The Hazards Of Crushing Laxatives: What You Need To Know

Laxatives are a common medicine used to stimulate bowel movements. While they are generally safe for occasional use, they can be misused, particularly by those with eating disorders such as bulimia nervosa, who use them to induce vomiting and fasting. Laxative abuse can lead to severe health issues such as dehydration, electrolyte imbalance, gastrointestinal irritation, organ damage, and dependence. It can also cause a drop in blood pressure and, in rare cases, even death. Those who misuse laxatives should seek medical advice and treatment, which may include psychotherapy and changes to eating habits.

Laxative overdose

A laxative overdose occurs when someone takes more than the normal or recommended amount of this medicine. This can be accidental or intentional. Laxatives are a medicine used to produce bowel movements and relieve constipation. They are typically used when natural methods such as eating enough fibre, drinking enough water, and exercising, are ineffective.

Most laxative overdoses in children are accidental. However, some people, particularly those with eating disorders, take more than the recommended dose of laxatives to try to lose weight. This is known as laxative abuse and is associated with bulimia nervosa. 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.

The misuse of laxatives can lead to serious health consequences, including:

• Dehydration
• Electrolyte imbalances
• Chronic constipation
• Urinary tract infections
• Organ damage
• Increased risk of colon cancer
• Gastrointestinal discomfort
• Rectal irritation and bleeding
• Intestinal blockage
• Choking
• Drop in blood pressure
• Gastrointestinal irritation
• Inability to control bowel movements
• Heart problems
• Coma
• Seizures
• Cardiac arrest
• Death

If you suspect someone has overdosed on laxatives, call your local emergency number or poison control centre immediately. Do not induce vomiting unless instructed to do so by a healthcare professional. Have the following information ready:

• Person's age, weight, and condition
• The name of the product, including ingredients and strength, if known
• Time it was swallowed
• The amount swallowed
• Whether the medicine was prescribed for the person

Laxative abuse

Laxatives are commonly taken to help with constipation and are relatively safe when used occasionally and as directed. However, when taken over long periods or in higher-than-recommended doses, they can lead to laxative abuse and dependence. This occurs when the body becomes reliant on laxatives for regular bowel movements, and stopping their use can lead to withdrawal issues.

The misuse of laxatives can cause a range of physical and mental health problems, including:

• Dehydration: Laxatives remove water and fluids from the body, leading to dehydration and symptoms such as muscle weakness, dizziness, and confusion. In severe cases, dehydration can be life-threatening.
• Electrolyte imbalances: Excessive laxative use can disrupt the balance of electrolytes like potassium, sodium, and calcium, which are essential for regulating bodily functions such as heartbeat and blood pressure. Electrolyte imbalances can lead to organ damage, including kidney and liver failure, and, in some cases, can be fatal.
• Chronic constipation: Over time, laxative abuse can make constipation worse as it reduces muscle tone and nerve signalling in the digestive tract.
• Urinary tract infections (UTIs): Chronic dehydration from laxative abuse can increase the risk of UTIs by concentrating chemicals in the urine and irritating the urethra.
• Organ damage: Prolonged and excessive laxative use can cause lasting damage to internal organs, including the liver and kidneys.
• Increased risk of colon cancer: Studies have shown that the overuse of laxatives can double the risk of colon cancer.
• Gastrointestinal issues: Laxative abuse can lead to gastrointestinal discomfort, gas, loose stools, and diarrhoea. It can also cause rectal irritation and an increased risk of infection and bleeding during bowel movements.
• Heart problems: Laxative abuse has been linked to cardiovascular issues, including heart palpitations and arrhythmia.
• Mental health issues: Laxative abuse is associated with depression, anxiety, and a lack of self-confidence. Those who misuse laxatives often feel shame or embarrassment about their behaviour and may withdraw from friends and family.

Treatment for laxative abuse typically involves psychotherapy, such as dialectical behaviour therapy (DBT) or cognitive-behavioural therapy (CBT), and addressing any underlying trauma that contributes to disordered eating. It is important to stop taking laxatives, but this should be done gradually to minimise withdrawal issues.

Laxative misuse

Laxatives are commonly used to treat constipation and are available over the counter without a prescription. They come in several forms, including pills and liquids. While laxatives are relatively safe when used as directed, they can be misused or abused, particularly by individuals with eating disorders. Laxative misuse occurs when someone attempts to lose weight or "feel thin" by repeatedly using laxatives. This can lead to a range of serious health complications and even life-threatening conditions.

The belief that laxatives promote weight loss is a myth. By the time a laxative acts on the large intestine, most nutrients and calories have already been absorbed by the small intestine. Laxatives artificially stimulate the large intestine to empty its contents, but the weight lost is mostly water, minerals, electrolytes, and indigestible waste. This "water weight" quickly returns as soon as the person rehydrates. If the person chronically misusing laxatives refuses to rehydrate, they risk severe dehydration, which can be fatal.

Other health consequences of laxative misuse include disturbance of electrolyte and mineral balances, which are necessary for the proper functioning of vital organs like the colon and heart. Electrolyte imbalances can negatively affect kidney and heart function and, in some cases, lead to fatal complications such as coma, seizures, and cardiac arrest. Urinary tract infections (UTIs) are also more common in those who misuse laxatives due to chronic dehydration.

Laxative abuse is often associated with individuals who have body dysmorphia or eating disorders such as anorexia nervosa and bulimia nervosa. It is a dangerous way of dealing with feelings of shame, depression, the need for acceptance, control, or anxiety. Treatment for laxative misuse typically involves working with a team of health professionals, including a physician, psychiatrist, psychotherapist, and dietician. It is crucial to address both the physical and emotional issues underlying laxative misuse to prevent short-term and long-term damage to physical health.

Laxative side effects

Laxatives are a convenient solution for addressing occasional constipation or related discomfort. While they are generally safe for such use, there is potential for misuse, with some individuals taking them excessively to try to lose weight. However, this is ineffective and can cause serious side effects.

Dehydration

Laxatives remove water and other fluids from the body, which can lead to dehydration. Symptoms of dehydration include muscle weakness, dizziness, thirst, inability to urinate, dark urine, confusion, and dry mouth. In severe cases, dehydration can be life-threatening, leading to hypovolemic shock and even death.

Electrolyte imbalance

Excessive laxative use can disrupt the balance of electrolytes like potassium, sodium, and calcium in the body. Electrolytes are essential for regulating many bodily functions, including heartbeat, blood pressure, muscle movements, and digestion. Electrolyte imbalances can negatively affect kidney and heart function and may even lead to fatal complications such as coma, seizures, and cardiac arrest.

Chronic constipation

Over time, excessive laxative use can worsen constipation rather than relieve it. This is because the colon may become less responsive to normal signals for bowel movements, requiring higher doses of laxatives to produce a movement. This can lead to a cycle of increasing laxative dependence.

Organ damage

Prolonged and excessive laxative use can cause lasting damage to internal organs, including the liver and kidneys. This is due to the increased workload on these organs as they compensate for the effects of the laxatives on the digestive tract.

Increased risk of colon cancer

The excessive use of laxatives has been linked to a twofold increase in the risk of colon cancer. This may be due to the physical trauma caused to the colon lining, which can create openings or tears that increase the risk of bacterial infections.

Other side effects

Other potential side effects of laxative misuse include gastrointestinal discomfort, gas, loose stool, rectal irritation, urinary tract infections, heart problems, depression, anxiety, and rectal prolapse.

Laxative treatment

Laxatives are a convenient solution for addressing occasional constipation or related discomfort. However, laxative abuse can lead to severe health consequences, including dehydration, electrolyte imbalance, organ damage, and dependence. Treatment for laxative abuse involves a comprehensive approach, including stopping laxative use, psychological intervention, and supportive care.

Stopping Laxative Use

Central to the treatment process is the cessation of laxative use, which must be done safely and effectively. This may involve gradually reducing laxative use to minimize withdrawal issues while closely monitoring progress. Side effects of stopping laxative use can include bloating, cramping, and constipation.

Psychological Intervention

Psychological interventions are necessary due to the established link between laxative misuse and eating disorders. These interventions include therapy and counseling, with the aim of uncovering the underlying causes of the behavior. Cognitive-behavioral therapy (CBT) is a common approach that helps individuals identify and change harmful thought patterns and behaviors.

Supportive Care

Supportive measures may include electrolyte replacement and medications to alleviate digestive distress. These can help manage any physical complications of laxative misuse, such as dehydration and electrolyte imbalances.

Medical Treatment

If you or someone you know has overdosed on laxatives, seek medical help right away. Call your local emergency number (such as 911 in the US) or your local poison control center. Do not try to induce vomiting unless instructed to do so by a healthcare professional. Have the following information ready:

• Person's age, weight, and condition
• The name of the product (ingredients and strength, if known)
• Time it was swallowed
• The amount swallowed
• If the medicine was prescribed for the person

Frequently asked questions