Laxative overdose Information | Mount Sinai

Laxative abuse

A laxative is a medicine used to produce bowel movements. Laxative overdose occurs when someone takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

Most laxative overdoses in children are accidental. However, some people regularly take overdoses of laxatives to try to lose weight.

This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

Using too much of these drugs can cause symptoms of a laxative overdose:

• Bisacodyl
• Carboxymethylcellulose
• Cascara sagrada
• Casanthranol
• Castor oil
• Dehydrocholic acid
• Docusate
• Glycerin
• Lactulose
• Magnesium citrate
• Magnesium hydroxide
• Magnesium oxide
• Magnesium sulfate
• Malt soup extract
• Methylcellulose
• Milk of magnesia
• Mineral oil
• Phenolphthalein
• Poloxamer 188
• Polycarbophil
• Potassium bitartrate and sodium bicarbonate
• Psyllium
• Psyllium hydrophilic mucilloid
• Senna
• Sennosides
• Sodium phosphate

Other laxative products may also cause an overdose.

Where Found

Below are specific laxative drugs, with some brand names:

• Bisacodyl (Dulcolax)
• Cascara sagrada
• Castor oil
• Docusate (Colace)
• Docusate and phenolphthalein (Correctol)
• Glycerin suppositories
• Lactulose (Duphalac)
• Magnesium citrate
• Malt soup extract (Maltsupex)
• Methylcellulose
• Milk of magnesia
• Mineral oil
• Phenolphthalein (Ex-Lax)
• Psyllium
• Senna

Other laxatives may also be available.

Symptoms

Nausea, vomiting, abdominal cramping, and diarrhea are the most common symptoms of a laxative overdose. Dehydration and electrolyte (body chemicals and minerals) imbalance are more common in children than adults. Below are symptoms specific to the actual product.

Bisacodyl:

• Cramps
• Diarrhea

Senna; Cascara sagrada:

• Abdominal pain
• Bloody stools
• Collapse
• Diarrhea

Phenolphthalein:

• Abdominal pain
• Collapse
• Diarrhea
• Dizziness
• Drop in blood pressure
• Low blood sugar
• Rash

Sodium phosphate:

• Abdominal pain
• Collapse
• Diarrhea
• Muscle weakness
• Vomiting

Magnesium-containing products:

• Abdominal pain
• Collapse
• Coma
• Death
• Diarrhea (watery)
• Drop in blood pressure
• Flushing
• Gastrointestinal irritation
• Muscle weakness
• Painful bowel movements
• Painful urination
• Slowed breathing
• Thirst
• Vomiting

Castor oil can cause gastrointestinal irritation.

Mineral oil can cause aspiration pneumonia, a condition where vomited stomach contents are inhaled into the lungs.

Products containing methylcellulose, carboxymethylcellulose, polycarbophil, or psyllium may cause choking or intestinal blockage if they are not taken with plenty of fluids.

Home Care

Seek medical help right away. DO NOT make a person throw up unless poison control or a health care provider tells you to.

Before Calling Emergency

Have this 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

Poison Control

Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does not need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

Take the container with you to the hospital, if possible.

The provider will measure and monitor the person’s vital signs, including temperature, pulse, breathing rate, heart function, and blood pressure. Symptoms will be treated. The person may receive:

• Activated charcoal
• Blood and urine tests
• Breathing support, including oxygen and (rarely) a tube through the mouth into the lungs and breathing machine (ventilator)
• Chest x-ray
• ECG (electrocardiogram, or heart tracing)
• Intravenous fluids (IV, or through a vein)
• Medicines to treat symptoms

Outlook (Prognosis)

How well a person does depends on the type of laxative swallowed, how much was swallowed, and how much time passed before treatment was received.

First-time laxative overdoses are rarely serious. Severe symptoms are most likely in people who abuse laxatives by taking large amounts to lose weight. Fluid and electrolyte imbalances may occur. Inability to control bowel movements may also develop.

Laxatives containing magnesium can cause serious electrolyte and heart rhythm disturbances in people with impaired kidney function. These people may require the extra breathing support noted above.

Aronson JK. Laxatives. In: Aronson JK, ed. Meyler’s Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:488-494.

Meehan TJ. Approach to the poisoned patient. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 139.

Last reviewed on: 7/12/2021

Reviewed by: Jacob L. Heller, MD, MHA, Emergency Medicine, Emeritus, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A. D.A.M. Editorial team.

Don’t bomb the bowel with laxatives

If constipation becomes chronic, don’t keep playing laxative roulette. See your doctor for an exam.

Occasional irregularity is a fact of life, but you can minimize it with some basic steps. You should be sure you are eating a fiber-rich diet, drinking adequate fluids, and staying physically active. But when you do have constipation, start with the gentlest and safest option, like a bulk-forming laxative. If laxatives don’t work, ask for help. You should see your doctor and discuss it if you are constantly needing to take laxatives.

First choice: bulk-forming laxatives

Bulk-forming laxatives draw water into stool, making it softer and easier to pass. But don’t expect instant gratification: these can take a half-day to several days to provide relief. They are safe to use daily. They contain various ingredients, and you may have to try more than one to find the product that helps you with minimal side effects, such as flatulence and bloating. They may be marketed as laxatives or as fiber supplements.

For stuck stools…

Stool softeners add moisture to stools to make them softer and easier to pass. Mineral oil, a lubricant, helps stools “slide on by” if the stools feel stuck low in your bowels, if you have an internal tear or “fissure,” or if you have pain from hemorrhoids during bowel movements. Don’t take mineral oil at the same time as stool softeners. Take 1 tablespoon at breakfast or lunch. But don’t use it for more than a few days, because mineral oil interferes with absorption of some vitamins and if inhaled it can cause pneumonia. Consider wearing a protective pad in your undergarments to absorb any leakage.

Other laxative options

If stool softeners aren’t providing enough help, the osmotic laxative polyethylene glycol (MiraLAX or a generic version) is good next step. These products hold water in stool to soften it and increase bowel movements. Common side effects are gas, bloating, and nausea. Another option that works for some people is diet candies containing the sweetener sorbitol. These essentially trigger a mild case of the runs. You may experience bloating and gas along with the laxative effect, however.

Another option would be a magnesium-based laxative, such as milk of magnesia or magnesium citrate. These are members of a larger class of laxatives called saline osmotics, which draw water into the bowels and trigger bowel movements. The active ingredients include magnesium, sulfate, citrate, and phosphate. But don’t take more than the recommended amounts of these laxatives, or use them long-term, because they can throw off your chemistry. Combined with an underperforming kidney or heart failure, saline osmotic laxatives can be dangerous.

Stimulant laxatives

Stimulant laxatives such as senna and bisacodyl trigger contractions in the bowels that push the stool along. But if you take stimulant laxatives too often, you could become dependent on them to have a bowel movement at all—possibly because the bowel has stopped functioning normally.

When to talk to a doctor

If you find yourself trying one laxative after another, see your doctor for an evaluation. Additional testing can lead to better therapy and rule out any possible serious malfunctions. And if it is just constipation, your doctor can offer other medications to you that may be more helpful than over-the-counter laxatives.

What will happen to the body if you regularly take a laxative for two weeks: November 08, 2022, 11:03

Still from the movie “Dumb and Dumber”.

November 08, 2022, 11:03

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Many people find it easier to take a laxative than to see a doctor if they have problems with stools. But the passion for these drugs threatens the development of an extremely unpleasant disease. It will be much more difficult to treat it than to deal with constipation, Tengri Lifestyle reports with reference to Doctorpiter.

Regular use of these medicines may lead to the development of laxative disease. So in medical language they call addiction to laxatives and the subsequent inability to empty the intestines without taking them.

According to gastroenterologist Vera Samsonova, laxatives have been actively and aggressively promoted in various social networks, magazines and even clinics, positioning them as a means of quickly and safely solving delicate problems.

Of course, the fact that the drug will help clear the intestines from the contents and bring relief for the first, second and even tenth time is indisputable. But over time, people notice that the usual remedy has become worse to help, you need to take it more often, increase the dose, and going to the toilet without a laxative is generally a problem. The frequency of side effects also increases – this is the beginning of laxative disease. And with such neglected problems, most of them already go to a specialist.

90 percent of problems occur within 2 weeks

Under the influence of drugs, the intestines are emptied, because the drugs strongly irritate the intestinal walls, cause an increase in the volume of water inside the intestine, or activate motility. And everything would be fine, but the intestines get used, and rather quickly, to what everyone is doing for him with the help of laxatives. As a result, motility suffers, metabolism is disturbed, and a state of “lazy gut” occurs.

There is research evidence that almost 90 percent of people with constipation develop laxative sickness within two weeks of taking laxatives. If you cancel these funds, constipation only intensifies, and not everyone wants to correct nutrition, drinking regimen and move more instead of drinking drugs. A vicious circle is formed, which is difficult to break.

What if it’s a harmless weed?

Do not be under the illusion that the problem will arise only from pharmaceutical “chemistry”, but if these are natural herbal remedies or recipes passed down to us from ancestors, this is safe. No, the origin of the laxative has little effect on the development of laxative disease. Moreover, often herbal, natural remedies even more often provoke a problem, because people are wary of pharmacy “chemistry”, but there is no such alertness in relation to herbal remedies.

In fact, stimulation of the intestines with various substances provokes disturbances in motility, a disorder of the close connections between the muscles in the walls of the intestines and the nervous system. Without constant stimulation, motor skills weaken, become lethargic, which is why, in order to empty, you need to take drugs again each time.

Dangerous complications

In addition to the fact that the main problem is not solved – the regularity of the chair, there is also a lot of new ones. Among them – malabsorption in the colon of water and ions, vitamins. This disrupts the water-electrolyte balance, the plasma becomes acidic, we feel worse and worse.

Constant irritation of the mucosa eventually leads to inflammation, atrophy of the intestinal villi, melanosis of the intestinal walls and even cancer. The nerve ganglia of the intestine suffer, they atrophy, and in the future it will be difficult to restore motor skills.

When the intestines are irritated, bloating, spasms, flatulence, diarrhea and weight loss occur. If ions are lost, especially potassium, the heart rate suffers, pressure jumps. It is often necessary to correct such problems already in the hospital and then restore the stool for a long time and systematically.

Meanwhile, according to experts, no more than 10-15 percent of constipation has organic causes – that is, they are associated with intestinal problems. Most often this is the result of an unhealthy diet, changes in physical activity, fluid deficiency. In addition, constipation often occurs in pregnant women due to the peculiarities of the anatomy – the growing uterus simply puts pressure on the intestines. Often the elderly also suffer from this – aging of the body, accumulated diseases and inactivity – all this contributes to problems at this age.

And for all these people, laxatives are not a solution to the problem, but only the acquisition of new health disorders. Only in some people, constipation is a symptom of digestive problems: intestinal strictures, polyps, cancer, disorders in the liver, pancreas, a consequence of a stroke, and so on. But they also need to solve the problem with laxatives last.

What will happen to the body if you take laxatives regularly for at least two weeks

• Health

Many people find it easier to take a laxative than to go to the doctor if they have problems with stool. But the passion for these drugs threatens the development of an extremely unpleasant disease. Treating it will be much more difficult than dealing with constipation.

November 7, 2022

Source:

iStockphoto

It would seem that what’s wrong with eliminating constipation with laxatives, because they are sold in pharmacies and are designed specifically to solve such problems? If we are talking about episodic problems with stools that are associated with travel, stress or dietary changes, taking laxatives is acceptable. But the regular use of these drugs can threaten the development of laxative disease. So in medical language they call addiction to laxatives and the subsequent inability to empty the intestines without taking them.

We asked gastroenterologist Vera Samsonova for details about the causes of this disease and how to deal with it.

Specialists in the field of gastroenterology and coloproctology began to talk about laxative disease not so long ago. Pathology is one of the “man-made” problems, that is, it is created due to the fact that people can buy laxatives at the nearest pharmacy without a prescription at a relatively low price. They do not go to the doctor to find out the causes of constipation and eliminate them so that the stool improves.

It is easier to deal with the consequences, that is, simply clear the intestines of accumulated masses and wait for the next episode. It is good if the instructions are read before using the medicine, everything is done in strict accordance with it and there are no side effects that accompany the use of certain laxatives. But in any case, the problem is not solved.

Read also

You will still get to the doctor. But already with complications. , magazines and even clinics, positioning them as a means of quickly and safely solving delicate problems.

Of course, the fact that the drug will help clear the intestines from the contents and bring relief for the first, second and even tenth time is indisputable. But over time, people notice that the usual remedy has become worse to help, you need to take it more often, increase the dose, and going to the toilet without a laxative is generally a problem. The frequency of side effects also increases – this is the beginning of laxative disease. And with such neglected problems, most of them already go to a specialist.

90% of problems occur within 2 weeks

Under the influence of drugs, the intestines are emptied, because the drugs strongly irritate the walls of the intestine, cause an increase in the volume of water inside the intestine or activate motility. And everything would be fine, but the intestines get used, and rather quickly, to what everyone is doing for him, with the help of laxatives. As a result, motility suffers, metabolism is disturbed, and a state of “lazy gut” occurs.

There is evidence from studies that almost 90% of people with constipation develop laxative disease within two weeks of taking laxatives. If you cancel these funds, constipation only intensifies, and not everyone wants to correct nutrition, drinking regimen and move more instead of drinking drugs. A vicious circle is formed, which is difficult to break.

Read also

Why a laxative is the last resort

No more than 10-15% of constipation has organic causes – that is, they are associated with problems of the intestine itself. Most often this is the result of an unhealthy diet, changes in physical activity, fluid deficiency. In addition, constipation often occurs in pregnant women due to the peculiarities of the anatomy – the growing uterus simply puts pressure on the intestines. Often the elderly also suffer from this – aging of the body, accumulated diseases and inactivity – all this contributes to problems at this age.

And for all these people, laxatives are not a solution to the problem, but only the acquisition of new health disorders. Only in some people, constipation is a symptom of digestive problems – intestinal strictures, polyps, cancer, disorders in the liver, pancreas, a consequence of a stroke, etc. But they also need to solve the problem with laxatives last.

What if it’s a harmless “weed”?

You should not be under the illusion that the problem will arise only from pharmacy “chemistry”. And if it’s natural herbal remedies or recipes handed down to us from ancestors, it’s safe. No, the origin of the laxative has little effect on the development of laxative disease. Moreover, often herbal, natural remedies even more often provoke a problem, because people are wary of pharmacy “chemistry”, but there is no such alertness in relation to herbal remedies.

In fact, stimulation of the intestines with various substances provokes disturbances in motility, a disorder of the close connections between the muscles in the walls of the intestines and the nervous system. Without constant stimulation, motor skills weaken, become lethargic, which is why, in order to empty, you need to take drugs again each time.

Read also

Dangerous complications

In addition to the fact that the main problem is not solved – the regularity of the chair, there is also a lot of new ones. Among them – a violation of absorption in the colon of water and ions, vitamins. This disrupts the water-electrolyte balance, the plasma becomes acidic, we feel worse and worse.

Constant irritation of the mucosa eventually leads to inflammation, atrophy of the intestinal villi, melanosis of the intestinal walls and even cancer. The nerve ganglia of the intestine suffer, they atrophy, and in the future it will be difficult to restore motor skills.