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Gastroenterology  (Expert Forum)
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Laxative Abuse
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D. Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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MedHelp Member's Question

Laxative Abuse

by danddand, Sep 03, 2003 12:00AM
My wife is addicted to laxatives. She takes 4-5 CVS brand laxatives, containing Bisacodyl every night before bed. We were married 5 years ago and it was then that I found out that she has been taking laxatives for 25-30 years. She is currently 52 years old.

I tried to get her help by taking her to a GI specialist.She had a colonoscopy that came back ok. The doctor didn't seem to want to deal with the laxative issue, and commented "that it was too late to change now"

My wife has become extremely deffensive about even talking about the subject and said it is a closed topic. I am worried because she is having more incidents now of vomiting, the other night very severely.Every couple of weeks she wakes up vomiting. She complains constantly about headaches, and abdominal pain. She always has gas, a tumultuous stomach, wakes up in the middle of the night and goes in the bathroom and stays for long periods of time. When we go someplace, it is always an issue about her having to go to the bathroom or her not being able to go yet.Some days she seems fine and very happy, but other days it seems like she is getting much worse to me.



What are her dangers from this long term abuse and what can i do for her? Can anyone help me?

Doctor's Answer

by Kevin Pho, MD, Sep 06, 2003 12:00AM
Erin, PA has kindley addressed the main issues of laxative abuse in her comments below and I agree with her assessment.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.

Member Comments (9)

by GI.PA, Sep 03, 2003 12:00AM
The dangers are very real.  Her gut is addictive to the stimulant action of the laxitive.  She will need more laxitives over time to get the same effect.  These higher doses of laxatives can cause cramps and vommitting.  She needs a new GI, someone who will listen.



There is a medication called Miralax that has been a miracle for many patients like your wife (and my dad).  It is a stimulant free laxative that can be safely used long term and is extreamly effective in reducing, if not eliminating the need for OTC laxitives.  You can check it out at Miralax.com.  In large doses this medication is used to clean people out before colonoscopy (under the name Nulyte or Colyte).  



For people who are severely stimulant-dependent, starting dose can be up to 3-4 X per day and then after a week or two (cleaning out the cement), it can be slowing lowered to the most effective dose to get a BM. It is during this time that the stimulant laxitives can be phased out. Although not officially approved for long term use (FDA will be doing this soon), we have used it safe and effectively in patients for years.



It is possible there is a psychiatric componet to the laxitive use as these can be abused for weight loss, but clinically I have found this to be the case only rarely.



Hope this helps.



GI.PA

Erin



by tessa0825, Sep 03, 2003 12:00AM
Just another word about Miralax....It has certainly been a wonder drug for me...After an invasive cancer surgery in 95, I battled chronic constipation for the next 7 yrs because of a paralyzed bowel that was the result of the surgery....I started seeing a differnt GI about 15-18 months ago, the first thing he did, after colonoscopy and EGD, was put me on Miralax 17gm. I started with higher doses and leveled off at 17gm twice a day..I have stayed with that dose for many months now and recently for this problem as well as others, zelnorm 6mg twice a day was recently added....Best of luck to you and your wife...Tessa

by tessa0825, Sep 03, 2003 12:00AM
Be prepared, miralax is pretty pricey..Probably depends on where you are at but where I live its about $110.00/month for a twice a day dose...Compared to Zelnorm though thats pretty cheap....

by danddand, Sep 05, 2003 12:00AM
My wife is very resistent to any change in this area. I am having a very hard time even talking to her about it. What are her risks if she goes on like this? Many days she seems to be full of energy and acting just fine and I wonder if I am just overreacting. Are the dangers great form this type of long term abuse (25-30 years)?

by GI.PA, Sep 05, 2003 12:00AM
Overtime the same dose of laxitives wont work anymore.  You need more and more every day to get the same result.  So, you keep taking more and more and sooner or later they can cause electrolyte abnormalities, colon injury.  In addition, the meds that may work for her now (Miralax or Zelnorm) may not work for her when things become even more advanced.



GI.PA

by Kary, Sep 24, 2003 12:00AM
I read everyone's comments on this subject so I thought that I would share a different prespective.  I abuse laxatives.  I HAVE to take 6 of them a day just to get some relief.  It is definately an addiction...it becomes very necessary.  I feel for his wife becuse I know what it is like.  I initially started doing it to control my weight (I only weighed 110 lbs at the time) and I lost some weight.  Now, 13 years later, I am simply taking them because now I have to.  It is very embarrassing and hard to discuss with anyone.  I don't even want to see a doctor even though I know I have a serious problem.  I know that people think that it should be simple to get over your embarrasssment and see a doctor about this condition but it's not that easy.  I read things, get scared, feel sick and still cannot make myself go to get checked out.  I would love to hear any suggestions. Thanks for your time.

by dtarr, Nov 25, 2003 12:00AM
I am a youth pastor (for ages 11-18) at the church where I work.  I just met with a high school girl who has been using laxatives for 6 months, recognizes it is a problem, but does not know what to do next.  Her parents know and don't seem to want to help.  What should I tell her to do as her next step?  I know her body will probably begin to freak out if she just tries to quit cold turkey.  What should she do, medically speaking, as she is trying to stop using laxatives?  Any advice would help.  Thank you!!!

by dtarr, Nov 25, 2003 12:00AM
I am a youth pastor (for ages 11-18) at the church where I work.  I just met with a high school girl who has been using laxatives for 6 months, recognizes it is a problem, but does not know what to do next.  Her parents know and don't seem to want to help.  What should I tell her to do as her next step?  I know her body will probably begin to freak out if she just tries to quit cold turkey.  What should she do, medically speaking, as she is trying to stop using laxatives?  Any advice would help.  Thank you!!!

by yoshi, Nov 27, 2003 12:00AM
To: dtarr
is the girl doing it to lose weight or to move her bowel??

there are natural laxative you can find in health food section of most supermarkets.

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