Liquid Enema Research Articles

Round Worm Intestinal Obstruction: A Single Center Study

Introduction: Ascariasis is one of the most cosmopolitan intestinal parasite infections and can be found in inhospitable regions inhabited by human beings, but its highest prevalence is observed in the tropical and subtropical areas. In contrast to silent forms of this illness or chronic symptomatology, massive infestation in children can lead to serious complications requiring urgent surgical attention by experts. Intestinal obstruction has been estimated to occur in 2 per 1000 Ascaris-infected children per year. We are presenting a study emphasizing initial conservative treatment for round worm obstruction, whether partial or complete. Material and Methods: Patients with partial or complete round worm obstruction without signs and symptoms of peritonitis admitted to the Department of Pediatric Surgery IMS, BHU, Varanasi, India, were included in this study. They were given nil by mouth, intravenous fluids, antibiotics, piperazine salt through nasogastric tube and glycerine plus liquid paraffin emulsion enemas and were evaluated for duration of hospital stay, rate of conversion to surgical treatment and complications. Results: One hundred and seventy-five patients (92%) were treated successfully with conservative management. Only 14 patients (8%) required surgical intervention. In one case (0.52%) there was post-operative mortality, in two cases (1.1%) resection and anastomosis was required. Mean hospital stay was 4.3 days for the patients responding to conservative management. Conclusion: Round worm intestinal obstruction can be effectively treated by conservative management.

Effect of Simotang oral liquid on anal exhaust in patients after abdominal gynecological operation

To study the effect of Simotang oral liquid and glycerin enema on the patients' bowel sound (BS) restoration and anal exhaust after abdominal gynecological operation. Ninety patients with benign tumor who had undergone gynecological operation were randomly divided into the Simotang group, treated after operation with Simotang oral liquid; the enema group, treated with glycerin enema, and the control group, non-treated. The restoration time of BS and anal exhaust were observed. Compared with the control group, the restoration time of BS and anus exhaust were both significantly shorter in the Simotang group and the enema group, showing statistical significance (P < 0.05); but the difference between the two treated groups was insignificant (P > 0.05). Simotang oral liquid and glycerine enema both could benefit the restoration of anal exhaust and BS after abdominal operation.

Comparative study of enema retention and preference in ulcerative colitis

Background: Therapeutic enemas are often used to treat active colitis but their retention may be limited because of urgency to defecate. Some preparations may be better retained and tolerated than...

Putting Rectal 5-Aminosalicylic Acid in Its Place: The Role in Distal Ulcerative Colitis

Oral aminosalicylates such as sulfasalazine and mesalamine are widely prescribed for the treatment of mild or moderately active distal ulcerative colitis. However, a critical review of the literature demonstrates that rectal 5-aminosalicylic acid (5-ASA) is the optimal therapy for this disease. Meta-analyses of published trials show that rectally delivered 5-ASA is superior to placebo and to conventional rectal corticosteroids in inducing remission of distal ulcerative colitis, whereas the combination of rectal 5-ASA with a rectal corticosteroid or oral aminosalicylate is superior to rectal 5-ASA alone. For maintaining remission of distal ulcerative colitis, rectal 5-ASA is significantly better than placebo and at least as effective as oral 5-ASA. The dosage forms available for rectal delivery include suppositories, foams, and liquid enemas, and selection among these preparations should be guided by the proximal extent of disease and patient preference. The efficacy of rectal 5-ASA is complemented by its low rate of reported adverse effects, which may reflect its reduced potential for systemic absorption. This review summarizes the evidence supporting the role of rectal 5-ASA as a first-line therapy for mild or moderately active distal ulcerative colitis, and offers guidelines for its use.

Nicotine treatment for ulcerative colitis.

Ulcerative colitis and Crohn’s disease are chronic inflammatory bowel diseases of unknown aetiology which, although similar in various aspects, exhibit some contrasting features. A typical example is their relationship with cigarette smoking. While smoking appears to exert deleterious effects in Crohn’s disease [1, 2], there is overwhelming epidemiological evidence that smoking protects against ulcerative colitis, the risk of developing the disease being significantly lower in smokers than in non-smokers or former smokers [2, 3]. The fact that patients with ulcerative colitis who resume or start smoking often experience clinical improvement [4] prompted attempts to verify the hypothesis that nicotine might be the active component of smoking responsible for the beneficial effects on the course of the disease. Preliminary, uncontrolled observations employing nicotine gum, a pharmaceutical form generally poorly tolerated, yielded encouraging but inconclusive results [5]. The introduction of transdermal nicotine in the market made it possible to assess the potential therapeutic role of nicotine in a more extensive way.

Better quality of therapy with 5-ASA colonic foam in active ulcerative colitis

We evaluated the efficacy, tolerance, and acceptance of a new 5-ASA colonic foam versus 5-ASA liquid enema in the short-term treatment of active ulcerative colitis in a three-week prospective, randomized, investigator-blind study, enrolling 233 patients from 12 outpatient clinics in Italy. In arm 1 of the study, 117 patients with mild attacks received 2 g of 5-ASA as foam or enema at bedtime. In arm 2, 116 patients with moderate attacks were given 4 g of 5-ASA as foam or enema at bedtime. End points were defined as complete relief of symptoms, and endoscopic and histological evidence of remission or improvement. In patients with mild relapse, 34 of 63 (54%) treated with foam were in clinical remission after only 10 days compared with 17 of 51 (31%) treated with enemas (P < 0.05). However, there was no statistically significant difference between foam (83%) and enema (74%) after three weeks. In patients with moderate relapse, a higher proportion of patients achieved complete clinical remission in the foam group (63%) compared with enema group (52%) after three weeks (difference 11%, 95% CI -7 to 29). No significant differences were observed in endoscopic and histological evaluation of colonic mucosa between treatment groups in either arm. 5-ASA foam was well tolerated. No unexpected adverse events were reported. Patient evaluation of therapy showed that foam was much better accepted than enema because foam was more comfortable, more practical, easier to retain, and interfered less with daily living.(ABSTRACT TRUNCATED AT 250 WORDS)

Rectal topical corticosteroid preparations

Topical corticosteroid preparations have been the main treatment for attacks of mild to moderate proctitis and left-sided ulcerative colitis since the 1950s.1 This article reviews the liquid enema, foam and suppository formulations available.

A New Oral Lavage Solution vs Cathartics and Enema Method for Preoperative Colonic Cleansing

Sulfate free-electrolyte lavage solution is a new osmotically balanced electrolyte gut lavage solution for colon surgery that has been formulated for improved taste and reduced water and electrolyte changes. Sixty patients were prospectively randomized to receive a 1-day preparation with sulfate free-electrolyte lavage solution or a 3-day preparation using a clear liquid diet, cathartics, and enemas. The patient groups were similar in age, race, male-female ratio, and the types of colonic resections performed. Colonic cleansing was better with sulfate free-electrolyte lavage solution (100% vs 63% "good" to "excellent" cleansing). Patient tolerance evaluated by a questionnaire showed more overall discomfort with sulfate free-electrolyte lavage solution but no difference between the preparations in individual symptoms of fullness, cramping, nausea, or vomiting. One patient developed a low level of serum potassium after a cathartic and enema preparation, while there were no complications with sulfate free-electrolyte lavage solution. Patient taste questionnaires showed a slight preference for sulfate free-electrolyte lavage solution (53%) over a polyethylene glycol electrolyte lavage solution (47%). This study confirms that sulfate free-electrolyte lavage solution is a safe and effective method of preoperative colonic cleansing.

Pneumatic reduction: Advantages, risks and indications

It is easy to say that a “new” controversial technique is either perfect or useless. Invariably the truth lies somewhere in between. Overall, we strongly believe the air enema technique to be quicker, safer and more effective than liquid enemas in our hands using the guidelines outlined above. However, which ever technique is used, the radiologist involved should take into account the clinical circumstances of each patient. Safety has to be of prime concern in this as in any technique, and we believe that these guidelines are a safe starting point for further evaluation.

Abdominoperineal excision of the rectum: a prospective study based on a standardized method.

AbstractA prospective and consecutive series of 72 patients with rectal carcinoma was subjected to excision of the rectum. The operations were performed according to a standardized program based on previous studies and established surgical principles: Two days on a liquid diet, laxative, and enemas. Irrigation of the pelvic cavity with 5 liters of saline solution after removal of the specimen. Leaving the pelvic peritoneum unsutured. Obliteration of the presacral cavity with living omentum, uterus, or small intestine. Suprapubic, closed suction drainage. Primary closure of abdominal and perineal wounds without drainage. Antibiotic prophylaxis against aerobic as well as anaerobic bacteria. Parenteral nutrition from the first postoperative day and until the bowel acts properly. Two patients died postoperatively (3%), and 93% achieved primary healing of the perineal wound.

FOREIGN BODIES IN STOMACH

This case is reported because of its general interest and to add it to the literature on the curiosities of medicine. M. H. L., a woman, aged 46, married, was admitted to the State Hospital at Central Islip, Feb. 10, 1932. The diagnosis was involution melancholia with suicidal tendencies. Sept. 6, 1933, she vomited and complained of constipation. A large hard mass was palpable in the upper left quadrant of the abdomen. Liquid petrolatum and enemas were administered daily, with little appreciable effect on the mass. September 11, a roentgenogram showed a mass of what appeared to be metallic spoons in the stomach. September 12, a laparotomy was performed. An incision was made in the upper anterior surface of the stomach and the following objects were removed: forty-eight teaspoons, one teaspoon handle, three bolts, one nut, one prune pit, one button, one small piece of glass, two pieces of spring