Chemical colitis caused by hydrogen peroxide vaginal douche: A case report

Abstract

BACKGROUNDHydrogen peroxide is one of the most common household disinfectants worldwide. Hydrogen peroxide has been documented as a rare cause of chemical colitis.CASE SUMMARYWe present a case of 31 years old lady who presented to our hospital with rectal bleeding and abdominal pain after using hydrogen peroxide vaginal douche as an enema. She underwent colonoscopy which showed findings suggestive of chemical colitis and was managed conservatively. Hydrogen peroxide can induce chemical injury in the colon. Clinical presentation and endoscopic findings of chemical colitis are nonspecific. History taking is an important tool in identifying the underlying etiology. Review of literature showed few case reports, mostly were managed with oral antibiotics and conservative approach.CONCLUSIONChemical colitis is usually managed conservatively. Complications including perforation, stricture and peritonitis may happen and need aggressive treatment accordingly.

The Dangers of Ingesting Antiseptics: Hydrogen Peroxide-Induced Chemical Colitis

“…12 Presentation varies from asymptomatic to abdominal pain, nausea, vomiting, and bloody diarrhea. 10,11,13 Findings on physical examination ranges from mild abdominal tenderness to signs of acute abdomen if perforation occurs. 10,11,13 Clinical manifestations may extend to the esophagus and upper gastrointestinal tract by direct contact.…”

“…It can also manifest radiographically as stricture and fistula depending on time of presentation and severity of exposure. 9,13 Colonoscopy findings include mucosal edema, erythema, friability, purulent exudates, erosions, and ulcerations. 9,13 Diagnosis can be challenging because presentation overlaps with other pathologies, and radiological and histopathological features can be nonspecific.…”

“…9,13 Colonoscopy findings include mucosal edema, erythema, friability, purulent exudates, erosions, and ulcerations. 9,13 Diagnosis can be challenging because presentation overlaps with other pathologies, and radiological and histopathological features can be nonspecific. Biopsy findings of chemical colitis include edema, acute inflammation with neutrophilic infiltration, ulceration, necrosis and extravasation of red blood cells, granular atrophy with hyalinization of lamina propria, and evidence of ischemic colitis.…”

“…Biopsy findings of chemical colitis include edema, acute inflammation with neutrophilic infiltration, ulceration, necrosis and extravasation of red blood cells, granular atrophy with hyalinization of lamina propria, and evidence of ischemic colitis. 13 Conservative medical management is the mainstay of the treatment with discontinuation of the offending agent, bowel rest, IV hydration, and a short course of antibiotics. 13 Nonsteroidal anti-inflammatory drugs, corticosteroids, and Alhasson et al Hydrogen Peroxide-Induced Chemical Colitis mesalamine might be added; however, no proven benefits have been shown.…”

“…13 Conservative medical management is the mainstay of the treatment with discontinuation of the offending agent, bowel rest, IV hydration, and a short course of antibiotics. 13 Nonsteroidal anti-inflammatory drugs, corticosteroids, and Alhasson et al Hydrogen Peroxide-Induced Chemical Colitis mesalamine might be added; however, no proven benefits have been shown. 5 Surgery is indicated when complications develop, but colectomy is rarely required in the absence of rupture.…”