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References: Laxative

Med J Aust. 1991 Dec 2-16;155(11-12):820-1.
"Bread: it's a great way to go". Increasing bread consumption decreases laxative sales in an elderly community.

Egger G, Wolfenden K, Pares J, Mowbray G.

Discipline of Behavioural Science, Faculty of Medicine, University of Newcastle, NSW.

OBJECTIVE: To test the effects on laxative sales of two methods of promoting increased consumption of wholemeal/wholegrain bread by the elderly. DESIGN: Community intervention trials were carried out in two test communities and one control community on the mid-north coast of New South Wales. PARTICIPANTS: Small retirement communities with a high proportion of the population aged over 55 years. INTERVENTIONS: A community organisation strategy (COS) involving the media, community activities and social marketing principles using the theme "Bread: It's a Great Way to Go" was compared with a patient education strategy (PES) through local doctors and a control community (CON). MAIN OUTCOME MEASURES: Wholemeal/wholegrain bread sales and laxative sales. RESULTS: There was a 49% decrease in laxative sales corresponding to a 58% increase in sales of wholemeal/wholegrain bread in the COS community but no significant changes in either the PES or CON communities. CONCLUSIONS: The study suggests a positive, cost effective approach for increasing fibre intake and improving gastrointestinal problems in the elderly.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1660562&dopt=Abstract constipation laxative

Am J Med. 1992 Jan;92(1):41-4.
Barium enemas in the frail elderly.

Gurwitz JH, Noonan JP, Sanchez M, Prather W.

Hebrew Rehabilitation Center for Aged, Boston, Massachusetts.

PURPOSE: The objective of this investigation was to determine the frequency of and predictors for inadequate barium enemas in the frail elderly. PATIENTS AND METHODS: The medical and radiologic records of 171 elderly institutionalized patients (mean age = 85.3 years), who underwent barium enema examinations, were retrospectively reviewed. The study outcome of primary interest was the radiologist's report of the adequacy of examination as indicated in the written summary of the results of the barium enema procedure. RESULTS: Eighty-eight (51.5%) of the 171 studies were deemed inadequate, with poor bowel preparation a primary or contributing factor in 89.7% of the inadequate studies. Among a variety of demographic and clinical factors, only long-term laxative and/or cathartic use was associated with an inadequate study (odds ratio = 7.0; 95% confidence interval 2.7 to 18.0). CONCLUSION: These results demonstrate a very high frequency of inadequate barium enema examinations in the very old and suggest a need for improved methods of bowel preparation in this patient population, especially in those who are long-term users of laxatives and cathartics.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1731508&dopt=Abstract constipation laxative

Ann Clin Biochem. 1991 Nov;28 ( Pt 6):568-73.
Diagnosis of the abuse of magnesium and stimulant laxatives.

Duncan A, Cameron A, Stewart MJ, Russell RI.

Gastroenterology Unit, Royal Infirmary, Glasgow, Scotland, UK.

A reliable diagnosis of laxative abuse can only be reached by chemical analysis. We report a modified thin layer chromatography approach for the detection and confirmation of over-the-counter colonic stimulant laxatives. Potential interference by dietary and drug components chemically similar to anthraquinones was investigated and the method was found to be specific in this respect. The diagnosis of magnesium laxative abuse is more difficult since magnesium is a component of body fluids. By inducing diarrhoea with magnesium salts in volunteers we have established that the diagnosis can be made by measuring magnesium concentrations in stool water, with 30 mmol/L being an appropriate cut-off concentration.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1776806&dopt=Abstract constipation laxative

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