Rectal injury attributable to enema

Abstract

Constipation is one of the most common complaints in the general population, and is associated with substantial economic cost. Postoperative ileus (POI) maybe one of the contributory factor for no passage of stool. Despite a lack of strong evidence for their clinical utility, laxatives or prokinetics have been used to treat POI in clinical practice.

Many a times, patients self-medicate or take over-the-counter drugs to treat constipation and sometime end up with complications requiring urgent medical consultation. Dietary modification, laxatives are some of the first line treatment of constipation. Bowel cleansing enemas are also frequently used to relieve constipation. Though, very effective, sometimes may cause serious adverse events. Some of the common side effects are anal irritation, burning sensation, diarrhea, nausea and cramps. Bowel injuries following use of bowel cleansing enema is a rare incident.

We report two cases that developed rectal injury following use of enema (glycerin 15% w/v and sodium chloride 15% w/v).