Evaluation of a Laxative Withdrawal Protocol in Patients with Anorexia Nervosa and Bulimia Nervosa

Objectives

The purpose of this evaluation is to determine the usefulness and effectiveness of a laxative withdrawal protocol used in a tertiary care regional referral Eating Disorders Program.

Setting

A Canadian 400 bed teaching institution.

Design

Patients were recruited to participate in the laxative withdrawal protocol either as in-patients or out-patients. Patients were followed weekly or every two weeks for six months or until weaned off laxatives.

Results

Ten patients were enrolled with seven patients completing the study. Five out of seven patients (71%) were successful at decreasing their laxative intake by 50%; the average time required was 15.4 ± 7.2 weeks. Three were able to completely withdraw from laxatives; the average time required was 27 ± 2.6 weeks.

Conclusions

The patients who were successful were very motivated to be weaned off laxatives, were more stable with their eating disorder, and used fewer laxatives per day. The patients who were unsuccessful tended to have a long history of eating disorder and heavy laxative use or were struggling with their eating disorder.  In conclusion, the laxative withdrawal protocol appears to be successful in stable out-patients who are highly motivated to be weaned off laxatives.

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Jody Harper, B.Sc. Pharm, Marianna Leung, B.Sc. Pharm, C. Laird Birmingham, MD, FRCPC, FACP, ABIM

Department of Pharmacy, St. Paul’s Hospital Eating Disorder Programs, St. Paul’s Hospital Providence Health Care, Vancouver, British Columbia, Canada

Canadian Society of Hospital Pharmacists (British Columbia Branch) Residency Research Presentation Night, Vancouver, British Columbia, Canada. May 8, 2002.

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