Laxative Abuse Syndrome

The Laxative Abuse Syndrome is characterized by continuous abuse of purgatives. It is considered a subtype of Münchausen Syndrome, which itself is a psychological disorder, where patients feign disease, illness or psychological trauma, simply to draw negative attention or sympathy to themselves.

Symptoms and clinical findings of the Laxative Abuse Syndrome are often perplexing and may mimic inflammatory bowel disease or malabsorption syndromes. Patients frequently complain of diarrhea alternating with constipation and may have nausea, vomiting and weight loss[1]. Also, these patients sometimes exhibit significant renal injury[2]. Psychiatric disturbances are common and may include anorexia nervosa.
Getting to the right diagnosis may be extremely difficult and may require special chemical analysis of urine and feces and even a search of the patient's possessions.

Treatment is often frustrating because the patient is rarely willing to admit to laxative abuse let alone cooperate in attempting to stop it. Physicians must be aware of the Laxative Abuse Syndrome in order to avoid harming the patient with extensive, expensive and often invasive (including laparotomy) procedures.

[1] Oster et al: Laxative abuse syndrome in American Journal of Gastroenterology – 1980 
[2] Wright et al: Renal injury associated with laxative abuse in Southern Medical Journal – 1987

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