Signs Of Overuse: Laxative Abuse And Your Health

Laxatives are a medication used to treat constipation by stimulating bowel movements. However, laxative abuse, or the excessive use of laxatives, is often associated with eating disorders, particularly bulimia nervosa and anorexia nervosa. People with eating disorders may use laxatives to purge calories or food, attempting to lose weight or control their weight. This abuse can lead to severe dehydration, a reduction in electrolytes, mineral deficiencies, gastrointestinal damage, and an increased risk of colon cancer. The abuse of laxatives can also cause physical and emotional withdrawal, with individuals experiencing shame, depression, and anxiety.

Laxative abuse and eating disorders

Laxatives are a type of medication used to treat constipation. However, they are commonly misused in an attempt to lose weight or control weight. This is known as laxative abuse or excessive laxative use, and it is closely associated with eating disorders, particularly bulimia nervosa (BN) and anorexia nervosa. People with binge-purge type anorexia nervosa are also likely to abuse laxatives.

Laxative abuse involves using laxatives habitually, frequently, or in higher-than-recommended doses for weight loss or control. The aim is to stimulate bowel movements so that food is purged from the body before calories and fat can be absorbed. However, this is a false assumption as laxatives generally work by stimulating the movement of the large intestine (colon) after calories and nutrients have already been absorbed by the small intestine. Therefore, the weight loss caused by laxatives is minor, temporary, and due to a decrease in water weight.

People who misuse laxatives often show classic signs of eating disorders, such as a preoccupation with thinness and body image, shame and guilt about food, and withdrawal from loved ones. They may also exhibit secretive eating behaviours, often bingeing and then feeling guilty about it afterward.

The health risks of laxative abuse include:

• Diarrhea
• Dehydration
• Electrolyte imbalances
• Chronic constipation
• Urinary tract infections (UTIs)
• Organ damage
• Increased risk of colon cancer
• Gastrointestinal damage
• Bowel nerve damage
• Rectal prolapse
• Heart problems
• Depression and anxiety

Treatment for laxative abuse typically involves psychotherapy, such as dialectical behaviour therapy (DBT) or cognitive behavioural therapy (CBT), and changes in eating habits. It is important to address both the emotional issues that fuel eating disorders and the short- and long-term damage to physical health.

Short- and long-term side effects

• Gastrointestinal discomfort, gas, loose stool, and diarrhoea.
• Rectal irritation, which can lead to an increased risk of infection and bleeding during bowel movements.
• Dehydration, which can lead to hypovolemic shock and death.
• Electrolyte imbalances, which can negatively affect kidney and heart function and, in some cases, lead to coma, seizures, and sudden cardiac arrest.
• Chronic constipation and laxative dependency.
• Urinary tract infections.
• Organ damage, including acute renal failure (kidney failure), hepatic failure (liver failure), and pancreatitis.
• Increased risk of colon cancer.
• Heart palpitations and arrhythmia.
• Rectal prolapse.
• Depression and anxiety.
• Intestinal paralysis.
• Bowel nerve damage.
• Mineral deficiencies.
• Weight gain.
• Intestinal infections.
• Irritable bowel syndrome.
• Intestinal paralysis.

Laxative overdose

The most common symptoms of a laxative overdose are nausea, vomiting, abdominal cramping, and diarrhea. Dehydration and electrolyte imbalances are also common, especially in children. Laxatives containing magnesium can cause serious electrolyte and heart rhythm disturbances in people with impaired kidney function.

If you suspect a laxative overdose, it is important to seek medical help immediately and call your local emergency number or poison control center. Have the following information ready: the person's age, weight, and condition; the name of the product (including ingredients and strength, if known); the time it was swallowed; the amount swallowed; and whether the medicine was prescribed for the person.

Laxative abuse can have serious short-term and long-term side effects, including gastrointestinal discomfort, gas, loose stool, diarrhea, rectal irritation, and an increased risk of infection and bleeding during bowel movements. It can also lead to dehydration, which can be life-threatening if not treated promptly.

Long-term complications of excessive laxative use include irritable bowel syndrome, kidney failure, liver failure, pancreatitis, and cardiovascular disease. It can also increase the risk of colon cancer and is associated with depression and anxiety.

Laxative misconceptions

Laxatives are commonly used to treat constipation, but they are also frequently misused as a means of weight loss. This misuse is often driven by misconceptions about their effectiveness and safety. While laxatives can create a sense of reduced bloating and temporary weight loss, they do not lead to long-term weight loss. In fact, they can contribute to weight gain due to the activation of the renin-aldosterone system, which leads to edema. The following paragraphs will address common misconceptions about laxatives and provide information on their actual effects and risks.

Misconception: Laxatives Promote Weight Loss

Laxatives do not promote long-term weight loss. They work by stimulating the movement of the large intestine (colon) after calories and nutrients have already been absorbed by the small intestine. While they can create a sense of reduced bloating and temporary weight loss, this is due to the loss of "water weight," which quickly returns as soon as the individual consumes fluids or food. Additionally, studies have shown that excessive laxative use can lead to weight gain over time, as individuals tend to increase their body mass index (BMI).

Misconception: Laxatives Are a Safe Way to Lose Weight

Laxatives are not a safe method for weight loss. They can cause a range of serious short- and long-term health consequences, including gastrointestinal discomfort, gas, loose stool, diarrhea, rectal irritation, and an increased risk of infection and bleeding during bowel movements. Dehydration is also a common side effect, as laxatives remove water and fluids from the body. In severe cases, dehydration resulting from laxative abuse can lead to hypovolemic shock and even death.

Misconception: Laxatives Only Affect the Digestive System

Laxatives can have systemic effects and impact various organs in the body. The excessive use of laxatives can lead to organ damage and the loss of organ function. This includes acute renal failure (kidney failure), hepatic failure (liver failure), and pancreatitis (inflammation of the pancreas). Additionally, the disruption of electrolyte balance caused by laxative abuse can affect the heartbeat, blood pressure, and muscle movements. In some cases, electrolyte loss can lead to coma, seizures, and sudden cardiac arrest.

Misconception: Laxatives Are Harmless if Used Occasionally

Even minor degrees of stimulant laxative abuse may increase the incidence of eating disorders. The use of laxatives as a weight-loss strategy can be indicative of underlying disordered eating behaviours and can lead to a cycle of misuse and negative health consequences. Additionally, the discontinuation of laxatives after a period of abuse can result in unpleasant physical symptoms such as bloating, cramping, and constipation, further reinforcing the reliance on laxatives.

Laxative abuse treatment

Laxative abuse is a serious issue that can lead to severe health concerns. Treatment for laxative abuse typically involves working with a team of health professionals with expertise in treating eating disorders, including a physician, psychiatrist, psychotherapist, and dietician. Support from loved ones is also beneficial.

Initial Medical Care

For severe cases of laxative abuse, hospitalization may be required before therapeutic treatment. This involves addressing any immediate physical issues caused by laxative abuse. For example, individuals with extreme dehydration may need rehydration through intravenous methods, while those with colon infections may require antibiotics.

Inpatient Programming

Inpatient treatment is suitable for individuals with a serious problem with laxatives. They reside at the facility with others in recovery and receive medical and therapeutic services. Common therapies include cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).

Partial Hospitalization Programming

Partial hospitalization treatment is for those who don't need inpatient care but require more structure than outpatient programs. Individuals can choose to reside at home or at the facility and spend most of their time participating in therapeutic exercises.

Outpatient Programming

Outpatient programming is designed for those with less severe cases of laxative abuse. Individuals attend the program for a few hours a day or a couple of days a week, engaging in individual psychotherapy, group therapy, and developing strong coping skills.

Diet and Lifestyle Changes

As individuals return to normal eating, dietitians can help with eating plans that prevent constipation. This includes drinking plenty of fluids, increasing fiber intake through fruits and vegetables, and exercising regularly.

It is important to note that stopping laxatives abruptly can cause side effects like bloating, cramping, and constipation. Therefore, it is recommended to speak with a healthcare provider about natural ways to manage during recovery.

Frequently asked questions