Laxative Abuse Research Articles

When and What to Test for Diarrhea: Focus on Stool Testing.

To review stool diagnostic tests in acute and chronic diarrhea. Narrative review of published literature. (A). In acute diarrhea, stool tests are indicated when there is strong pre-test probability of infectious etiology or C. difficile infection (CDI) suggested by >3 unformed bowel movements per 24h, symptoms lasting >7 days, and circumstances that are suggestive of infection. Several commercially available rapid tests for bacterial, viral or protozoal infections may be offered in addition to traditional methods (e.g. culture, microscopy), and provide a result within 6 hours. For CDI infection, a highly sensitive test such as glutamate dehydrogenase test is required; however, this does not distinguish infection from carrier state. That differentiation requires specialized nucleic acid amplification test (for toxin B) or enzyme immunoassays for toxin A or B, which are unfortunately not generally offered by microbiology labs. (B). Chronic diarrhea may result from inflammatory, fatty, osmotic or secretory causes; the commonest causes are IBS-D/functional diarrhea. Current recommendations in societal guidelines or clinical practice updates regarding stool tests in IBS-D/functional diarrhea in the absence of alarm symptoms include testing for giardia, calprotectin, fecal immunochemical test (FIT), and bile acid diarrhea (BAD). Comprehensive stool biochemical analyses (osmolality, pH, electrolytes) differentiate osmotic from secretory diarrhea and identify laxative abuse. Specific stool diagnostic tests for BAD and exocrine pancreatic insufficiency can lead to specific diagnosis and treatments. Surrogate markers associated with high fecal output and rapid transit in chronic diarrhea are stool form and colonic transit. Fecal testing is still very relevant in the practice of gastroenterology and deserves introduction of advanced microbiological and biochemical tests.

Hypomagnesaemia among Diabetic Patients with Chronic Kidney Disease: A Cross-sectional Study

Background: The clinical role of magnesium, especially of hypomagnesaemia, in diabetic and chronic kidney disease patients has been underestimated for many years. Objective: To determine the frequency of hypomagnesaemia in diabetic patients with chronic kidney disease and to investigate the relationship of magnesium level with glycemic and renal status. Methodology: This was a cross-sectional observational study performed on 100 diabetic patients with chronic kidney disease, admitted to BIRDEM General Hospital, Dhaka, Bangladesh, excluding patients with history of chronic diarrhea, laxative abuse, diuretic use, alcoholism and those on dialysis. Several socio-demographic and biochemical parameters were analyzed and compared with magnesium level. Results: Frequency of hypomagnesaemia among the study population was 37% (p= 0.009) and the frequency was found to be increasing with increasing stage of chronic kidney disease. Frequency of hypomagnesaemia was more in patients with uncontrolled fasting blood glucose, post meal blood glucose and HbA1c level (p<0.05). Serum magnesium levels positively correlated with serum creatinine levels (Pearson’s correlation coefficient, r=0.428, p=0.001) and inversely correlated with GFR (Pearson’s correlation coefficient, r= -0.275, p= 0.006). Conclusion: The frequency of hypomagnesaemia among diabetic patients with chronic kidney disease is common. So it would be prudent to routinely monitor for hypomagnesaemia in diabetic patients with chronic kidney. Bangladesh Crit Care J September 2024; 12 (2): 132-137

The Clinical and Psychopathological Profile of Inpatients with Eating Disorders: Comparing Vomiting, Laxative Abuse, and Combined Purging Behaviors.

The previous literature on purging behavior in eating disorders (EDs) suggests an overall more complicated clinical picture for individuals with this symptomatology. So far, no studies have analyzed the possible differences between the specific types of purging among ED inpatients. A clinical sample of 302 inpatients with EDs was classified according to no purging behaviors, vomiting, the abuse of laxatives, and both vomiting and the abuse of laxatives. Participants completed the following questionnaires: the Eating Disorder Examination Questionnaire (EDE-Q), Frost Multidimensional Perfectionism Scale (F-MPS), State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). Clinical information was collected for each individual. Significant differences in the four groups were evidenced in age (p < 0.001), years of illness (p < 0.001), BMI at discharge (p < 0.001), STAI state anxiety (p < 0.001), STAI trait anxiety (p < 0.001), BDI (p < 0.001), EDE-Q eating concerns (p < 0.001), EDE-Q shape concerns (p < 0.001), EDE-Q weight concerns (p < 0.001), EDE-Q global score (p < 0.001), and F-MPS parental criticism (p < 0.001). ED inpatients with purging behaviors were older, had a longer duration of illness, higher parental criticism, and worse general and eating psychopathology. No differences emerged between the specific types of purging behavior. Purging behavior is a marker of severity in EDs independently of the specific type of purging. The appearance of any purging behavior must be regarded as a considerable red flag and be followed by an intensification of the cure.

#2696 The effect of laxatives on reducing serum phosphate levels of probiotics in hemodialysis patients: a subanalysis of RCT

Abstract Background and Aims Dysbiosis of the intestinal microbiota in chronic kidney disease increases uremic toxin, which damage the epithelial tight junctions and increase the permeability of the intestinal wall via endotoxemia and systemic inflammation. Some articles reported that probiotics reduced the uremic toxin and decreased inflammation biomarkers in CKD patients. Meanwhile, we have already reported that oral administration of Bifidobacterium longum in a gastro-resistant seamless capsule decreases serum phosphate levels in patients receiving hemodialysis (Clin Kidney J, 5:373-374, 2012). In addition, in this congress, we reported that three-combination probiotics decreased serum phosphate levels. Meanwhile, some articles reported the relationship hypophosphatemia and laxative abuse. The aim of this subanalysis study is to evaluate the efficacy of laxatives on reducing serum phosphate levels of three-combination probiotic in patients receiving hemodialysis. Method A 6-month prospective, randomized, double-blind, placebo-controlled study was conducted at three hemodialysis centers. As probiotic therapy, of three-combination probiotics (Bio-Three) tablets, each containing 2 mg of lactomin (Streptococcus faecalis T-110), 10 mg of Clostridium butyricum TO-A, and 10 mg of Bacillus mesentericus TO-A, were used. The patients receiving hemodialysis were randomly assigned to the Bio-Three group (n = 37) and the placebo group (n = 36). In both the Bio-Three group and the placebo group, patients orally received 6 tablets 3 times daily. We evaluated the effect of probiotic on serum phosphate level and gut microbiome before and 6 months after the start of treatment. The gut microbiome composition was analyzed by a 16s rRNA gene-based sequencing protocol. In addition, in patients with laxative (n = 24), we evaluate the effect of probiotic on serum phosphate levels and gut microbiome. Results The serum phosphate levels in the Bio-Three group significantly decreased after 6-month treatment, while did not change in the placebo group. Furthermore, the serum phosphate level in patients with Bio-Three and laxative additionally decreased. In a 16s rRNA gene-based sequencing protocol analysis, serum phosphate levels were positively correlated with the occupancy ratio of Erysipelotrichaceae, Lachnospiraceae, Oscillospiraceae, Ruminococcaceae, and Sutterellaceae and were negatively correlated with the occupancy ratio of Leuconostocaceae and Lachnospiraceae in patients with Bio-Three and laxatives. Conclusion In this subanalysis study, the effect of reducing serum phosphate levels on three-combination probiotic might be augmented by laxatives and the specific bacteria in the gut microbiome might contribute to the decrease of serum phosphate levels.

Starvation hepatitis and refeeding-induced hepatitis: mechanism, diagnosis, and treatment.

Anorexia nervosa (AN) is one of the most common psychiatric disorders among young adults and is associated with a substantial risk of death from suicide and medical complications. Transaminase elevations are common in patients with AN at the time of hospital admission and have been associated with longer lengths of hospital stay. Multiple types of hepatitis may occur in these patients, including two types that occur only in patients with AN: starvation hepatitis and refeeding-induced hepatitis. Starvation hepatitis is characterized by severe transaminase elevation in patients in the advanced phase of protein-energy deprivation and is associated with complications of severe starvation, such as hypoglycaemia, hypothermia, and hypotension. Refeeding-induced hepatitis is characterized by a milder increase in transaminases that occurs in the early refeeding phase and is associated with hypophosphatemia, hypokalemia, and hypomagnesaemia. Among the most common forms of hepatitis, drug-induced liver injury is particularly relevant in this patient cohort, given the frequent use and abuse of methamphetamines, laxatives, antidepressants, and antipsychotics. In this review, we provided an overview of the different forms of anorexic-associated hepatitis, a diagnostic approach that can help the clinician to correctly frame the problem, and indications on their management and treatment.

The prevalence of laxative and diuretic abuse in patients with anorexia nervosa and bulimia nervosa

The article is devoted to the study of laxative and diuretic abuse among patients with anorexia nervosa (AN) and bulimia nervosa (BN). The medical records of 152 patients with AN and NB, who were hospitalized in a specialized clinic for the treatment of eating disorders, were studied. Of 152 patients, 52 % (N=79) had restricting anorexia nervosa, 29.6 % (N=45) had purgative anorexia nervosa, and 18.4 % (N=28) had bulimia nervosa. The number of people abusing laxatives and diuretics in the groups with AN purgative type and BN did not differ significantly. Laxative abuse accounted for 42.2 % (N=19) and 42.9 % (N=12) in AN purgative type and BN, respectively. Diuretics abuse accounted for 20 % (N=9) and 17.9 % (N=5) in AN purgative type and BN, accordingly. The total number of laxative and diuretic abusers among the patients with eating disorders was 20.4 % (N=31) and 9.2 % (N=14), respectively.

Laxative Abuse Is Associated With a Depleted Gut Microbial Community Structure Among Women and Men With Binge-Eating Disorder or Bulimia Nervosa: The Binge Eating Genetics Initiative.

This study assessed the associations of binge eating, compensatory behaviors, and dietary restraint with the composition and diversity of the intestinal microbiota among participants with binge-eating disorder or bulimia nervosa. We analyzed data from 265 participants aged 18 to 45 years with current binge-eating disorder or bulimia nervosa enrolled in the Binge Eating Genetics Initiative study. We evaluated the associations of binge-eating frequency; presence/absence and frequency of vomiting, laxative use, and compulsive exercise; and dietary restraint with abundances of gut microbial genera, species, and diversity (Shannon diversity, Faith phylogenetic diversity, and Peilou's evenness) from 16S rRNA gene sequencing. General linear regression models adjusted for potential confounders, including age and current body mass index, were used to test associations; p values were corrected for the false discovery rate. The normalized abundance of four genus- and species-level gut microbes and three diversity indices were lower among Binge Eating Genetics Initiative participants who reported any laxative use compared with those who reported no laxative use. Vomiting frequency was positively associated with the normalized abundance of the genus Escherichia-Shigella , a potential pathobiont, although the association was attenuated to nonsignificance after adjustment for age, body mass index, and binge-eating episodes. Laxative use was highly and uniformly predictive of a reduced gut microbial diversity including potential commensals and pathobionts, and should be assessed and accounted for in all future studies of eating disorders and the gut microbiota. Future studies should collect data on specific medications-particularly laxatives-and dietary intake to obtain unbiased estimates of the effect of eating disorders on the gut microbiota and identify potential downstream clinical implications.Trial Registration:ClinicalTrials.gov identifier: NCT04162574 .

143: THE BROKEN AND CLOTTED HEART: A CASE OF TAKOTSUBO CARDIOMYOPATHY WITH LEFT VENTRICULAR THROMBUS

Introduction: Takotsubo cardiomyopathy is a rare heart disease characterized by systolic dysfunction and ballooning of the left ventricle (LV). It is triggered by intense physical or emotional stress and causes symptoms similar to myocardial infarction. Even though rarely associated with complications, 1-2% of patients may develop LV thrombi. Description: A 39-year-old female with a history of gastric bypass surgery, anorexia nervosa, laxative abuse, and depression presented with vomiting, diarrhea, generalized weakness, and chest pain. She had a blood pressure of 75/45 mmHg, heart rate of 130/min, respiratory rate of 18/min, and SpO2 of 95%. Physical examination showed a semi-responsive female with poor peripheral pulses and cyanotic lips. EKG showed sinus tachycardia, left anterior fascicular block, and nonspecific ST changes. Laboratory results were significant for white count of 14.1 K/uL, BNP of 1560 pg/dL, troponins of 5.11 ng/ml, creatinine of 1.47 mg/dL and lactate of 4.8 mmol/L. The patient was transferred to the intensive care unit, resuscitated with fluids, and started on a heparin infusion, norepinephrine, and broad-spectrum antibiotics for suspected infection. An echocardiogram showed globally reduced ejection fraction (EF) of 30-35%, evidence of partial noncompaction of the LV apex and a mobile echo density near the mid anterior lateral wall which was later confirmed on cardiac magnetic resonance imaging. Coronary angiography revealed no flow limiting disease. The patient was managed supportively and continued on a heparin infusion with a plan to start goal directed medical therapy as tolerated for heart failure. A follow up transesophageal echocardiography two days later showed EF of 50-55% and a persistent mass in the LV apex with multiple lobes and various echogenicity. A final diagnosis of takotsubo cardiomyopathy complicated by LV thrombus was made. Discussion: Takotsubo cardiomyopathy is a rare cause of myocardial injury which is reversible in a few months. Reported incidence of LV thrombus is 1-2% with cardioembolic complications observed in 1.3% of patients. Timely diagnosis remains challenging due to nonspecific clinical picture. Appropriate treatment of LV thrombus is pivotal to ensure prevention of long-term neurological sequelae.

Literature review of Aloe vera cytotoxicity

Aloe vera juice enables the body to heal from cancer and from the damage caused by radio and chemotherapy that destroys healthy immune cells crucial for recovery. Aloe vera emodin, an anthraquinone, can suppress or inhibit the growth of cancer cells making it have antineoplastic properties. The role of Aloe in carcinogenicity has not been evaluated well. The chronic abuse of Anthracoid-containing laxatives has been hypothesized to play a role in colorectal cancer. Aloe vera tincture and melatonin administration were studied as standard therapy against metastatic solid tumors. (c, 2016 For thousands of years, plants are an important source of medicine in pharmaceutical biology. As per WHO, 80% of the population today relies on traditional medicine.

Review of the Pathophysiologic and Clinical Aspects of Hypokalemia in Children and Young Adults: an Update.

This article examines the regulatory function of the skeletal muscle, renal, and adrenergic systems in potassium homeostasis. The pathophysiologic bases of hypokalemia, systematic approach for an early diagnosis, and therapeutic strategy to avert life-threatening complications are highlighted. By promoting skeletal muscle uptake, intense physical exercise (post), severe trauma, and several toxins produce profound hypokalemia. Hypovolemia due to renal and extra-renal fluid losses and ineffective circulation activate secondary aldosteronism causing urinary potassium wasting. In addition to hypokalemic alkalosis, primary aldosteronism causes low-renin hypertension. Non-aldosterone mineralocorticoid activation leading to low-renin and low-aldosterone hypertension occurs in Liddle’s syndrome and apparent mineralocorticoid excess. Although there is enzymatic inhibition of cortisol synthesis in congenital adrenal hyperplasia, precursors of aldosterone produce low-renin hypokalemic hypertension. In addition to the glucocorticoid effect, hypercortisolism activates mineralocorticoid receptors in Cushing’s syndrome. Genetic mutations involving furosemide-sensitive Na+-K+-2Cl− co-transporters and thiazide-sensitive Na+-Cl− transporters result in (non-hypertensive) salt-wasting nephropathy. Proximal and distal renal tubular acidosis is associated with hypokalemia. Eating disorders causing hypokalemia include bulimia, laxative abuse, and diuretic misuse. Low urinary potassium (<15 mmol/day) and/or low urinary chloride (<20 mol/L) suggest a gastrointestinal pathology. Co-morbidity of hypokalemia with chronic pulmonary and cardiovascular diseases may increase the fatality rate.

Adverse events related to herbal dietary supplements and over-the-counter medications containing laxatives: a 10-year update from the Italian Phytovigilance and Pharmacovigilance systems.

Products containing anthraquinones (AQ) are associated with an increased risk of serious adverse events (AEs). We performed an update of the available evidence retrieved by the spontaneous reports of AE associated with herbal dietary supplement (DS) and over-the-counter medications (OTC-M) used as laxatives. Analysis and evaluation of AE reports retrieved from the Italian Phytovigilance and Pharmacovigilance systems was performed from February 2011 to December 2020. Totally 110 AE reports, 24 related to herbal DS and 86 to OTC-M, were analyzed. Most subjects were females. Herbal products analyzed mostly contained AQ derivatives. Most AEs were gastrointestinal (41.6%), central nervous system (18.2%), and dermatological disorders (12.6%). The number of AE reports recorded in the last 10 years is still relatively low. However, given the seriousness of some AEs, that does not represent a guarantee of safety. This study may contribute to enhance public awareness on the risks associated with misuse or abuse of laxatives.

Relationship between Anorexia Nervosa and Less Weight: A Medication Treatment Analysis

Anorexia nervosa is an eating disorder causing people to obsess about weight and what they eat. It is a characterized by a distorted body image with a fear of overweight. This causes abnormally low body weight. People with anorexia has an intense fear of gaining weight and distorted perception of weight. It mainly of two types-&#x0D; &#x0D; I) RESTRICTING- where person loses weight by severe limitation of food intake.&#x0D; ii) BEINGE/PURINGING- in which there are periods of food intake that are compensated by self induced vomiting, laxative or diuretic abuse or excessive exercise.&#x0D; &#x0D; Signs maybe behavioral or physical like obsessing about weight, weight gain fears, eating only low calorie food, bloated, constipated, irritable, distracted and not able to concentrate.&#x0D; It is prevalent in young women and teenage girls. People consider anorexia nervosa in connection with females but it can affect people of any sex or gender. Master agreement is for intricate, broad, long haul medicines that utilization a comprehension of the brain Physiology, precise standards and methods acquired from persuasive support treatment and argumentative conduct treatment. These therapies ought to be acted in various settings that meet the degree of power and level of management and clinical consideration required. There is a need to arrange crafted by a wide scope of clinical and mental administrations which frequently don’t cooperate. Due to the age bunch included and the also time span included, patient consideration frequently goes through many changes. This is the pinnacle of backslide and decompensation.

Psychological disorders in the oral health care practice. Feeding and eating disorders

Feeding and eating disorders are characterised by a persistent disturbance of eating or eating-related behaviour that results in the altered consumption or absorption of food, which significantly impairs physical health or psychosocial functioning. These disorders usually develop during childhood and are characterised by high morbidity and mortality rates. The aberrant eating habits lead to under- or overweight and the compensatory behaviours such as vomiting, laxative abuse, and rumination, can greatly impact the overall physical condition and especially the dentition and the oral cavity. Because people suffering from these conditions are often inclined to conceal these, the dentist or dental hygienist can be the first one to raise questions about possible diagnoses of eating disorders.

Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients\u2014a pilot study

BackgroundStimulant laxative abuse as a purging behavior can be profound in those with eating disorders. However, the psychopathology leading to stimulant laxative abuse is poorly understood. Furthermore, the medical impact of stimulant laxative abuse has not been studied in this population.MethodsSix individuals abusing stimulant laxatives underwent a barium enema to assess for evidence of the cathartic colon syndrome and 29 individuals engaging in any purging behaviors completed the Tri-dimensional Personality Questionnaire-Short Form, Sensitivity to Punishment/Sensitivity to Reward Questionnaire-Short Form, Beck Depression Inventory, and the State Trait Anxiety Inventory questionnaires.ResultsThree of the six patients completing the barium enema had the radiographic findings consistent with cathartic colon. Individuals engaging in laxative abuse showed higher Novelty Seeking compared to those engaging in other forms of purging, and those engaging in any form of purging behavior showed greater Sensitivity to Punishment compared to Sensitivity to Reward. There was also the presence of greater Harm Avoidance than Reward Dependence in this population.ConclusionThere may be different psychopathology that contributes to the abuse of stimulant laxatives than that associated with other forms of purging. Regardless of the driving factor, further research is warranted to discover best therapeutic interventions given the potential to develop the cathartic colon syndrome with ongoing use of stimulant laxatives.Plain English SummaryCathartic colon is a condition whereby the colon, or lower intestine, is converted into an inert tube incapable of propagating fecal matter. It is thought to develop due to over-use of stimulant laxatives. However, it is unclear if this condition truly exists and whether it contributes to the constipation experienced by individuals with eating disorders who have extensive past histories of abusing laxatives. It is also unclear if laxative abuse presents with different medical complications than other forms of purging. The purpose of this study is to determine whether radiographic evidence of cathartic colon can be found in eating disorder patients abusing stimulant laxatives, whether there are different medical complications with laxative abuse versus other forms of purging, and to examine the psychological composition of individuals who engage in severe laxative abuse. Specifically, the authors investigated the interrelationship between Harm Avoidance and Reward Dependence, with emphasis on gaining a better understanding of Reward Dependence by examining both Sensitivity to Reward and Sensitivity to Punishment in patients who engage in severe laxative abuse. Our findings suggest that stimulant laxative abuse may cause the development of cathartic colon changes and that there may be unique psychopathology that contributes to the abuse of stimulant laxatives. Given the higher Novelty Seeking personality-dimension in those abusing laxatives, it is possible that this purging behavior may be considered addiction-like in nature, which would have distinct treatment implications.

Clubbing Due to Laxative Abuse.

Clubbing Due to Laxative Abuse.

1392 Challenges of Heart Surgery on A Patient with Anorexia Nervosa: A Rare Case Report of The Perilous Effects on The Myocardium

Abstract This peculiar case highlights the detrimental effects of Anorexia Nervosa (AN) on myocardial tissue, and the significant impact this can have on surgical outcome. A 49-year-old female with history of AN presented acutely unwell with confusion, dizziness, deranged electrolytes and metabolic acidosis. She had lost significant weight in the past month with suspected laxative abuse. She required intubation due to extensive bilateral pulmonary effusions and multiple organ failure. Echocardiogram showed appearance of a rheumatic mitral valve with severe stenosis, a mean gradient of 16mmHg and moderate regurgitation. Urgent surgical intervention to replace the valve was indicated. Following replacement of the mitral valve, torrential bleeding ensued after coming off bypass. This had resulted from a dramatic atrio-ventricular dissociation. Attempts to repair the deficit were hampered by extremely fragile myocardial tissue. Unfortunately, despite extensive efforts to repair the damage and control bleeding, it was ultimately in vain. Histology of the myocardium in AN patient has revealed evidence of diffuse endocardial and interstitial fibrosis and myxoid material deposition. This case is the first to illustrate the sequelae of AN on myocardial tissue with its subsequent peri-operative impact. Before surgical intervention we suggest that maximal efforts to optimize nutrition should be undertaken pre-operatively, seeking to reverse the structural changes caused by AN. This case highlights the need for further exploration of the effects that a patient’s nutritional status can have on the quality of tissue being operated on.

S1889 Colon Cleansing for Weight Loss: A Case of Severe Pancolitis

Introduction: Colon cleanses in the form of oral laxatives marketed as weight-loss tools are becoming increasingly popular. Here, we outline a case of a previously healthy 30-year-old female who presented with diarrhea and was found to have severe pancolitis after a 14-day colon cleanse in the form of an oral herbal supplement called ZuPoo. Case description/methods: The patient initially presented to the emergency department with diarrhea and abdominal pain that persisted 10 days after stopping a colon cleanse. On arrival, she was tachycardic to 140bpm, tachypneic to 40bpm, and febrile to 38.2°C. Labs were notable for a leukocytosis of 20,900 μl and a normal lactate of 1.4 mmol/L. Blood cultures and infectious stool panels including c dif were negative. CT scan of the abdomen showed diffuse severe pan colitis and moderate small bowel dilatation. She was started on IVF and empiric IV antibiotics and admitted. She underwent a sigmoidoscopy on day 2 with concern for inflammatory bowel disease showing mild to moderate inflammation with biopsies negative for active inflammation (Figure 1). Her diarrhea progressed, and she was persistently tachycardic despite heavy IV fluid resuscitation with a leukocytosis of 56,000 μl and a lactate of 9.6 mmol/L. On day 4 she became pulseless in asystole after an episode of large volume emesis. She was intubated and ROSC was achieved after 20 minutes. An x-ray of her abdomen showed pneumatosis intestinalis and she underwent emergent bowel resection. She had progressive multi-organ failure and 4-pressor shock. Over the following 3 days, she underwent multiple bedside laparotomies with bowel resections. She was treated with broad spectrum antibiotics and high dose steroids before the ultimate decision to withdraw care was made. Discussion: This case demonstrates a temporal relationship between a colon cleanse and severe prolonged diarrhea with pancolitis on imaging without a clear etiology otherwise. There is available data on the risks colonic irrigation for weight loss including dehydration, electrolyte imbalances, infection, and perforation. Information on the risks of herbal supplements used for colon cleansing, however, is not widely available and poorly studied. A 2016 study showed that 10.5% of women aged 23-35 used over the counter laxatives for weight loss. While studies in the past have outlined the dangers of laxative abuse, further research is needed to carefully elucidate the risks of commercially available herbal supplements marketed as colon cleanses for weight-loss.Figure 1.: Previously healthy 30-year-old patient presented with prolonged diarrhea after using an herbal colon cleanse for weight loss with a flexible sigmoidoscopy showing mild erythema, granularity, and decreased vascular pattern in the rectum and sigmoid colon.

Anorexia: the great taboo

Anorexia: the great taboo

Негативні ефекти зловживання послаблюючими засобами у лікарській практиці

Зловживання проносними засобами — це розлад, що характеризується незрозумілою і мінливою низкою шлунково-кишкових, електролітних і кислотно-лужних відхилень, що можуть призвести як до виникнення хронічних захворювань, так і до смертельних наслідків. Зловживання самоіндукуєтся, завуальоване і пов’язане з психологічними відхиленнями, що ускладнює постановку діагнозу. Як безпечний проносний засіб пацієнтам, які потребують тривалого лікування запорів, може бути рекомендований препарат ИзіДу.

Laxative Abuse Cessation Leading to Severe Edema

Stimulant laxatives are a common class of laxatives that is abused by patients with eating disorders. We present a case of a 30-year-old female who presented with dyspnea, peripheral edema and weight gain who had been chronically using laxatives. Her symptoms were consistent with rebound edema caused by sodium and free water shifts with abrupt cessation of excessive stimulant laxative use. This case highlights the use of furosemide as the mainstay treatment for rebound edema and weight gain.