The case against mineral oil

Summary

• 1.) A survey of the literature before and after its introduction does not disclose a valid reason for the use of mineral oil in the treatment of constipation. On the contrary, the literature contains numerous derogatory reports, any one of which is sufficient to question the advisability of the internal use of mineral oil under any circumstances. When all these reports are evaluated as a group, there can be no single doubt that mineral oil and its emulsions should never be used internally. As Morgan has expressed it, “It would not be too unfair to say that in some respects mineral oil has earned its niche in the section of toxicology rather than in pharmacology” (16).

• 2.) Mineral oil including its emulsions alters the normal physiology of evacuation and tends to result in faulty bowel habits, acts to increase ano-rectal infection by compression into the anal crypts, retards healing of postoperative rectal wounds, is absorbed through the intestinal wall into the body in quantities up to 60%, interferes with the utilization and retention of calcium and phosphorus, interferes with digestion and absorption of other nutrients, frequently produces a serious loss of weight, prevents the absorption of the oil soluble vitamins A, D, E, and K, tends to reduce prothrombin levels, interferes with estrogen therapy, is an indirect cause of pruritus ani, may induce “mineral oil poisoning,” develops a dependent state so that increased doses are necessary, aggravates existing local rectal conditions by converting the rectum into an abnormal reservoir, is esthetically objectionable, may cause lipid pneumonia, may possess minute traces of carcinogenic substances, and makes complete evacuation impossible.