Abstract
Constipation is a common condition. Hydrogen peroxide enemas have rarely been reported as a home remedy for constipation in the pediatric age group. We present a case report and literature review of hydrogen peroxide induced colitis in pediatric siblings, aged 2 years and 9 years. The siblings presented with vomiting and bloody diarrhea an hour following the enema. Physical exam, vital signs, blood, and electrolyte counts were normal, but CT scans showed mucosal thickening of the rectum and colon. Their symptoms resolved after oral intake was curtailed and fluids were replaced intravenously. We discuss existing reports of complications from hydrogen peroxide enemas. Patients may present with abdominal pain and bloody diarrhea. Onset of symptoms varied from minutes to a day and bowel ulceration with necrosis and perforation has occurred, although fatality is rare. Diagnostic tests included computed tomography (CT) scan, sigmoidoscopy, or biopsy. Recovery period ranged from 3 days to 8 months. Public education regarding the dangers of hydrogen peroxide enemas is needed.
Highlights
Constipation is a common problem, reported in up to 30% of children
We found 21 published cases related to hydrogen peroxide enema
Prior cases show the patient population as mostly older adults with constipation from secondary causes. This is the first case of colitis due to hydrogen peroxide enema in siblings in the pediatric age group
Summary
Constipation is a common problem, reported in up to 30% of children. Internet searches for homemade remedies to treat constipation deliver hydrogen peroxide enema among the results. Hydrogen peroxide has been known to cause colitis and, in a few cases, bowel perforation. The earliest use of hydrogen peroxide enema in the pediatric population is documented by Olim and Ciuti to treat meconium ileus in the newborn [1]. We present an unusual case of two siblings, aged 2 years and 9 years, presenting with bloody diarrhea and vomiting due to chemical colitis following hydrogen peroxide enema. We present a systematic review of prior such cases. Few such cases have been reported in the pediatric population
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