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Laxatives and Eating Disorders


Two types of over-the-counter laxatives that are commonly used include stimulant laxatives (i.e., those containing castor oil, bisacodyl, phenolphthalein, cascara sagrada, casanthranol, senna, and aloe), which irritate the colon to induce bowel movements; and, bulk-forming laxatives, such as those containing psyllium and/or wheat bran, which add bulk (mass and volume) to the bowel. Use of stimulant laxatives, in particular, is not recommended for more than one week, nor at a dosage greater than what is recommended on the package. When laxatives are taken regularly for a prolonged period of time, one or more adverse effects, some of which are serious and/or dangerous, can occur. These include:

• abdominal cramping and pain
• diarrhea and/or vomiting, which can cause electrolyte, fluid, and mineral (i.e., calcium, magnesium, and potassium) imbalances. (Potassium loss, for example, may cause some decreased muscle tone and, thereby, weaken muscles.) Loss of these nutrients can result in dehydration, metabolic acidosis or alkalosis, tetany, and heart failure.
• malabsorption, which can cause osteomalacia (caused by impaired absorption of vitamin D and calcium), which is deformed bone development
• protein-losing enteropathy, which involves a loss of gastrointestinal (GI) protein, and is associated with certain disorders of the GI tract and heart
• steatorrhea, which is greasy diarrhea caused by malabsorption of fat
• damage to the GI tract, including weakening of intestinal musculature, stomach ulcers, and cathartic colon, which is a poorly functioning colon that develops after years of laxative abuse. This can lead to an inability to have a bowel movement when not taking laxatives, resulting in constipation problems. Permanent bowel damage usually results if not treated in time.
• liver disease
  

As you can see, some of these side effects may indicate other serious health problems as well, which would require a visit to a health care provider.


Complications

• Gastrointestinal Complications:  Nausea, vomiting, weight loss, malabsorption syndromes, protein - losing gastroenteropathy, cathartic colon (where the colon ceases to function adequately).
  
• Nongastrointestinal Complications:  Fluid and electrolyte abnormalities, hyperuricemia, hypocalcemia, and hypomagnesemia.  Pigmentation of the skin and digial clubbing have also been described.
  
• Laxative withdrawal:  Fluid retention, which can be dramatic, causing weight increases in excess of 10 pounds, and constipation.

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