Laxative Overdose: What's Too Much?

Laxatives are a type of medicine used to treat constipation and induce bowel movements. While they can be a helpful tool when used appropriately, laxative misuse can lead to serious health consequences and even death. Laxative overdose occurs when an individual takes more than the recommended amount, which can be accidental or intentional. The most common symptoms of a laxative overdose include nausea, vomiting, abdominal cramping, and diarrhoea, while more severe symptoms can include dehydration, electrolyte imbalances, kidney damage, and heart rhythm disturbances. It is crucial to seek immediate medical help in case of a laxative overdose and not to induce vomiting unless instructed by a healthcare professional.

What are the signs of a laxative overdose?

The signs and symptoms of a laxative overdose can vary from person to person, depending on the type of laxative consumed and the amount taken. It is important to note that any overdose of laxatives should be treated as a medical emergency, and emergency services should be contacted immediately.

Some of the most common symptoms of a laxative overdose include:

• Nausea
• Vomiting
• Abdominal cramping
• Diarrhea
• Dehydration
• Electrolyte imbalances
• Drop in blood pressure
• Bloody stools
• Abdominal pain
• Severe gas

In addition to these general symptoms, specific types of laxatives may cause more severe reactions. For example, an overdose of magnesium-based laxatives can lead to:

• Irritation of the gastrointestinal tract
• Severe and watery diarrhea
• Reduced blood pressure (hypotension)
• Weak muscles and lethargy
• Urination and bowel movement difficulties
• Breathing difficulties

Similarly, an overdose of sodium phosphate laxatives can result in:

Weak muscles and collapse

It is crucial to seek immediate medical attention if you or someone you know is experiencing any of these symptoms, as a laxative overdose can have serious and potentially fatal consequences.

What to do if someone has overdosed on laxatives

Yes, it is possible to overdose on laxatives, and it can be harmful and even deadly. If someone has overdosed on laxatives, it is important to act quickly and seek medical help immediately. Here is a step-by-step guide on what to do:

• Call for emergency medical help: Dial 911 or your local emergency number, or contact your local poison control center. In the United States, you can reach the poison control center by calling the toll-free Poison Help hotline at 1-800-222-1222.
• Do not induce vomiting: Do not try to make the person throw up unless instructed to do so by a medical professional or poison control specialist. The person is likely already dehydrated, and inducing vomiting can be dangerous.
• Gather important information: While waiting for emergency services to arrive, gather the following information:

• Person's age, weight, and current condition
• The name of the laxative product (including ingredients and strength, if known)
• The time the laxative was ingested
• The amount of laxative ingested
• Whether the laxative was prescribed to the person or taken without a prescription

• Take the laxative container with you: If possible, bring the container or packaging of the laxative to the hospital or emergency room. This will help medical professionals identify the specific laxative and determine the appropriate treatment.
• Monitor the person's condition: Keep a close eye on the person's vital signs, including temperature, pulse, breathing rate, heart function, and blood pressure. If possible, administer breathing support and intravenous fluids if the person is severely dehydrated.
• Seek long-term support: Once the immediate health threats have been addressed, consider the long-term consequences of laxative abuse. Laxative overdose is often associated with eating disorders or other mental health issues. Seek professional help to address these underlying causes and prevent future incidents.

Remember, the most important step is to seek immediate medical assistance. Do not delay calling for help, as laxative overdose can have serious and potentially fatal complications.

Laxatives and eating disorders

Laxatives are a valuable tool for treating constipation, but they can also be misused by people with eating disorders. People with anorexia nervosa (AN) or bulimia nervosa (BN) may abuse laxatives in an attempt to lose weight or avoid weight gain. They may mistakenly believe that taking laxatives will cause food to pass through the digestive system before calories are absorbed. However, this is not the case, as by the time a laxative acts on the large intestine, most calories have already been absorbed in the small intestine.

Laxative misuse can have serious health consequences and can even lead to overdose or life-threatening conditions. It can cause severe dehydration, which can result in tremors, weakness, blurry vision, fainting, kidney damage, and even death. Additionally, it can lead to disturbances in electrolyte and mineral balances, including sodium, potassium, magnesium, and phosphorus, which are necessary for the proper functioning of nerves and muscles, including those in the colon and heart. This can result in improper functioning of vital organs.

Laxative abuse can also cause internal organ damage, such as a stretched or "lazy" colon, colon infection, irritable bowel syndrome, and, rarely, liver damage. It can also increase the risk of colon cancer. Furthermore, repeated laxative use can lead to the loss of muscle and nerve response in the intestines, making it difficult to move stool without increasing the dosage of laxatives. This can create a cycle of dependency and abuse, similar to drug addiction, with physical withdrawal symptoms and psychological dependence.

Recognising the signs of a laxative overdose is important. Symptoms can include abdominal pain, bloody stools, severe gas, stomach cramps, and a drop in blood pressure. In the case of an overdose, it is crucial to call emergency services or a poison control centre immediately. Do not induce vomiting, as the person is likely already severely dehydrated.

Treating laxative misuse requires working with a team of health professionals with expertise in treating eating disorders, including physicians, psychiatrists, psychotherapists, and dieticians. Support from friends and family can also be beneficial. It is important to address both the physical and psychological aspects of the disorder.

Laxative overdose treatment

If you suspect that someone has overdosed on laxatives, call 911 or your local poison control centre immediately. Do not induce vomiting, as the person is likely to be dehydrated. Try to determine when and how much laxative was taken.

Once the person has received emergency treatment for immediate health threats, it is important to address the longer-term consequences of laxative abuse. This behaviour is often indicative of an eating disorder, but even if it is not, it is important to find the right kind of help to address the issue and any underlying causes, both from a physical and psychological standpoint.

What to expect in the emergency room

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, heart function, and blood pressure. The person may receive:

• Blood and urine tests
• Breathing support, including oxygen and (rarely) a tube through the mouth and a breathing machine (ventilator)
• ECG (electrocardiogram, or heart tracing)
• Intravenous fluids (IV, or through a vein)
• Medicines to treat symptoms

Prognosis

The prognosis of a laxative overdose depends on the type and amount of laxative consumed, the time between overdose and treatment, the severity of the symptoms, and the general health status of the patient. Individuals who have overdosed for the first time generally recover faster with adequate treatment, and no complications are observed.

Prevention

Laxative overdose can be prevented by:

• Always taking the right dose of medication at the recommended times
• Always following the instructions for usage of any health product
• Talking to your healthcare provider if the recommended dose of laxative does not provide adequate relief
• Refraining from self-medication
• Keeping medications out of the reach of children in child-proof containers
• For older individuals and those who tend to be forgetful, medications should be stored in single-dose containers with time labels to avoid multiple dosages
• Monitoring intake of this drug, especially in patients who have depression or harbour suicidal thoughts and behaviour

How to prevent a laxative overdose

Laxatives are a medicine used to produce bowel movements and prevent or relieve constipation. However, they can be harmful when misused or overdosed. Here are some ways to prevent a laxative overdose:

• Follow the recommended dosage: Always take the prescribed or recommended dose of laxatives. Do not exceed the recommended dosage or frequency, as it can lead to dangerous side effects.
• Stay hydrated: Drink plenty of water to maintain hydration. Laxatives can cause dehydration, especially with overuse, so it is essential to compensate by drinking adequate fluids.
• Avoid caffeine: Caffeine can cause dehydration, so it is advisable to limit or avoid caffeine intake when using laxatives.
• Monitor bowel movements: Keep track of your bowel movements to understand your body's patterns and identify when constipation occurs. This information can help determine the appropriate use of laxatives.
• Increase physical activity: Incorporate more movement into your day to stimulate bowel function naturally. Exercise can help regulate bowel movements and reduce the reliance on laxatives.
• Consume high-fiber foods: Include high-fiber foods in your meals to promote healthy digestion and soften stools, making them easier to pass.
• Seek professional help: If you or someone you know is misusing laxatives, especially as a means of weight loss, it is crucial to seek help from a healthcare provider or a mental health professional. They can provide guidance, support, and alternative solutions to address the underlying issues.
• Secure medications: Keep medications out of the reach of children, and use child-proof containers. For older individuals or those who are forgetful, consider using single-dose containers with time labels to prevent accidental overdoses.
• Monitor at-risk individuals: Pay close attention to individuals with eating disorders, depression, or suicidal thoughts, as they may be more prone to laxative overdose. Offer support and guidance, and ensure they have access to appropriate treatment and resources.
• Disclose medication usage: Provide your healthcare provider with a comprehensive list of all prescription and non-prescription medications you are currently taking. This information helps assess possible drug interactions and prevent accidental overdoses or adverse effects.

Frequently asked questions