Cathartic Colon

• Prolonged use of irritating stimulant-type laxatives results in neuromuscular incoordination from chronically increased muscle activity

• Usually requires 15 years or more of laxative use

Agents

            • Cascara

            • Castor oil

            • Senna

            • Phenolphthalein

            • Podophyllum

            • Aloin

Location

• Usually involves colon proximal to splenic flexure-i.e predominantly right colon

Imaging

• Effaced mucosa with smooth, flattened surface

• Absent haustrations

• Pseudostrictures-smoothly tapered areas of spasm

• Poor evacuation of barium

• Patulous ileocecal valve

• May have shortening of right colon

DDx

• Ulcerative colitis-except that rectum is spared in cathartic colon and there are no pseudopolyps or ulcerations