Laxative abusers risk cancer

DRUG REACTIONS Laxative abusers mk cancer

Available data indicate that anthranoid laxatives, including senna, aloe, cascara, frangula and rheum, are carcinogenic in humans, report German researchers. A prospective analysis of 1095 patients undergoing endoscopy revealed that the relative risk of colorectal cancer was 3.04 in patients with a history of anthranoid-containing laxative misuse.

Physicians who performed endoscopy were instructed to test for Pseudomelanosis coli, a reliable indicator of chronic anthranoid laxative abuse, during the procedure.

The incidences of pseudomelanosis coli were 6.9% in patients with no endoscopic abnormality, 2.3% in patients with inflammatory diseases, 9.1 % in patients with diverticulosis, 9.8% in patients with adenoma, and 18.6% in those with carcinoma. Furthermore, 31/33 patients with adenomas or carcinomas admitted to the misuse of anthranoid laxatives over a period of 10-30 years.

Despite the implications of this study, the researchers comment that chronic constipation together with a low fibre and high fat intake may predispose to the development of colorectal cancer. And the impact of these factors needs to be determined in future case-control studies. Siegers C-P, von Hertzberg-Louin E. Oue M. Schneider B. Anthranoid laxative abuse - a risk for colorectal cancer? Gut 34: 1099-1101. Aug 1993

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ISSN 0156-2703l9310814-<Xl211$1.rxfJ Adlalntamatlonal Ltd

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INPHARMAe 14 Aug 1993