Study Looks at Enema Benefits in Constipated Children

Addition of regular enemas found to provide little benefit to oral laxative regimen
By Jane Parry
HealthDay Reporter

THURSDAY, Oct. 15 (HealthDay News) -- Regular enemas may not provide additional benefit to oral laxative regimens used in children with chronic and severe constipation, according to a randomized controlled trial completed in the Netherlands and published in the October issue of Clinical Gastroenterology and Hepatology.

Marloes E.J. Bongers, M.D., of the Emma Children's Hospital Academic Medical Centre in Amsterdam, Netherlands, and colleagues conducted a study of 100 children aged 8 to 18 years with functional constipation for a minimum of two years. The children were randomized to a control group (oral laxatives, education and behavioral strategies) or an intervention group (oral laxatives, education and behavioral strategies, as well as three rectal enemas a week for three months, then two a week for three months, and finally one a week for the same time period).

The researchers found normalization of defection in both the control and intervention groups. However, defecation frequency was higher in the intervention group as compared to the control group at 26 and 52 weeks. Both groups demonstrated similar overall success rates (47.1 percent in the intervention group and 36.1 percent in the control group) and reduction in fecal incontinence episodes.

"This randomized controlled trial showed that application of rectal enemas on a regular basis was well-tolerated but had no additional effect on conventional treatment with oral laxatives for severely constipated children," the authors conclude. "There is no place for rectal enemas in the maintenance therapy in these severely constipated children. Rectal enemas should only be used for initial disimpaction."

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