Abstract Laxatives appear to be one of the most common group of drugs sold in retail pharmacy presently. Use of these drugs appears to be by all patients regardless of age, gender, race, education level and income group. Reasons for ingestion of laxatives also appear to vary among patients. This study investigated patients wishing to purchase laxatives from a suburban pharmacy in Johannesburg located near the inner-city. It clarified the patient’s own perception of what constipation is, why he or she ingested this formulation and for how long this product had been used. The study also reviews adverse effects that patients experienced using these products. Following the exclusion criteria, the sample size totaled 197. Data was collected over a period of ten weeks from February 2006 until April 2006, in which patients wishing to purchase laxatives were asked to complete a confidential questionnaire regarding their use of laxatives. Results obtained revealed that there is widespread misuse of laxative products amongst the patients questioned. A large percentage of patients (66%) were not in their own opinion constipated and were using laxatives for purposes other than for which these products are indicated. Many patients (71%) are ignorant as to normal frequency of bowel habits, and 81% of patients were using laxatives to treat conditions other than constipation. An encouraging aspect of this study showed that with appropriate education and drug control, many patients could be taught to treat their medical conditions more correctly than by using a laxative as a generalized detoxification product to cure all illnesses.

BACKGROUND:Laxatives are among the most widely used over-the-counter medications in the United States but studies examining their potential hazardous side effects are sparse. Associations between laxative use and risk for fractures and change in bone mineral density BMD] have not previously been investigated.METHODS:This prospective analysis included 161,808 postmenopausal women (8907 users and 151,497 nonusers of laxatives) enrolled in the WHI Observational Study and Clinical Trials. Women were recruited from October 1, 1993, to December 31, 1998, at 40 clinical centers in the United States and were eligible if they were 50 to 79 years old and were postmenopausal at the time of enrollment. Medication inventories were obtained during in-person interviews at baseline and at the 3-year follow-up visit on everyone. Data on self-reported falls (greater than or equal to]2), fractures (hip and total fractures) were used. BMD was determined at baseline and year 3 at 3 of the 40 clinical centers of the WHI.RESULTS:Age-adjusted rates of hip fractures and total fractures, but not for falls were similar between laxative users and non-users regardless of duration of laxative use. The multivariate-adjusted hazard ratios for any laxative use were 1.06 (95% confidence interval CI], 1.03-1.10) for falls, 1.02 (95% CI, 0.85-1.22) for hip fractures and 1.01 (95% CI, 0.96-1.07) for total fractures. The BMD levels did not statistically differ between laxative users and nonusers at any skeletal site after 3-years intake.CONCLUSION:These findings support a modest association between laxative use and increase in the risk of falls but not for fractures. Its use did not decrease bone mineral density levels in postmenopausal women. Maintaining physical functioning, and providing adequate treatment of comorbidities that predispose individuals for falls should be considered as first measures to avoid potential negative consequences associated with laxative use.