Laxative abuse.

Amongst the patients of every gastroenterologist there is probably one, a woman, with a long history of abdominal discomfort and diarrhoea, perhaps with vomiting, weight loss, weakness, thirst, and a psychiatric illness. There may be a past history of an ill defined metabolic disorder or renal disease. Numerous investigations will have proved fruitless although a low serum potassium, a rather distensible, featureless colon on radiographs and non-specific inflammatory changes on rectal biopsy may not have been fully explained. The latest medication is of only temporary benefit and the notes become progressively thicker. This is the picture of a patient who is taking laxatives to excess and probably concealing the fact from her doctor.