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2014 ; 3
(2
): 209-214
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Diuretics-assisted treatment of chronic laxative abuse
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Shirasawa Y
; Fukuda M
; Kimura G
CEN Case Rep
2014[Nov]; 3
(2
): 209-214
PMID28509201
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Hypopotassemia with acid-base imbalance caused by laxative abuse is one of the
disorders that nephrologists can be consulted for. Although laxatives are not
supposed to form psychological dependence in themselves and their abuse should be
cured theoretically by just finishing the overdose, the patients often resist
treatment due to unpleasant symptoms such as edema and worsening constipation.
Thus, chronic laxative abuse is often regarded as a drug addiction. We report a
successfully treated case of chronic laxative abuse, where drastic reduction of
laxatives was achieved by applying diuretics. After drastic reduction of
laxatives, diuretics were added until they eased edema and bloating so that the
patient could feel them to be tolerable, paying attention to lab data such as
potassium and renal function. The diuretics, which substituted for laxatives in
fluid control, could be tapered off over 3 months without any withdrawal symptoms
or a need of additional laxatives. Our experience of simple but successful
treatment of chronic laxative abuse emphasizes importance of physical management
and suggests that there are cases where the two different kinds of drugs,
laxatives and diuretics, can practically be regarded as swappable in the
treatment of laxative abuse. This presentation should contribute to accumulation
of knowledge in how to treat chronic laxative abuse where no standardized method
is established yet.
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