Sourabh Sharma*1, A. K. Gadpayle1, Harish Kumar Gupta1, Naveen Kumar1, Neha Sharma2
1Dr Ram Manohar Lohia Hospital, New Delhi, India
2Dr S.N. medical college, Jodhpur, Rajasthan, India
Dr. Sourabh Sharma
Department of Medicine, PGIMER and Dr Ram Manohar Lohia Hospital, New Delhi-110001
Mobile No: +91-9599702038.
Objective: Phenolphthalein is habit forming laxative and is available as over-the-counter drug in developing countries. Chronic consumption of Phenolphthalein can damage any organ system. Its use should be strongly discouraged. Materials and methods: A 38 years old female presented with abdominal pain, decreased urine output, nausea and weakness for two weeks. In past she had abdominal Koch’s in 2005 and following that multiple admissions in surgical unit for sub-acute intestinal obstruction. Results: On evaluation she had deranged renal function, severe hypocalcemia, hypokalemia, hypomagnesemia, metabolic acidosis with increased anion gap, and severe anaemia. On third day of admission, repeated enquires for possible cause of these derangements revealed that she was abusing over-the-counter available Phenolphthalein as laxative for last 6 years. Within one week of stopping phenolphthalein, her deranged kidney functions and electrolyte disturbances improved. Conclusion: Phenolphthalein was used as laxative in past, but was banned in 1990s because of potential carcinogenic role. However, in developing country like India, it is still available freely. The case emphasise the fact that patients can present with complications of over-the-counter banned drugs and detected in time, Phenolphthalein toxicity is reversible with supportive care.
Keywords: Phenolphthalein, Acute kidney injury, laxative abuse, metabolic acidosis