The Truth about Laxative Abuse

According to many eating disorder websites, laxative abuse is another form of an eating disorder and is usually combined in various ways with anorexia, bulimia, over-eating and/or over-exercising.  Laxative abuse is a very common feature of eating disorders because there are so many misconceptions about it being safe. 

Most laxative abuse begins slowly and the reasons for the use change over time.  Laxative usage is normal when constipation has persisted for a long time and a bowel movement is necessary.  However, many people with eating disorders will abuse and overly use laxatives, believing that they are losing weight from the use.  This unfortunate belief leads to many health complications from the use of a substance that is not needed.  The reality is that the body has already absorbed all the calories and nutrients from the food before it is pushed into the lower end of the bowel (where laxatives work).  Most laxative abusers eventually realize that there are no long-term weight loss effects from taking laxatives constantly; however they continue to use them because of the learned behavior patterns that have become ingrained in the sufferer’s life. 

The dangers of laxative abuse

There are many long-term side-effects of abusing laxatives, such as diarrhea, abdominal cramps and flatulence.  The more serious dangers include persistent constipation (because the body becomes dependent on laxatives for a bowel movement), chemical imbalances in the blood and dehydration.  Laxative abusers risk chemical imbalances due to the loss of salts and minerals. These chemical imbalances can seriously affect the body’s electrolyte system and hinder the body’s ability to absorb vitamins.  Laxative abuse can also lead to gastrointestinal tract damage and the weakening of the intestinal musculature.  Liver disease in extreme cases is possible. 

Laxative abuse is particularly common with stimulant purgatives, which raises several concerns. The first concern is laxative dependence (mentioned above), in which the peristalsis (wave-like contraction of the colon) can no longer be achieved naturally and must be stimulated through various substances.  Another concern is potassium imbalance, resulting from the force movement of digestive materials and the inability of the intestines to absorb the nutrients fast enough.  Yet another concern is the possibility that laxatives could permanently damage the digestive tract after years of abuse.  As with anything, if you are pregnant or nursing, consult your physician before taking any type of laxative.

Laxative abusers that have been using laxatives for an extended period of time may experience:
• severe abdominal pain
• bloating
• gas
• dehydration
• chronic diarrhea
• electrolyte disturbances (which can lead to heart problems)
• chronic constipation (when laxative abuse is abruptly stopped)

When trying to stop the abuse of laxatives, it is generally best to seek medical help/advice so as not to disrupt the delicate balance of bacteria in the colon.  Too rapid a withdrawal can lead to dangerous levels of constipation and serious nausea.  It is also a very difficult psychological withdrawal because the majority of laxative abuse has strong psychological effects on the addicted individual.

Understanding laxative dependence is difficult because the nature of laxative dependence is a controversial matter.  Some medical professionals maintain that laxative dependence results, in part, from degeneration of the nerves in the intestines, dulling the natural response that stimulates peristalsis.  Other medical professionals maintain that dependence may simply be psychological.  Laxatives generally exacerbate potassium losses, and this problem can be compounded quickly by the use of other drugs (legal or illegal). Regardless, potassium imbalance, from long-term use of laxatives, has been blamed for deaths of many otherwise healthy women. 

For Your Information…
There are several types of laxatives which may be in oral or suppository form: 

1. Bulking agents: compounds that increase the amount of bulk in the intestines either by withdrawing water from the body or increasing bulk when combined with fluids
2. Lubricants: softeners (emollient laxatives) or lubricants such as mineral oil which ease the passage of waste and counteract excessive drying of the intestinal contents.
3. Stimulants: laxatives that stimulate muscular action of the intestines (cascara sagrada, senna)

Bulking agents (fiber)
Bulking agents include dietary fiber and cause the stool to be bulkier and retain more water. These types of laxatives draw water from the body into the intestines, making it easier for peristaltic action (wave-like contractions of the colon) to take place.  Another type of bulking agent is a stool softener.  These cause fats and water to penetrate the stool through the intestines, making it much easier for the digestive material to move along.  Many types of bulking agents quickly prove ineffective with prolonged use.  With the use of saline, Epsom salt or Milk of Magnesia, this type of bulking agent (called a hydrating agent) causes the intestines to concentrate more water within, softening the stool.  Even though it is the most gentle of the laxatives, if not combined with fluids, bulking agents can lead to constipation.

Lubricants
Lubricants simply make the stool more slippery, which eases the passage of waste. This can also help counteract excessive drying of the intestinal contents.

Stimulants
As the name suggests, stimulants encourage peristaltic action (wave-like contractions of the colon).  The can be quite dangerous under certain circumstances and are the most severe among laxatives.

  
Please Note: Digestion Health’s information is not a substitute for medical or psychological evaluation and treatment. For help with the physical and emotional problems associated with eating disorders, please consult your physician and a mental health professional.