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Human & Experimental Toxicology
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Experience with a Screening Method for Laxative Abuse

F.A. de Wolff

Laboratory of Toxicology, University Hospital, 2333 AA Leiden, The Netherlands

P.M. Edelbroek

Laboratory of Toxicology, University Hospital, 2333 AA Leiden, The Netherlands

E.J.M. de Haas

Laboratory of Toxicology, University Hospital, 2333 AA Leiden, The Netherlands

P. Vermeij

Laboratory of Toxicology, University Hospital, 2333 AA Leiden, The Netherlands

1 Abuse of laxatives may lead to a variety of serious disorders which are usually difficult to recognize because of the heterogenicity of the toxic effects.

2 In order to facilitate the diagnosis of chronic laxative poisoning, a laboratory screening method for the detection of colonic stimulants in urine has been designed and has been applied in practice over a three-year-period.

3 During this period, 157 samples from 81 patients were sent to the laboratory. Fifteen patients (18.5%) were definitely shown to use self-prescribed laxatives.

4 Next to the diphenolic compounds: bisacodyl, phenolphthalein and bisoxatin, the anthraquinone derivative rhein, a metabolite of vegetable laxatives, was found in several cases. In the urine of three patients a substance resembling rhein was found, which was shown to be aloe-emodin.

5 It is concluded that chronic self-poisoning with laxatives is a fairly common disorder that can easily be overlooked. Laboratory screening of the urine of suspected patients is an economic and reliable method for its diagnosis.

Human & Experimental Toxicology, Vol. 2, No. 2, 385-389 (1983)
DOI: 10.1177/096032718300200235
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