Bulk Laxative Ileus

Abstract

In an elderly nursing home resident who had taken excessive dosages of bulk laxative for many years, small-bowel obstruction developed, requiring surgical intervention. A carcinoma of the ascending colon probably was the immediate cause of the obstruction, which resulted in the accumulation and inspissation of the bulk laxative throughout the small bowel. Great care should be exercised in the long-term use of these laxatives.

Intestinal obstruction caused by a laxative drug (Psyllium): A case report and review of the literature

“…The drug increases gut distension due to progressive swelling of colloid bolus. When distension reaches a certain critical level, the bowel is unable to pass the bolus which may precipitate intestinal obstruction and spontaneous rupture of the bowel [ 1 , 16 ].…”

Colonic impaction in guineapigs fed a chemically defined diet: a case report

“…In other animal species and in man intestinal impactions and obstructions have been associated with high levels of dietary fibre and inadequate water intake (Meagher, 1972;Tennant, Wheat & Meagher, 1972;Kang & Doe, 1979;Berman & Schultz, 1980;Ensley et al, 1982;Robertson, 1982;Cheeke, 1983). These same factors appeared to have contributed to the development of impactions in the guineapigs of this experiment.…”

“…Intestinal impactions and obstructions have been reported in other non-ruminant herbivores, in particular the horse (Meagher, 1972;Tennant, Wheat & Meagher, 1972; Robertson, 1982), rabbit (Cheeke, Patton & Templeton, 1982;Cheeke, 1983) and langur (Ensley et ai., 1982 bowel obstruction occurred in mice fed 20% wt/wt hydrophilic fibre in experimental diets (Toth, 1984). Intestinal obstructions occurred in man when excessive dietary fibre was consumed without adequate water intake (Kang & Doe, 1979;Berman & Schultz, 1980).…”

Nursing Home Research

“…Among the articles published in 1980 was one on the usefulness of ingestion of chlorophyllin in controlling body and fecal odors 5 . Another article that same year discussed the role of bulk laxatives in the pathogenesis of small bowel obstruction 6 . A 1989 article discussed the use of air‐fluidized beds in the treatment of decubitus ulcers, 7 which was reminiscent of a 1981 article on a double‐layered, launderable bed sheet 8 …”