How do you counsel patients about the potential benefits of laxatives when they are experiencing overflow diarrhea and are concerned about it getting worse with these medications?

I'll preface this by saying I rarely see this, and I will approach this answer as if this patient were in palliative care. But I think I would start with education on the mechanism of this type of diarrhea and the rationale for using laxatives to improve the situation. I would also discuss that, after the constipation is alleviated, the goal would be to titrate laxatives to avoid this situation in the future, and that there may be a period of looser stools as we find the right regimen.

I think i...