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- Laxatives are remedies taken when one is constipated and having problems moving his or her bowels (defecating).
- Repeated, excessive laxative use causes the bowels to relax and get lazy; thereby weakening the musculature of the gut, and causing the bowels to be unable to move the bulky stool they carry, resulting in Constipation and other problems.
- Stimulant laxatives work by irritating the large intestine (colon) to induce movement (e.g., Bisacodyl, Castor oil, Senna, phenolphthalein, danthron, etc.).
- Cathartic laxatives draw water into the colon to enhance the movement of the stool (Milk of Magnesia, Colyte, Epsom salt). Bulk forming laxatives like psyllium (i.e., Fibercon, Metamucil) and wheat bran increase the mass and volume of the stool.
- Normally, laxative use should not be daily, and they should not be used routinely for more than two weeks, unless monitored by a physician.
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- Urine studies
- Blood chemistries
- Stool fat analysis
- Endoscopy
- Psychological evaluation
- All may be necessary
Treatment
- Bulk forming laxatives are natural and the safest.
- Suddenly stopping laxatives may induce a withdrawal syndrome of mood swings, severe Constipation, fatigue, Bloating.
- Increasing fluids, especially water in diet (6-10 glasses or more, if there are no contraindications, such as heart, liver, or kidney disease)
- Increasing dietary fiber (vegetables, grains such as oat, fruits, psyllium)
- Regular exercise
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- Laxative Abuse may interfere with absorption of vitamins and minerals (e.g., Vitamin D, Calcium, Magnesium), which can lead to bone problems such as Osteomalacia.
- Overuse may affect the absorption of essential fats, leading to greasy diarrhea, as well as fluid and vital protein malabsorption, which can lead to weight loss and metabolic disturbances (i.e., acidosis, alkalosis).
- Cancer of the colon and liver disease may also be associated with excess laxative use.
- Laxative Abuse can affect the absorption of other medications and cause serious problems, especially in the elderly.
- Melanosis Coli (light brown pigmentation in the mucosa of the colon) seen often during lower endoscopy of the colon and associated with some types of laxatives (anthraquinones), which usually resolves after discontinuing use.
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