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What Are The Side Effects Of Laxatives?

Posted on Tue, 28 Oct 2014

Question: My 8 yr old daughter has been taking prescription laxatives for 2.5yrs (lactulose + sodium picosulphate). Are there side effects from long term use?

Answered by Dr. Deepak Kishore Kaltari (5 minutes later)

Hi
Welcome to Healthcaremagic

I am Pediatric Surgeon and deal with constipation on children . Do write to me directly for detailed discussion.

Take care

Best regards
Dr Deepak Kaltari
Consultant Pediatric Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (5 hours later)

Thank you. We first went to a paediatrician when she was 6 because she was still mostly incontinent (urine and bowel movements). After the usual training strategies, it was found that she was badly constipated. Now we have another younger child we can see that her bowel movements have never been "normal" from birth. She rarely has a 'formed' stool, and when she goes to the toilet, things are very explosive and foul smelling. She does go daily now, and rarely has any kind of accident, but when she needs to wee it is very urgent. She also takes tolteridone. We have tried altering the doses of both the laxatives, but she usually does become constipated again, and has more wetting accidents. We dont really know what we're doing though - the doctors just tend to say "try things and see what works". Her diet is full of fruit and veg, and we use whole wheat versions of bread, pasta etc. She probably doesn't drink enough, although this is something we're working on. We tried Movicol previously but didnt get on with that at all. Thank you.

Answered by Dr. Deepak Kishore Kaltari (11 hours later)

Brief Answer:
Double voiding will be helpful

Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day
Dear Ms

Thanks for writing to me. First and foremost let me reassure you things can be taken care off.

I would reassure you the following
1. Lactulose is safe laxative. The only major drawback is dependency .
2. Ensuring adequate fiber ,water and bowel training are pillars for treatment

I would suggest you the following before we proceed to definitive treatment

1. Thorough clinical examination : To rule out Urogenital sinus( There is only single opening through which vagina and urethra open) , to rule out anal fissure. Per rectal examination to rule out impacted stools

2. Ultrasound scan of abdomen : To document normal urinary tract

3. Urodynamic pressure flow study of urinary tract

4. Thyroid function test like Serum T3, T4 and TSH to rule out Hypothyroidism

I would suggest you the following

1. Ensure good intake if water : Follow rule if 1 which I normally advise . 1 glass of water 1 hour before meals . 1 glass of water 1 hour after every meals will ensure adequate intake of water . As her diet is adequate in fiber content , ensuring adequate intake of water is very important

2. Regular toilet training : Ensure that she voids urine every 2 hours and double voiding at night. Double voiding is urinating twice with a gap of 10 minutes apart before retiring to bed. This will ensure bladder is adequately empty so that the urgency decreases

3. Give Lactulose every alternate days for 2 weeks and then twice a week. This will ensure s smooth tapering of Lactulose

Do keep me updated

Take care Madam

Regards
Deepak

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar