Surreptitious Use of Laxatives or Diuretics

Patients with a factitious cause frequently have large-volume diarrhea (> 1 L/d). It should be remembered that this condition is not infrequent, occurring in 15 to 20% of patients referred to a referral center with chronic diarrhea. The primary treatment of these patients is having a high suspicion for the diagnosis because no clinical feature except for a history of psychiatric illness or macroscopic melanosis coli on sigmoidoscopy assists in the diagnosis. Some patients have a medical or veterinary background. Some laxatives increased the osmotic gap in the stool (magnesium), and its detection will help lead to the diagnosis (Phillips et al, 1995). However, with others, the osmotic gap is not increased, and only screening for laxatives in the stool or urine will establish the diagnosis. There is a chapter on managing patients with factitious or exaggerated illnesses (see Chapter 42, "Exaggerated and Factitious Disease").

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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