Enema-induced perforation of the rectum in chronically constipated patients

Paran, Haim; G, Butnaru; Neufeld, David; Magen, Amalia; Freund, U

doi:10.1007/bf02236216

Cited by 58 publications

(44 citation statements)

References 10 publications

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“…Anecdotal reports of irrigation-induced perforation have been published [27][28][29] and based on the reporting of perforations compared with catheters dispensed, the estimated risk of irrigation-induced perforation has been calculated as one per 50 000 (0.0002%). 3 However, this is only an estimate as the true incidence of perforation in this community-provided treatment is not accurately quantifiable.…”

Section: Complicationsmentioning

confidence: 99%

Consensus review of best practice of transanal irrigation in adults

et al. 2013

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Study design: Review article. Objectives: To provide a consensus expert review of the treatment modality for transanal irrigation (TAI). Methods: A consensus group of specialists from a range of nations and disciplines who have experience in prescribing and monitoring patients using TAI worked together assimilating both the emerging literature and rapidly accruing clinical expertise. Consensus was reached by a round table discussion process, with individual members leading the article write-up in the sections where they had particular expertise. Results: Detailed trouble-shooting tips and an algorithm of care to assist professionals with patient selection, management and follow-up was developed. Conclusion: This expert review provides a practical adjunct to training for the emerging therapeutic area of TAI. Careful patient selection, directly supervised training and sustained follow-up are key to optimise outcomes with the technique. Adopting a tailored, stepped approach to care is important in the heterogeneous patient groups to whom TAI may be applied. Sponsorship: The review was financially supported by Coloplast A/S.

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Section: Complicationsmentioning

confidence: 99%

Consensus review of best practice of transanal irrigation in adults

et al. 2013

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“…27 There have been single reports of rectal prolapse and pain. 30 Bowel perforation, a serious and potentially fatal complication, has been reported; [40][41][42][43] however, the circumstances Fsuch as the type of system used, the type of user and the level of training received by the userFare not clear in all cases. Long-term follow-up studies calculated that non-fatal bowel perforation occurred in B1 per 50 000 irrigations.…”

Section: Safety Of Taimentioning

confidence: 99%

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Emmanuel

2010

Spinal Cord

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Study design: Neurogenic bowel dysfunction (NBD) is a common occurrence after spinal cord injury (SCI) and in patients with spina bifida or multiple sclerosis. The impact of NBD on well-being is considerable, affecting both physical and psychological aspects of quality of life. Transanal irrigation (TAI) of the colon promotes the evacuation of faeces by introducing water into the colon and rectum through a catheter inserted into the anus. Regular and controlled evacuation in this manner aims at preventing both constipation and faecal soiling. Objectives: The aim of this study was to review current evidence for the efficacy and safety of TAI in patients with NBD. Materials and methods: A literature search was conducted in PubMed. All identified papers were assessed for relevance based on the title and abstract; this yielded 23 studies that were considered to be of direct relevance to the topic of the review. Results: A multicentre, randomized, controlled trial has supported observational reports in demonstrating that TAI offers significant benefits over conservative bowel management in patients with SCI, in terms of managing constipation and faecal incontinence, reducing NBD symptoms and improving quality of life. Among other populations with NBD, TAI shows the greatest promise in children with spina bifida; however, further investigation is required. The overall safety profile of TAI is good, with few, and rare, adverse effects. Conclusions: Building on the positive data reported for patients with SCI, continued evaluation in the clinical trial setting is required to further define the utility of TAI in other populations with NBD.

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“…198 The cause of perforation in patients who underwent enemas has been reported to be the device tip, related to localized weakness of the rectal wall and obstruction. 199 Because of their adverse irritating effects, resulting in rectal mucosa damage, soap enemas should be avoided. Suppositories can help to initiate or facilitate rectal evacuation and have been used for many decades for chronic constipation in many forms, including the presumably inert but lubricating glycerin, and as stimulants, such as bisacodyl.…”

mentioning

confidence: 99%

Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

Shin

Jung

Lee

et al. 2016

J Neurogastroenterol Motil

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The Korean Society of Neurogastroenterology and Motility first published guidelines for chronic constipation in 2005 and was updated in 2011. Although the guidelines were updated using evidence-based process, they lacked multidisciplinary participation and did not include a diagnostic approach for chronic constipation. This article includes guidelines for diagnosis and treatment of chronic constipation to realistically fit the situation in Korea and to be applicable to clinical practice. The guideline development was based upon the adaptation method because research evidence was limited in Korea, and an organized multidisciplinary group carried out systematical literature review and series of evidence-based evaluations. Six guidelines were selected using the Appraisal of Guidelines for Research & Evaluation (AGREE) II process. A total 37 recommendations were adopted, including 4 concerning the definition and risk factors of chronic constipation, 8 regarding diagnoses, and 25 regarding treatments. The guidelines are intended to help primary physicians and general health professionals in clinical practice in Korea, to provide the principles of medical treatment to medical students, residents, and other healthcare professionals, and to help patients for choosing medical services based on the information. These guidelines will be updated and revised periodically to reflect new diagnostic and therapeutic methods.

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Enema-induced perforation of the rectum in chronically constipated patients

Abstract: Awareness of the possible injury from enemas administered to chronically constipated patients should be stressed. A high degree of suspicion by the attending physician is extremely important, because prompt diagnosis and early surgical treatment carries a relatively good prognosis.

Cited by 58 publications

References 10 publications

Consensus review of best practice of transanal irrigation in adults

Consensus review of best practice of transanal irrigation in adults

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

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