Colon Irrigation Shows Progress in the Management of Constipation

Abstract

Introduction: Constipation is a common complaint that primary care physicians and gastroenterologists encounter daily. There are several causes for constipation, which can be further categorized as primary constipation (e.g. normal or slow colon transit or pelvic floor dysfunction) or secondary to a variety of systemic disorders or medication induced. Management of chronic constipation includes patient education, behavior modification, dietary changes, or laxative therapy. Severe cases may result in manual disimpaction or even in surgical intervention. Many patients require increasing doses and frequency of several laxative medications, be it surfactant, osmotic, stimulant laxatives, or varying combinations. These medications can often carry significant cost, produce undesirable side effects, or cause significant electrolyte shifts. We sought to evaluate the use of colon irrigation in relieving constipation. Methods: 23 patients with constipation underwent a colon irrigation procedure from August 2016 to January 2017. Patients ranged in age from 22-74yo (mean 58yo) 37% male and 63% female. No consistent drug use or medical history was identified. Past medical history for the patient population included: Crohn's=2; Diabetes=1; IBS=4; Intestinal obstruction=1. Patients were not given any pre-procedure medication or dietary instructions, but encouraged to continue with their current routine. Results: 100% of patients had excrement while undergoing the colon irrigation procedure. For evaluation purposes, the excrement characteristics were divided into four phases. Table 1 describes each phase and the YES/NO answer relates to whether the phase was discerned and verified in each patient. Few symptoms experienced by the patient during the procedure were reported as noted in Table 2. No relationship was noted between age and symptoms experienced during the procedure.Table: Table. Excrement PhasesTable: Table. Symptoms Experienced During the ProcedureConclusion: Colon irrigation appears to be a well-tolerated, safe method of immediate relief for patients suffering with constipation. The colonic irrigation process is an easier and less expensive alternative to a gastrograffin enema, which is performed by radiologists at an x-ray facility, for severe constipation.