bo-Linn GW, Santa Ana CA, Morawski SG, Fordtran JS.

Self-induced purging with laxatives is common among bulimic persons, who assume that purging reduces intestinal absorption of ingested calories. However, the efficacy of purging in reducing calorie absorption has never been studied, probably because the standard calorie balance procedure is expensive and time consuming. With a recently devised method, calorie absorption during a single day was measured to determine to what extent phenolphthalein or saline purge reduced calorie absorption. In two bulimic patients who regularly used laxatives for weight control and five normal young women, even extreme purging producing 4 to 6 L of diarrhea caused calorie absorption to decrease by only about 12% of calorie intake. The theoretical basis on which laxatives are taken for weight control is unsound.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6190422&dopt=Abstract constipation laxative



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