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Are Laxatives in Hospitals Sending Money Down the Drain?

A study of laxatives in hospitals found that a lot of nursing time is spent giving docusate, a bad-tasting stool softener with little evidence of efficacy.

Constipation is common among hospitalized patients. A new study suggests, however, that the most common use of laxatives in hospitals might be a big waste of time and money.

A Study of Laxatives in Hospitals:

Researchers at McGill University Health Centre in Montreal, Canada, evaluated laxative use and found that more than 258,000 doses were dispensed during 2015. By far the most commonly used product was docusate, a stool softener, with 165,000 doses. This required more than 2,000 hours of nurses’ time to deliver.

What Is Wrong with Docusate?

The problem is that there is not good evidence to support the use of docusate for constipation. The authors suggest that its continued use amounts to flushing money down the toilet.

In an invited commentary in the same issue of JAMA Internal Medicine, two physicians recommend that the profession be more thoughtful about laxatives in hospitals. drop ineffective drugs from their formularies. They suggest that would mean no statins for hospice patients or aggressive use of insulin for tight glucose control in people unlikely to survive. Hospitals would no longer rely on docusate for constipation in most cases.

Have You Tasted Docusate?

They specifically recommend that doctors prescribing docusate should be required to taste it personally. They themselves found that liquid docusate made them gag. They predict that prescriptions for the drug would change quickly after such a taste test.

JAMA Internal Medicine, June 20, 2016

If you have had trouble with constipation and wonder what kinds of treatments might be helpful, we suggest our Guide to Constipation. It contains a recipe for “Power Pudding” as well as other recommendations from readers.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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