Laxative Abuse: Why Should You Not Be Fully Dependent on Laxatives?

Laxatives are medications used to treat constipation when lifestyle changes have not worked. Depending on the type of laxative, they work either by stimulating bowel movements, softening stools, or increasing stool bulk. Common types of laxatives include bulking forming laxatives, such as ispaghula husk, osmotics, such as lactulose, stimulant laxatives and stool softeners. (1)

While laxatives are safe for temporary use and provide relief for occasional constipation, there is a potential for them to be misused. 

What are the consequences of laxative misuse?

Laxative misuse is defined as either taking large amounts of laxatives or using them regularly, exceeding their recommended daily dosage. A common type of laxative misuse is utilising them for weight loss. (2)

These can have many significant implications on health, including: 

Severe dehydration:  

Using too many laxatives can cause diarrhoea, which can lead to loss of fluid from the bowel; the body responds by retaining fluid to try to protect itself against dehydration. Signs and symptoms of dehydration include dry skin and mouth, tremors, weakness, brittle nails, and blurry vision. (3)

Electrolyte imbalance:

Laxative abuse can disturb electrolyte and mineral balances of sodium, potassium, and magnesium. These minerals are important in regulating nerve impulses in the heart. When potassium levels in the body are low, the heart may lose its regular beating rhythm, causing arrhythmias. Signs of electrolyte imbalances include muscle cramps, weakness and irregular heartbeat. (3)

Impaired intestinal function: 

Laxative dependency can also cause a sudden loss of intestinal muscle, which means the colon stops responding to regular doses of laxatives; therefore, larger amounts of laxatives may be required to produce bowel movements. (3)

What are some alternatives to laxatives? 

There are many different ways to prevent constipation without becoming dependent on laxatives. Some of these include ensuring adequate fluid intake to prevent dehydration, increasing fibre intake, which comes from foods such as fruits, vegetables, grains, and lentils, and regular exercise. (4)

If you or someone you know may be at risk of laxative abuse, it is advised to seek help from a healthcare professional. 

References:

1. NHS website. (2017, October). Laxatives. Nhs.uk. https://www.nhs.uk/medicines/laxatives/

2. Levinson, J. A., Sarda, V., Sonneville, K., Calzo, J. P., Ambwani, S., & Austin, S. B. (2020). Diet pill and laxative use for weight control and subsequent incident eating disorder in US young women: 2001–2016. American Journal of Public Health, 110(1), 109-111.

3. Bashir, A., & Sizar, O. (2024). Laxatives. In StatPearls [Internet]. StatPearls Publishing.

   
   

4. Liu, L. W. C. (2011). Chronic constipation: current treatment options. Canadian Journal of Gastroenterology and Hepatology, 25, 22B-28B.

Assessed and Endorsed by the MedReport Medical Review Board