Health Expert Luke Coutinho Talks About Enema And The Hidden Dangers To It

Enema should be done only under the supervision or advice of a physician.

Highlights

• Enemas are used to treat a variety of medical conditions
• Regular enema use can also lead to a condition called hyponatremia
• Enema also puts you at a risk include perforation of the rectum

Have you ever heard of enema? Broadly speaking, enema is the introduction of a fluid into the rectum and large intestine through the anus. Enemas are used for a variety of reasons. These include detoxification, constipation and even weight loss. Enema should be done only under the supervision or advice of a physician. However, undergoing the process of enema frequently can have poor health outcomes. This leads to poor health outcomes. Health expert Luke Coutinho in his recent Instagram post said, “There is a new fad. People are using enemas and intensive colon cleansing to feel lighter, lose weight and combat constipation. This is extremely dangerous with severe side effects.” His post also said, there are no short cuts to weight loss, glowing skin and flat tummies. This new fad enema is destructive to one’s health.

Also read: 8 Foods That Cause Constipation For Sure

Doing enema on a regular basis (is two to three times a week) can harm to muscles in the intestine. Regular enema use can also lead to a condition called hyponatremia. This condition is also called water intoxication. Hyponatremia is an imbalance of the electrolytes that occurs when the body does not have enough sodium (salt). Acute hyponatremia can be dangerous and may require treatment with medication or IV fluids. Hyponatremia can cause muscle spasms and swelling of the brain that leads to mental impairment. This is a particular concern when using enemas with plain tap water.

On extreme cases overuse of phosphate enemas in order to treat constipation can lead to a condition called hyperphosphatemia. In this condition in which the blood levels of phosphate salts become elevated.

Enema also puts you at a risk include perforation of the rectum, which further requires surgery to repair and possible damage to internal organs. Furthermore, the “washing” out of the rectum and intestine can interfere with your body’s normal absorption of nutrients and fluids. This further leads to chemical imbalances and weakening the muscles.

Persistent diarrhea duet to enema may result in a serious loss of body water (dehydration) and salt or minerals. This may have a negative effect to the kidneys and heart. You may also suffer discomfort in the belly or mild abdominal cramps or gas. If these symptoms worsen you must consult a doctor immediately. 

Also, if you suffer from the symptoms of dehydration, you must contact the doctor immediately. Some common symptoms of diarrhea are dry mouth and constantly feeling thirsty, lack of tears, dizziness, nausea, light headedness, or pale and wrinkled skin.

Before doing enema, you must consult the doctor or pharmacist and tell him about your medical history, especially if you suffer from serious loss of body water (dehydration), high or low levels of certain minerals in the blood (such as potassium, calcium, sodium, phosphate), kidney disease, certain digestive problems, heart disease or liver disease.

Also read: Top 9 Tips To Prevent Constipation

(Luke Coutinho, Holistic Lifestyle Coach – Integrative Medicine)

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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Constipation – Diagnosis and treatment

Diagnosis

In addition to a general physical exam and a digital rectal exam, doctors use the following tests and procedures to diagnose chronic constipation and try to find the cause:

• Blood tests. Your doctor will look for a systemic condition such as low thyroid (hypothyroidism) or high calcium levels.
• An X-ray. An X-ray can help your doctor determine whether our intestines are blocked and whether there is stool present throughout the colon.
• Examination of the rectum and lower, or sigmoid, colon (sigmoidoscopy). In this procedure, your doctor inserts a lighted, flexible tube into your anus to examine your rectum and the lower portion of your colon.
• Examination of the rectum and entire colon (colonoscopy). This diagnostic procedure allows your doctor to examine the entire colon with a flexible, camera-equipped tube.
• Evaluation of anal sphincter muscle function (anorectal manometry). In this procedure, your doctor inserts a narrow, flexible tube into your anus and rectum and then inflates a small balloon at the tip of the tube. The device is then pulled back through the sphincter muscle. This procedure allows your doctor to measure the coordination of the muscles you use to move your bowels.
• Evaluation of anal sphincter muscle speed (balloon expulsion test). Often used along with anorectal manometry, this test measures the amount of time it takes for you to push out a balloon that has been filled with water and placed in your rectum.

• Evaluation of how well food moves through the colon (colonic transit study). In this procedure, you may swallow a capsule that contains either a radiopaque marker or a wireless recording device. The progress of the capsule through your colon will be recorded over 24 to 48 hours and will be visible on X-rays.

  In some cases, you may eat radiocarbon-activated food and a special camera will record its progress (scintigraphy). Your doctor will look for signs of intestinal muscle dysfunction and how well food moves through your colon.

• An X-ray of the rectum during defecation (defecography). During this procedure, your doctor inserts a soft paste made of barium into your rectum. You then pass the barium paste as you would stool. The barium shows up on X-rays and may reveal a prolapse or problems with muscle function and muscle coordination.
• MRI defecography. During this procedure, as in barium defecography, a doctor will insert contrast gel into your rectum. You then pass the gel. The MRI scanner can visualize and assess the function of the defecation muscles. This test also can diagnose problems that can cause constipation, such as rectocele or rectal prolapse.

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Treatment

Treatment for chronic constipation usually begins with diet and lifestyle changes meant to increase the speed at which stool moves through your intestines. If those changes don’t help, your doctor may recommend medications or surgery.

Diet and lifestyle changes

Your doctor may recommend the following changes to relieve your constipation:

• Increase your fiber intake. Adding fiber to your diet increases the weight of your stool and speeds its passage through your intestines. Slowly begin to eat more fresh fruits and vegetables each day. Choose whole-grain breads and cereals.

  Your doctor may recommend a specific number of grams of fiber to consume each day. In general, aim for 14 grams of fiber for every 1,000 calories in your daily diet.

  A sudden increase in the amount of fiber you eat can cause bloating and gas, so start slowly and work your way up to your goal over a few weeks.

• Exercise most days of the week. Physical activity increases muscle activity in your intestines. Try to fit in exercise most days of the week. If you do not already exercise, talk to your doctor about whether you are healthy enough to start an exercise program.
• Don’t ignore the urge to have a bowel movement. Take your time in the bathroom, allowing yourself enough time to have a bowel movement without distractions and without feeling rushed.

Laxatives

Several types of laxatives exist. Each works somewhat differently to make it easier to have a bowel movement. The following are available over-the-counter:

• Fiber supplements. Fiber supplements add bulk to your stool. Bulky stools are softer and easier to pass. Fiber supplements include psyllium (Metamucil, Konsyl, others), calcium polycarbophil (FiberCon, Equalactin, others) and methylcellulose (Citrucel).
• Stimulants. Stimulants including bisacodyl (Correctol, Dulcolax, others) and sennosides (Senokot, Ex-Lax, Perdiem) cause your intestines to contract.
• Osmotics. Osmotic laxatives help stool move through the colon by increasing secretion of fluid from the intestines and helping to stimulate bowel movements. Examples include oral magnesium hydroxide (Phillips’ Milk of Magnesia, Dulcolax Milk of Magnesia, others), magnesium citrate, lactulose (Cholac, Constilac, others), polyethylene glycol (Miralax, Glycolax).
• Lubricants. Lubricants such as mineral oil enable stool to move through your colon more easily.
• Stool softeners. Stool softeners such as docusate sodium (Colace) and docusate calcium (Surfak) moisten the stool by drawing water from the intestines.
• Enemas and suppositories. Tap water enemas with or without soapsuds can be useful to soften stool and produce a bowel movement. Glycerin or bisacodyl suppositories also aid in moving stool out of the body by providing lubrication and stimulation.

Other medications

If over-the-counter medications don’t help your chronic constipation, your doctor may recommend a prescription medication, especially if you have irritable bowel syndrome.

• Medications that draw water into your intestines. A number of prescription medications are available to treat chronic constipation. Lubiprostone (Amitiza), linaclotide (Linzess) and plecanatide (Trulance) work by drawing water into your intestines and speeding up the movement of stool.
• Serotonin 5-hydroxytryptamine 4 receptors. Prucalopride (Motegrity) helps move stool through the colon.
• Peripherally acting mu-opioid receptor antagonists (PAMORAs). If constipation is caused by opioid pain medications, PAMORAs such as naloxegol (Movantik) and methylnaltrexone (Relistor) reverse the effect of opioids on the intestine to keep the bowel moving.

Training your pelvic muscles

Biofeedback training involves working with a therapist who uses devices to help you learn to relax and tighten the muscles in your pelvis. Relaxing your pelvic floor muscles at the right time during defecation can help you pass stool more easily.

During a biofeedback session, a special tube (catheter) to measure muscle tension is inserted into your rectum. The therapist guides you through exercises to alternately relax and tighten your pelvic muscles. A machine will gauge your muscle tension and use sounds or lights to help you understand when you’ve relaxed your muscles.

Surgery

Surgery may be an option if you have tried other treatments and your chronic constipation is caused by a blockage, rectocele or stricture.

For people who have tried other treatments without success and who have abnormally slow movement of stool through the colon, surgical removal of part of the colon may be an option. Surgery to remove the entire colon is rarely necessary.

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Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Alternative medicine

Many people use alternative and complementary medicine to treat constipation, but these approaches have not been well-studied. Researchers currently are evaluating the usefulness of acupuncture.

Preparing for your appointment

You’ll likely first seek medical care for constipation from your family doctor or general practitioner. You may be referred to a specialist in digestive disorders (gastroenterologist) if your doctor suspects a more advanced case of constipation.

Because appointments can be brief, and because there’s often a lot of information to cover, it’s a good idea to be well-prepared. Here’s some information to help you get ready, and what to expect from your doctor.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there’s anything you need to do in advance, such as restricting your diet or eating certain high-fiber foods to prepare for diagnostic testing.
• Write down any symptoms you’re experiencing.
• Write down key personal information, including any major stresses or recent life changes, such as traveling or becoming pregnant.
• Make a list of all medications, vitamins, supplements or herbal medications you’re taking.
• Take a family member or friend along. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

For constipation, some questions you might want to ask your doctor include:

• What’s the most likely cause of my symptoms?
• What kinds of tests do I need, and how do I need to prepare for them?
• Am I at risk of complications related to this condition?
• What treatment do you recommend?
• If the initial treatment doesn’t work, what will you recommend next?
• Are there any dietary restrictions that I need to follow?
• I have other medical problems. How can I manage these along with constipation?

In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time to go over additional questions you may have. Your doctor may ask:

• When did you begin experiencing symptoms of constipation?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• Do your symptoms include abdominal pain?
• Do your symptoms include vomiting?
• Have you recently lost weight without trying?
• How many meals do you eat a day?
• How much liquid, including water, do you drink a day?
• Do you see blood with your bowel movements mixed in with the stool, in the toilet water or on the toilet paper?
• Do you strain with your bowel movements?
• Do you have any family history of digestive problems or colon cancer?
• Have you been diagnosed with any other medical conditions?
• Have you started any new medications or recently changed the dosage of your current medications?

Aug. 31, 2021

Enema While Pregnant – Benefits, Types & Home Remedies

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Last Updated on April 3, 2020

An enema is a procedure used to stimulate bowel movement by inserting liquid or gas through the rectum. An enema may be given to administer medication, to stimulate bowel movements, or to treat constipation. An enema can even be given to pregnant women to ease constipation, which is a common problem during pregnancy. It is given just before delivery to clear the bowels. But giving enemas to pregnant ladies is no longer common. There are several benefits of administering enemas but many people prefer alternatives. Read on to know about the different types of enemas and whether or not they are safe for a pregnant woman.

Are Enemas Safe During Pregnancy?

Administering an enema during pregnancy, especially in the first and third trimesters of pregnancy is not safe. Giving an enema during the first trimester could trigger a miscarriage and in the third trimester, it could lead to premature labour by causing contractions. Pregnancy is a delicate time and certainly not a time to experiment or try something new. Hence, it is best not to give an enema to a pregnant lady. However, if a doctor thinks it is necessary, it can be administered under the guidance of a professional.

What Are the Types of Enemas Used in Pregnancy?

Enemas during pregnancy are not really safe. However, there are some types of enemas which could be administered to expectant mothers, only if they are prescribed by a doctor.

• Mineral Oil Enema: Mineral oil is a laxative and a lubricant, which makes it an essential component of enemas used for treating constipation. Administering a mineral oil enema can make the bowels absorb water slowly. The oil attaches to the faeces and retains the water content in it, thus softening it. As a result, the stool passes easily. But sometimes inserting oil can also introduce harmful bacteria in the anus so a pregnant woman should consult a doctor before using any type of enema.

• Coffee Enema: Coffee enemas are usually administered to detoxify the liver and to cleanse the colon. But doctors generally don’t recommend this as coffee enemas can be potentially dangerous if administered incorrectly or too often.

• Soap Suds Enema: A soap suds enema is often used to treat constipation. For a thorough colon cleansing, a mild soap is added to the enema. It is a combination of distilled water and a small amount of mild soap. The soap can irritate your bowel but it will stimulate bowel movement.

• Probiotic Enema: A healthy balance between the bad bacteria and good bacteria helps maintain a healthy digestive system. It also reduces the risk of serious infections and disease. A probiotic enema is used to insert probiotics through the rectum. A probiotic enema helps eliminate the harmful bacteria in the colon and increase the number of good bacteria, thus keeping a healthy balance.

• Sodium Phosphate Enema: This enema is a medication prescribed by the doctor to treat constipation. It works by drawing water in the large intestine and causes a bowel movement within 5 minutes of administering it.

• Tap Water Enema: It is an injection of tap water into the rectum. The enema makes the colon to expand and initiate a bowel movement. A second enema may be required in case of serious constipation. However, this is not safe and a doctor must be consulted before you plan to administer it.
• Lemon Juice Enema: Made by mixing lemon juice and water, this enema helps provide relief from colitis, which is inflammation of the colon.

Benefits of Enemas

Mentioned below are some of the benefits of using enemas. Administering enemas to a pregnant woman can be beneficial for her, however, the potentials risks of enemas outweigh the benefits, hence they should be avoided.

• Help Treat Constipation: Enemas provide relief from constipation. Administering enemas can also cure constipation in people who don’t respond to laxatives.

• May Help Detect Growth of Cancerous Cells: Enemas are used before a colonoscopy procedure which helps detect any cancerous growth or polyps.

• May Assist in Weight Loss: Administering enemas can help in weight loss and therefore kick start the weight loss process.

• May Cleanse the Colon: The enema loosens up the hardened stool thereby helping it to pass easily. As a result, it flushes out built-up waste and cleanses the colon.

• Refreshes the mind: Removing all the toxins and old matter from within your body can relax you. As a result, it will make you feel lighter.

Alternate Ways to Treat Constipation in Pregnancy

As administering enemas during pregnancy is not safe and can affect the health of a pregnant woman, it is suggested that you try certain home remedies for constipation. If you also suffer from the problem of constipation during pregnancy, here are some home remedial measures that you can try.

1. Eat Yoghurt: Yoghurt is rich in probiotics and therefore can help in getting rid of the bad bacteria from the body. The calcium present discourages the growth of cells in the lining of the colon.

2. Eat High-Fibre Food: Eat high-fibre food items such as legumes, veggies, and whole grains to keep your gut health in check. Fibrous foods help in moving the food easily through the food canal and can ease the problem of constipation.

3. Drink Water: Drinking 8-10 glasses of water a day can help flush out toxins from your body. It may also help reduce water retention and keep your body hydrated.

4. Exercise: Being active during pregnancy can help assist in the smooth flow of bowel movement. You can indulge in light exercises. You can walk for 10-20 minutes or practice yoga for about half an hour.
5. Take Psyllium Seeds: Taking psyllium seeds can help cure constipation. However, it is suggested that you consult your doctor before taking these seeds as these seeds can react against some medicines.
6. Try Acupressure: You can also resort to acupressure instead of an enema or any medicine.
7. Aromatherapy: Relaxing your body and mind can help in bowel movement. Therefore having a soothing bath with aroma oil could help.

Do You Need to Take an Enema During Labour and Delivery?

Administering an enema during labour and delivery is not common now in various countries. However, in India, many doctors consider it if the need arises. Many doctors believe that administering an enema during labour or delivery can make the whole process of labour and delivery an easier experience for a pregnant woman or else she might defecate while pushing out the baby. Administering an enema also lowers the chances of the mother and the newborn contracting any infection. Moreover, passing stools after the delivery may be uncomfortable for a mother because of the fresh stitches and sore body. However, nowadays, it is said that all these claims are mere assumptions. Thus, it can be said that giving enemas during labour and delivery is a matter of choice rather than a necessity.

When to Visit a Doctor

Constipation during pregnancy can be very uncomfortable. It causes faeces to harden causing bleeding from the rectum and lower abdominal pain. If you have constipation in pregnancy, you should consult a doctor if you have tried every possible harmless home remedy for constipation.

You might be tempted to take mineral oil or coffee enema at home but you shouldn’t. Administering enemas during pregnancy is not safe and should be taken only if it is suggested by your doctor. Administering an enema in the first trimester of pregnancy can lead to a miscarriage. And in the third trimester, it could result in premature labour. You must consult your doctor before taking an enema at home.

Enemas can prove to be a boon for some and bane for others, especially for pregnant women. If you are uncomfortable taking an enema before childbirth, all you need to do is mention it in your ‘birth plan’ or to your doctor. The best way to stay clear of constipation and enema during pregnancy is to eat fibrous foods and fruits and drink 8-10 glasses of water a day. This will not only help you improve your bowel movements but also enrich your body with essential nutrients and keep your body hydrated.

Reference: Healthline.com

Also Read: Rectal Bleeding During Pregnancy

Seriously, There’s No Reason to Do a Coffee Enema

Coffee enemas and colonics have long been considered a popular-yet-wacky alternative wellness remedy. But after Goop published a “detox guide” this week recommending a device for doing a coffee enema at home, the Internet is showing a renewed interest.

In the detox guide, Alejandro Junger, M.D., is credited as the person originally recommending the device in a previous article about colonics. Dr. Junger, a cardiologist based in Los Angeles, told Goop that he especially recommends getting a colonic when you’re doing a cleanse (side note: don’t do a cleanse). “During a cleanse the colon eliminates extra mucus,” he told Goop. “Sometimes there is so much, and it is so sticky, that it stays adhered to the walls of the colon, blocking the elimination of what needs to be disposed of.”

But other experts dispute those claims, saying that there’s truly no need to give yourself a coffee enema or colonic literally ever.

We reached out to Goop (whose magazine is also published by Condé Nast, SELF’s parent company) for comment and they directed us to speak with Dr. Junger or other proponents of this practice. We reached out to Dr. Junger’s team twice during the week and were told that he was unavailable for comment at this time. So we spoke with two board-certified gastroenterologists who explained the differences between enemas and colonics, under what conditions you might consider one, and whether or not there should ever be coffee involved.

There is a time and a place for enemas, but you shouldn’t be doing them without your doctor’s blessing.

“There is a role for the enema [in medicine] because the concept of cleaning out the intestines is a worthy concept,” Christine Lee, M.D., a gastroenterologist at Cleveland Clinic, tells SELF. “The mechanics of how that’s done is what needs to be discussed.” With an enema, she explains, water or saline is delivered to the last part of your colon mainly via the gentle force of gravity.

The goal is, essentially, to dilute or dissolve any stool that’s sitting up there to make it easier to poop out. And if you’re dealing with extreme constipation or you’re prepping for a sigmoidoscopy, your doctor might recommend that you try an enema to help things along.

But she cautions against trying a colonic, which delivers fluid further into the bowel using pressure, which can be especially dangerous for people who have had past surgeries in the area. Additionally, colonics usually aren’t done in medical facilities, so their sterilization practices may not be ideal, putting you at risk for infections.

There isn’t much research on coffee enemas, but what we do have suggests the harms outweigh any supposed benefits.

First off, no, you don’t need to “detox” your colon or any other part of your body—you can thank your liver and kidneys for doing that already. “Our bodies have all of that in place,” Lisa Ganjhu, D.O., a gastroenterologist and clinical associate professor of medicine at NYU Langone Health, tells SELF. And, although drinking a moderate amount of coffee may come with some healthful benefits, you aren’t going to get those by squirting it up your butt.

Antegrade Continence Enema (ACE) (for Parents)

What Is an Antegrade Continence Enema (ACE)?

An antegrade continence enema is a different way to give an enema. Enemas can help someone poop if they become constipated or have another problem moving their bowels.

The most common type of enema (EN-eh-muh) puts liquid directly into the rectum, the last part of the large intestine, to help release poop. It’s simple to do and does not involve any kind of surgery. But because these start at the end of the large intestine (also called the colon or bowel) rather than the beginning, they work backward from how we move our bowels naturally. Usually, poop (or feces or stool) moves from the start of the large intestine, through the rectum, and out of the body via the anus.

An antegrade (which means “forward moving”) continence enema starts at the beginning of the large intestine, so poop moves out of the body more normally.

Why Is an Antegrade Continence Enema Done?

In children, an antegrade continence enema can treat fecal incontinence that happens because of serious health problems. Fecal incontinence is when a child can’t control his or her bowels. This doesn’t just mean pooping accidents — most kids with fecal incontinence have severe constipation.

In most cases, doctors consider an ACE only when fecal incontinence (FEE-kul in-KAHN-tih-nentz) is severe and hasn’t responded to other treatments. Less-invasive treatments work for most kids, such as dietary changes, laxatives, suppositories, and traditional enemas.

An ACE is helpful for kids who need long-term enema therapy. It lets them control their enemas through a tube that passes through the abdominal (belly) wall.

An ACE often works well for a child with:

• very severe constipation that isn’t helped by laxatives or other ways to release poop
• a condition that causes severe fecal incontinence, such as:

What Are the Types of Antegrade Continence Enemas?

The two types of antegrade continence enemas most often used for children are:

• an appendicostomy (also called Malone or MACE Procedure)
• a cecostomy

What Is an Appendicostomy (Malone or MACE Procedure)?

Appendicostomy (ah-pen-di-KOSS-tuh-mee) surgery makes a path from the belly button into the large intestine (colon).

An appendicostomy is often called a “Malone antegrade continence enema (MACE)” or a Malone. In this procedure, a surgeon creates a hole (or ostomy) in the skin of the belly that connects to the appendix and leads to the colon. 

The appendix is a small, finger-like tube attached to the cecum (SEE-kum). The cecum is the first part of the colon. An appendicostomy lets the enema liquid go in here, instead of through the rectum.

What Is a Cecostomy?

For a cecostomy (see-KOSS-tuh-mee), a surgeon creates a hole (ostomy) in the skin of the belly that opens directly into the cecum, the first part of the colon. 

The surgeon places a tube into the hole called a cecostomy tube, C-tube, or Chait tube. The cecostomy tube lets poop be flushed quickly and completely out of the large intestine. The enema fluid goes into a bag, then travels through tubing into the cecostomy. From the cecostomy tube, the fluid passes into the cecum. This encourages a bowel movement (BM).

What Are the Benefits of an ACE?

Parents usually begin helping kids use their ACE at home about 1 week after the cecostomy.

When a child has an ACE:

• A parent, guardian, caregiver, school nurse, or the child can slide a tube into the ACE and then let enema fluid flow into the colon.
• Enema fluid and poop flow from the beginning of the colon to the end and come out of the anus, not the hole in the belly.
• The child sits on the toilet during the enema, so the stool can be flushed normally.

A successful ACE:

• avoids a colostomy (a hole in the belly skin that connects to the colon and requires a bag for poop)
• does not need a bag
• may be hidden in the belly button or capped with a flat cover and hidden under clothing

What Happens Before an ACE?

A team of specialists that includes a pediatric surgeon usually treats children who have trouble pooping or poop accidents. Working with an experienced surgeon is important because slight differences in how the surgery is done can make a big difference in how well the ACE works.

The pediatric surgeon will discuss the risks and benefits of an appendicostomy, cecostomy, and other options. Together, you’ll decide which is best is best based on your child’s age, activities, and health problems.

You’ll sign a consent (permission) form. The surgery team will talk to you about:

• medicines to give your child and when
• when your child should stop eating before the surgery
• how to clear your child’s colon before the procedure (bowel prep), if necessary
• the plan for anesthesia during the procedure and pain control after it

On the day of surgery, the preparation (pre-op) team:

• will start an intravenous (IV) line
• may give your child antibiotics through the IV to reduce the risk of infection

What Happens During an Appendicostomy?

Most appendicostomies are done using two or three small cuts and a tiny camera (laparoscopy). The surgeon typically:

• creates a valve at the base of the appendix to prevent leakage
• opens the end of the appendix and attaches it to the skin
• checks for leakage
• places a tube in the appendicostomy to keep it open

If your child’s appendix was removed or isn’t long enough, the surgeon will make a tube from a piece of your child’s colon.

The surgeon usually removes the tube about 2 weeks after the surgery and replaces it with a stopper.

What Happens During a Cecostomy?

Doctors usually use one or more of these minimally invasive techniques to create a cecostomy:

• laparoscopy, which means using a tiny camera and 2–3 small cuts in the belly
• interventional radiology, in which the doctor uses X-ray and other images for guidance
• endoscopy, which uses a camera passed through the anus and the colon into the cecum

Steps for creating a cecostomy include:

• bringing the cecum close to the skin of the child’s belly
• making a hole through the skin into the cecum
• placing a capped tube into the cecostomy

The capped tube:

• keeps the cecostomy open
• prevents leakage from the cecum
• provides a convenient channel for enemas

Can I Stay With My Child During the Procedure?

No. You may stay in the preparation (pre-op) area until the team moves your child to the operating room. You’ll move to a waiting area during the surgery, then join your child in the recovery area after it’s done.

How Long Does ACE Surgery Take?

Cecostomy surgery usually takes less than an hour. Appendicostomy surgery usually takes about 2 hours. 

What Happens After the Procedure?

Your child will stay in the hospital for 2–3 days. During this time: 

• Your child will start eating regular food.
• The care team tests the ACE.
• An experienced continence nurse will teach you and your child how to use the ACE.

Doctors suggest replacing the cecostomy tube every 12–15 months.

What Are the Risks From ACE Surgery?

Any surgery can cause unexpected bleeding or infection. Rarely, these problems may be life-threatening. Fixing some problems may mean doing another surgery. 

Risks with an appendicostomy can include:

• ongoing problems pooping (constipation) or poop accidents (incontinence)
• narrowed or blocked appendicostomy passage (stricture)
• leakage of poop, poop-stained liquid, clear mucus, or gas. This can happen when a child has diarrhea from a viral infection.
• leakage of small amounts of poop-stained liquid from the child’s anus between enemas
• visible appendix lining at the appendicostomy opening (mucosal prolapse)

Risks with a cecostomy can include:

• ongoing constipation or poop accidents
• leakage of poop, poop-stained liquid, or gas around the cecostomy
• leakage of poop-stained liquid from the child’s anus between enemas
• red, bumpy tissue that forms around the opening

How Can Parents Help?

The best ways to help your child are:

• Follow the care team’s instructions.
• Ask about any home care instructions that are not clear. 
• Know that it will take time for your child to get used to the ACE. You also might need to try a few different types and quantities of enema liquid to find what works best for your child.

After the surgeon removes the tube from your child’s appendicostomy:

• Pass a tube through the appendicostomy daily to keep it open.
• Stay on the lookout for problems.

After the doctor says to begin using the cecostomy:

• Check and clean the cecostomy daily.
• Discuss any problems you have using the cecostomy with the care team. 

What Else Should I Know?

Fecal incontinence, no matter the cause, is upsetting for kids. It affects their quality of life and can be embarrassing, especially if a child has poop accidents. This can make kids feel isolated and alone, and lead to depression, behavior problems, and trouble at school. Soiling also can make kids an easy target for bullies.

An ACE can help end fecal incontinence. But because kids who have one don’t poop the way other kids do, emotional issues can still happen. Help your child focus on the benefits of the ACE, such as:

• An ACE can minimize or even prevent poop accidents.
• Kids sit on the toilet during the irrigation.
• Kids who wore diapers may no longer need to.
• Because you can time the enemas, kids don’t have to worry about using them away from home.
• An ACE can make it easier for kids to go to after-school activities and even sleepovers.
• The button or stopper is not noticeable under clothes. Kids also can wear colorful buttons to make these look less like medical devices.

When Should I Call the Doctor?

Call your child’s surgery team if:

• Your child has chills or a fever higher than 101°F (38.3°C).
• You notice a problem with the appendicostomy:
  • You can’t insert the tube.
  • The area around the opening is redder or more tender than when the surgeon last saw it.
  • It’s leaking poop or dark liquid.
• You notice a problem with the cecostomy:
  • The area around the opening is redder or more tender than when the doctor last saw it.
  • Poop or dark liquid leaks around the cecostomy.

Looking Ahead

Taking care of your child’s ACE can feel like a challenge. But you don’t have to go it alone. Your child’s care team has answers and can connect you with resources. 

You also can find support online at:

Enemas: Telling the Nonsense from the Benefits

Fair Warning: If you’ve gotten through life up to this point without learning what an enema is, do not read this while eating.

The basic concept of an enema is simple: force some liquid (water or other liquids) up through the anus into the colon. This softens any stools in the colon and triggers the normal muscle contractions that expel feces from the colon. Basically it’s a way of cleaning out the colon really, really well. Usually people use a syringe with a blunted tip to push the liquid in, or they use an enema bag that hangs up above the body and uses the force of gravity.

You wouldn’t think this would be the quack therapy of choice for people trying to make a quick buck off desperate cancer patients, but enemas are the subject of a baffling amount of nonsense and snake oil, especially once you move past ordinary water and get into the exotic stuff like coffee. The idea of “cleansing” the colon must feed into some kind of primal human anxiety or something, because we’ve certainly invented a lot of weird nonsense on that theme.

But even they’ve been abused in the name of “detoxification” and curing everything from AIDS to cancer, enemas do have legitimate uses supported by actual research, and for people with constipation, they can be a valuable tool. Here’s a look.

Enemas and the Problem of Quack Medicine

Before actually getting into the potential benefits of enemas, it’s time to stop and dispel a few myths about “colon cleansing.” Whatever enemas might do, they don’t “cleanse” “toxins” from the colon, and they definitely don’t cure cancer or make you immortal by doing that or anything else.

“Colon cleansing” is a particular branch of alternative medicine that advocates regular enemas as a way to cleanse the colon of “toxins.” This can seem very persuasive: it feels kind of logical that the colon would be full of gunk, especially if you eat a lousy diet. Taking an enema does tend to result in very dramatic amounts of waste, and it’s just uncomfortable enough to feel like it’s really doing something important.

Reality check:

• Having germs in the colon is not a problem. Most of your fecal matter is dead bacteria. Bacteria are supposed to be in the colon.
• If you eat a lousy diet, the majority of the damage will be done long before the food reaches your colon, and “cleansing” the colon will have a very minimal benefit. Most nutrient absorption takes place earlier in the digestive process, so you’re not preventing your body from absorbing something dangerous by “flushing” it out. Meat doesn’t “rot for 5 years in the colon” and neither does anything else.

There’s no evidence at all that “flushing” or “cleansing” the colon has any benefit for healthy people beyond your body’s built-in methods of waste disposal.

And in fact, colon cleansing can be dangerous, especially if you use something other than water. Coffee enemas are the most notorious: do you know what it feels like to burn the inside of your rectum? Because with a coffee enema, you could find out! Or perhaps you’d like a lovely case of proctocolitis, painful inflammation of the colon and the rectum. People have died from this stuff, so why does anyone do it?

The claim for coffee enemas is that they “stimulate” the liver or help you “detoxify” more quickly. It’s true that the liver is the major organ of detox in the body, and it’s true that a good diet can help the liver do its job, but “a good diet” as far as your liver is concerned means “healthy fats and minimal fructose going into your mouth,” not “room-temperature coffee going up your anus.” (Read more about Paleo for liver health here.) There’s no scientific evidence that coffee enemas do anything to speed or assist detoxification.

Coffee enemas might make you feel good, because they do contain caffeine. This study found that a coffee enema raised blood caffeine levels, not as much as a cup of coffee, but enough to be notable. Caffeine is a stimulant, an appetite suppressant, and a mood booster. But you know how else you can get those effects? Drinking a cup of coffee. There’s no benefit to putting it up the other end.

The title of this study says it best: the theory of colon cleansing is “a triumph of ignorance over science.”

So What do Enemas Actually Do?

That was the quack takedown. But remember from above that enemas do actually have their uses! It’s just that their uses have nothing to do with “cleansing” “toxins” from the colon, curing cancer, curing HIV, curing obesity, or anything else.

What enemas can do is offer reasonably safe (provided you’re using plain water and not coffee) and effective occasional symptom relief for  constipation. Even in people who eat well, chronic stress and other lifestyle factors can cause constipation, and occasional stressors like traveling just make it worse. And constipation can easily become a vicious cycle where hard, dry stools make it painful to defecate, which makes all the muscles in the area tense up, which adds to the constipation. Enemas can soften stools and induce bowel contractions – basically, they break that vicious cycle.

Enemas are very effective at inducing a bowel movement, so they’re a good tool for occasional relief, especially for functional constipation (constipation with no apparent reason – there’s no physical problem, but the person is still constipated). A long-term study found that 34% of patients with functional constipation got relief just by using enemas. That doesn’t sound great, but this kind of constipation is so widespread and so tricky to treat that 34% is nothing to sneeze at!

Enemas can be especially helpful for people with slow-transit constipation or people with constipation caused by nerve damage (e.g. diabetic constipation). Some research actually suggests that using an enema can increase transit time throughout the entire colon.

Magnesium supplements are also a gentler alternative to enemas and help relieve chronic constipation. Magnesium is a better choice for long-term use.

Of course, this is all assuming that you’ve already tried less invasive things like eating more fat, eating more fiber, drinking more water, and getting regular exercise. Obviously, that stuff comes first  (for one thing, it’s much easier and less unpleasant than taking an enema). But for occasional times when other remedies just aren’t cutting it, an enema can help break the vicious cycle and put you on the road back to normal bowel movements under your own steam.

On the other hand, there are reasons why some people shouldn’t take enemas – Inflammatory Bowel Disease is one of them, and so are some heart conditions. If you have a serious disease, see your doctor before trying an enema. Taking enemas on a regular basis can cause electrolyte imbalances – if you have a problem so severe that you need enemas constantly, go to a doctor.

Another potential problem is damage to the gut biome, but here it’s hard to say exactly what’s going on. Some studies have looked at the effect of laxatives and orally-ingested cleansing agents on the gut biome, but there’s not much there for enemas.

Summing it Up

If you want a reasonably safe and quite effective treatment for occasional constipation, an enema might be a good solution for you. They’re very cheap, they’re safe to administer at home as long as you stick with water, and they generally do work. There’s some discomfort and cramping involved, but water enemas usually don’t have serious side effects.

On the other hand, if you’re looking for a way to “detoxify” your colon…stop. The human body does detoxify itself, but that mostly happens in the liver. There are ways to support that with diet, but they involve eating healthy fats and avoiding excess fructose, not taking coffee enemas. Coffee enemas can be very dangerous and there’s no real evidence proving that they have any health benefits to justify the risks.

A Constipation Cocktail – CanadiEM

Constipation, as defined succinctly by Urban Dictionary, is when you’ve gotta go, but your ass says “no!” It is a diagnosis that I can truly empathize with – who hasn’t been at least a bit bunged up before?

The constipated patients that present to the ED take this everyday ailment to a whole new level. No one shows up a little constipated. Those that know they’re constipated come in as a last resort after trying the homemade remedies they saw on Dr. Oz. Those that don’t are diagnosed through a combination of clinical acumen, exclusion and a FOS x-ray. Regardless, it’s no fun to deal with for the nurses, the doctor or (most importantly) the patient. Regardless, they’re sick and tired of it and they want YOU to fix it. Help them Obi-Wan Kenobi, you’re their only hope.

While I have diagnosed and treated constipation, I didn’t have a great understanding of the treatment options or have a good Cocktail of my own. I suspect this is because:

-As a resident on the ward, I don’t actually take care of constipation. On the wards the nurses are monitoring the patient’s bowels and noting what treatments have been tried and worked (or didn’t).
-In the ER, I don’t know if my remedies worked or not unless there were instant results because my follow-up of constipation cases is nonexistent.
-Constipation cocktails seem to be as numerous as the bartenders that mix them with many doctors having their own “special recipe” and different services (ie gen surg vs peds vs obstetrics vs internal medicine) having different approaches at my institution. This has given me some experience with many treatments but minimal experience with any specific one.
-Poop, like me, doesn’t make it onto EMCrit. Scatology just ain’t that cool.

To make up for my ignorance, I have developed coping/survival strategies such as ordering whatever the nurses on the ward ask for (at least that way if it doesn’t work it’s not blamed on me) and, when in the ED, picking something the patient hasn’t already tried and sending them home to deal with their situation in precious privacy. I really wish I could just order up some lactu-seno-pico-glycol and let ‘er buck, but because I can’t it’s time to learn about it: BoringEM Style.  My goal for this post is to delve into a Constipation Cocktail in sufficient depth to adopt it for my own practice (and maybe yours?).

Rather than coming up with my own untested Cocktail, I have adopted one that I was introduced to through #FOAMed on ERCast’s Constipation Manifesto podcast.  Thanks to Rob Orman for his excellent podcast and Dr. Aaron Wall for sharing his recipe.

Dr. Wall’s Constipation Cocktail (aka the Orange Poly-Fleet – sounds yummy):

-Perform manual disempaction if indicated by stool in the rectal vault (the podcast has a great overview of an approach for this procedure)
-Provide 1/2 bottle (8oz or ~250mL) of Magnesium Citrate orally in the ED
-Advise the patient to mix 3-4 17g doses of Polyethylene Glycol daily until a soft stool is produced and then mix 1 17gdose daily for 3-4 weeks
-Recommend 1-2 Fleet Enemas daily for the next 2 days
-Counsel the patient to stop/limit the use of offending agents and to maintain well hydrated with oral fluids

So how do these drugs work? What are their contraindications? Complications? What should I tell the patient to expect?   How much will they cost?

A Constipation Cocktail

Manual Disempaction
These are available free to all Canadians through sponsorship by our government (although you might have to wait in the queue for a bit).  See the ERCast podcast for an excellent overview of how to perform this procedure.  I’ve done it as many times as ZDogg.

Magnesium Citrate
It’s a generic, OTC osmotic laxative aka Citromag that is made up of magnesium and citric acid.  As the magnesium salt is poorly absorbed in the intestine, fluid is retained in the bowels.  This fluid should soften the stool by increasing its water content and also increase the intraluminal pressure to help push things along.  Notably, it should be given on an empty stomach with water.  Because it contains magnesium, hypermagnesemia (hypotension/resp depression) is a possible complication and it should be used cautiously in patients with poor renal function.  As an osmotic diuretic, other electrolyte abnormalities could develop and are more likely with frequent/excessive use.  There have also been case reports of paralytic ileus secondary to hypermagnesemia.  The patient should be told to expect increased abdominal cramping and flatulence.  If they are purchasing the product themselves a 16oz bottle (2 doses) costs <$10CAN. While I found multiple articles mentioning Magnesium Citrate’s use for treating constipation, I could not find any addressing its efficacy or safety in the ED population. Anecdotally, it is stronger than PEG which is why it is a good drug to get things started.

Polyethylene Glycol
It’s a polyether (go-go gadget organic chemistry!) compound aka PEG, GoLYTELY, Miralax and multiple other names that is available OTC and works through a similar osmotic mechanism.  It is relatively inert in the gut as it is not metabolized or absorbed and it comes as a tasteless, odorless powder that dissolves in water.  As an osmotic laxative, electrolyte imbalances can develop.  However, a version called “PEG 3350” is available that has added electrolytes to minimize this risk.  It should be taken with the recommended quantity of water to prevent the osmosing of fluid into the intestine from the body. The patient should be told to expect bloating, cramping and flatulence.  The Orange Poly-fleet-recommended 4 week supply would cost the patient approximately $20CAN.  Long-term use has been studied and found to be both safe and effective.

Fleet Enema
Pop quiz: how many kinds of “Fleet Enema” are there?  Unbeknownst to me, the name “Fleet” is attached to every bowel-aid made by the FleetLabs Corporation.  This includes at least 4 different enemas (Fleet Saline, Fleet Extra, Fleet Bisacodyl & Fleet Mineral Oil).  At my institution, a “Fleet Enema” is synonymous with a “Fleet Saline Enema” and I’ll assume that is what Dr. Wall referred to in his ERCast podcast. This enema also works through an osmotic effect as it consists of a hypertonic solution of sodium phosphate.  However, rather than just preventing the absorption of water by the colon, it draws water in.  This promotes evacuation, generally within minutes.  There are multiple case reports of complications secondary to sodium phosphate enemas including dehydration, hypotension, hyperphosphatemia, hypocalcemia, hypernatremia and hypokalemia.  This was most recently discussed in a case series in JAMA published in February of 2012 that recommended using them only in low-risk patients.  Unfortunately, I did not find any studies assessing the safety or efficacy of sodium phosphate Fleet Enemas in the ED constipation population.  As with any enema, the patient should expect fecal urgency and anal discomfort.  Fleet enemas can be purchased OTC for <$5CAN.

In conclusion, with some reservations about Fleet Enemas, I am happy to have a Constipation Cocktail to use as if it were my own.  I’d be very interested to hear about the Constipation Cocktails that others are using, as well as any further discussion on the safety of Fleet Enemas.  Is everyone still using them? Any thoughts on alternatives?

That’s it for this week! Once again I’d like to thank everyone for supporting my baby of a blog.  In particular, thanks to those that tweeted/retweeted my posts, to Mike Cadogan @sandnsurf for the welcoming messages, advice and intro to the blogging community, and to Rob Orman @emergencypdx for the podcast referenced in this post.

Happy Holidays!

Brent Thoma @boringem

Additional references:
Pharmacologic information on the discussed drugs from epocrates

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90,000 Enema for the lazy! Why constipation is dangerous and how to deal with it | Health

Proctologists and urologists are the most demanded doctors, if we take into account the statistics of readers’ inquiries on direct lines, which are carried out in “AiF-Chelyabinsk”. Proctologists are traditionally treated with complaints of stool disorders. “Some are tormented by gas incontinence, others by stomach pains, and still others by stool disorders,” says proctologist Igor Krochek . – Problems are different, you should not be afraid of them and delay treatment too.Better to see a specialist. ”

About polyps in the intestine and colonoscopy

For a polyp, such a symptom as an admixture of blood in the feces is very characteristic. Most often, polyps are found quite by accident when examining the intestines for some other disease.

When a polyp complicates its course, bleeding occurs, due to this, an admixture of blood in the stool. If the polyp is in the area of ​​the cecum, then the blood will be dark.

If in the area of ​​the rectum, then it will be light, as in hemorrhoidal disease.A polyp can turn into cancer and become cancerous, but that’s another topic. In any case, I recommend you an examination of the large intestine – colonoscopy. The fact is that sometimes more terrible diseases, including oncological ones, are hidden under the swelling.

Colonoscopy is an examination during which doctors examine the inside of the large intestine using a special probe. Before starting the procedure, the patient is placed on a couch, lying on its side.

After administering drugs for anesthesia, the patient quickly falls asleep and wakes up after the end of the examination.A colonoscope is inserted through the anus into the intestine – a long, thin and flexible tube equipped with a light source and a video camera that transmits the image to a monitor. The colonoscope is gradually advanced along the large intestine until it passes into the small intestine. The total duration of the colonoscopy is on average 20-30 minutes. After the end of the procedure, there is usually no pain or other unpleasant sensations.

Preparation for colonoscopy includes adherence to a special diet and procedures to cleanse the intestines.During the whole day the day before, it is necessary to completely refuse food and drink at least 3.5 liters of water. Beginning in the evening, on the eve of the colonoscopy, you must not eat or drink.

About constipation

Most elderly people very often complain of constipation. The fact is that with age, intestinal motility is disturbed, the muscles of the abdominal press and the pelvic floor weaken, which takes an active part in the implementation of the act of defecation.

In old age, the number of people with constipation of medicinal origin also increases.I recommend that you apply for a full-time appointment with a gastroenterologist.

Do not get carried away with enemas especially: there is no need to flush healthy flora from the body and make your intestines lazy. But on the other hand, the intestines need to be cleansed at least a couple of times a week. Otherwise, colostasis will begin – the accumulation and retention of solid feces in the rectum. The absorption of decomposition products into the blood will cause a severe intoxication.

Go swimming: it does create excellent intra-abdominal pressure after all.Swimmers do not have constipation. Be sure to pump the press. Press your legs to the floor (put a load on your knees or lower) and raise your torso while lying on your back.

Every day in your diet should be salads in sunflower or olive oil, cabbage, tomatoes, cucumbers, beets in sunflower oil, bran. Drink 2.5 – 3 liters of water a day. Every morning you should start with a glass of cool mineral water. Drink in small sips. And before going to bed – a glass of kefir and an apple.

In case of itching, microclysters with chamomile have a good effect.For 1 glass of boiling water – 1 tbsp. chamomile. Brewed, closed and let it brew until it cools completely. Then strain the entire glass and inject the broth with a rubber bulb into the rectum in the knee-elbow position, so that the pelvis is higher than the head. So you need to stand for five minutes. After that it will be possible to get up.

Problems are different, you should not be afraid of them and delay treatment too. Photo: Shutterstock.com

Enema will be asked to break – release it, it will have its effect. It will not ask, it will come out later.And so for the night for a whole month. The mucus that accumulates in the segmoid colon will be washed off and nothing will irritate the skin.

Comment

Igor Krochek, doctor-proctologist of the highest category, MD, professor:

“Patients often complain of bloating and terrible gas after drinking milk. This means that the point is intolerance to dairy products, they should be excluded from the diet, including even cheese. It is necessary to ensure that the gases go away well in the morning: after all, they, as a rule, accumulate during the night.When you wake up in the morning, lying in bed, lift your legs up and do an exercise similar to pedaling a bicycle: after that, gases usually go away well.
It is clear that sometimes you have to be patient, to keep the gases in yourself. But if you are not on a bus or in a minibus, let the gases go, you cannot hold them back. Otherwise, pain will appear. The gases will accumulate and sooner or later they will leave at the most inopportune time. ”

See also:

90,000 MICROLAX® microclysters for newborns

Number of views: 750 606

Date of last update: 29.10.2021

According to statistics, constipation occurs in every second baby. Difficulty emptying the intestines can be caused by the immaturity of the child’s digestive tract, inaccuracies in the diet of the nursing mother, improper introduction of complementary foods and other factors. This condition gives the baby physical discomfort and has a negative impact on development. MICROLAX ^® for children from 0 years old is the only laxative on the Russian market, designed specifically for use from the first days of a baby’s life up to 3 years old.Convenient and easy to use, it helps to soften dense feces, the onset of a laxative effect and delicate elimination of the problem.

Principle of action of micro enema for newborns MICROLAX

^® for children from 0 years old

MICROLAX ^® for children from 0 years, developed specifically for the health of babies and the convenience of mothers, acts in the same way as the universal MICROLAX ^® . The spout is designed for children from birth to 3 years old, so when using it, mothers do not have to think about calculating the dosage and finding a specially marked mark.MICROLAX ^® for children from 0 years old contains a complex of active ingredients that soften the “congestion” formed in the rectum. Sorbitol, sodium citrate and sodium lauryl sulfoacetate, complementing and reinforcing each other, stimulate the flow of water into the intestinal lumen, help soften feces and facilitate the process of emptying.

Advantages of MICROLAX

^® for children from 0 years old

Ease of use

Micro enema has a comfortable shape.For comfortable insertion, it is equipped with a shortened spout of the optimal length for the baby (4.7 cm).

Action MICROLAX

^® for children from 0 years old

MICROLAX ^® for children from 0 years old is a mild topical laxative and can take effect within 5-15 minutes * after use.

High Security Profile

MICROLAX ^® for children from 0 years old has a high safety profile. A local laxative acts directly on the dense feces that have accumulated in the baby’s rectum, and does not affect the organs of the digestive system, which are upstream of the digestive tract.

If your baby has a delicate problem, do not hesitate to solve it.

How to use MICROLAX

^® micro enema correctly for children from 0 years old?

See the announcement of the remedy for constipation in newborns MICROLAX

^® for children from 0 years old

* Approximate time of onset of action according to instructions for use.

90,000 Colic and other “tummy problems” in babies

Dmitry N. Izyakov

Pediatrician

April 25, 2021

1.Colic

This term hides at once two problems associated with pain and discomfort in the abdomen in children. There are two concepts in domestic and Western medicine, and two names: intestinal and infant colic.

Domestic medicine understands intestinal colic as episodes of abdominal pain associated with:

• with intestinal muscle spasm
• and / or with gas overflow (flatulence)
• and / or with difficulty in moving the contents.

Western medicine means infant colic episodes of crying

• starting at the age of 3 weeks
• occurring at least 3 times a week
• lasting at least 3 hours a day (rule of three triplets)
• occurring for no apparent reason
• usually at the same hours
• ending just as spontaneously with a sudden return of the child to his usual mood.

The cause of infant colic has not yet been reliably established, but there is more and more evidence that this is a variant of migraine, only it is not the head that hurts, but the nerve plexuses in the abdominal cavity.Hence, there are two fundamentally different approaches to treatment.

First – impact on the child . The second – impact on the mother of the child .

At the first approach, a doctor may recommend and / or prescribe:

1. For prevention:

• Compliance with a nursing mother’s diet
• Replacement of formula for a bottle-fed baby
• Correction of frequency and amount of food
• Individual prescription of complementary foods
• additional water addition
• additional laying on the stomach
• abdominal massage
• gymnastics for the abdominal muscles
• medicines for the prevention of spasm, flatulence and difficulty in moving the contents

2.For the treatment of seizures:

• for relieving spasm: warmth on the stomach, massage of the abdomen, a short period of hunger, when the child is given only water, on the contrary – frequent application to the chest, medicine (antispasmodic)
• to eliminate flatulence: gas outlet tube, medicine ( carminative or defoamer)
• to speed up the passage of the contents: pressing the legs to the stomach, enema, medicine (laxative or prokinetic)

On the second trip, the doctor may recommend and / or appoint:

• alternate presence of different family members with a crying child
• change of scenery for the period of an attack
• more frequent feeding
• methods of simple psychotherapy for mothers
• drugs for mothers: anxiolytics or sedatives
• pain relievers for a child based on paracetamol (up to 3 months) or ibuprofen (from 3 months).

I would like to emphasize that we are talking about pain in the abdomen, not dangerous for the life and health of the child . Any attack of abdominal pain, the cause of which the parent does not understand, requires a visit to a doctor! If an attack of abdominal pain is accompanied by one or more of the following symptoms:

• complete refusal to eat and drink
• vomiting
• temperature rise above 37.5 ° C
• any skin rash
• loss of consciousness
• increasing lethargy

– then the emergency call must be immediate!

2.Intestinal dysbacteriosis

This term exists only in domestic medicine, and it refers to a quantitative and qualitative change in the composition of the intestinal microflora, detected by seeding feces. It is NOT a disease, as it does not have any significant symptoms, except for harmless and medically insignificant changes in color, consistency, and stool odor. And therefore does not require medication.

Numerous dietary supplements are used for correction, which should be discussed with the attending physician. Dysbacteriosis is a consequence of any disease, therefore efforts to eliminate it should not replace the search and treatment of the primary disease.In a doctor’s diagnosis, this term cannot be used alone, but only as a consequence or complication of the underlying disease.

3. Changes in feces in a child

Color. For a doctor, only three options are significant:

• colorless (that is, white) – a sign of liver and / or biliary tract disease
• black – a sign of bleeding above or at the level of the stomach
• red (namely scarlet or crimson) – a sign bleeding from the intestines or obstruction.

No other colors are of medical importance. But, as practice shows, color is very important to many parents, which is a reason for unreasonable visits to a doctor.

Odor. A putrid smell has a definite significance. All the rest – none, but again they can bother parents, and those – doctors.

Consistency. Hard and dense, making it difficult to empty – a sign of constipation. Watery and very runny is a sign of diarrhea.All other options should not be a reason for seeking medical help.

Frequency. The only thing that matters is the increase in frequency relative to the usual one with a simultaneous increase in the amount of feces per day = diarrhea. On breastfeeding, stool retention of any duration is not constipated WITHOUT difficulty in defecation. An exclusively breastfed baby may have a stool frequency no more often, but sometimes the same as the frequency of feeding, as well as emptying his intestines WITHOUT difficulty once every 7-10 days.

Impurities. The following impurities in feces are important: streaks of blood, drops of scarlet blood, mucus. All other impurities have no medical significance.

4. Constipation

This term is understood as the difficulty in emptying the bowels, both with and without a change in stool frequency. The causes of constipation are varied and it is the doctor’s task to find out. To help the doctor find out the reasons, parents should know: what the feces look like after emptying, it is important that it is thick, or vice versa, liquid and

when the child’s urge to the next emptying begins.

To help with constipation, a first-aid kit should have: 1) a gas outlet tube with a limiter 2) glycerin suppositories for children 3) therapeutic microclysters “Microlax” They are used in this sequence when a child has an urge, but there is no stool during the day / nights (12 hours).

Start with tubing. If there is no effect after 30 minutes, then candle setting. If there is no effect for 2 hours, then the setting of microclysters. Laxatives for oral administration and enemas should not be used WITHOUT a doctor’s prescription.

5. Diarrhea

This term is understood as an increase in stool frequency and / or stool volume within 24 hours. Absolutely any diarrhea is the basis for consulting a doctor, even if the parent thinks that he knows the cause and has experience in the fight. Remember that any diarrhea can be a life-threatening intestinal infection!

However, there are two remedies that parents can use for primary care:

1. rehydration agent = soldering by age – Dilute Humana electrolyte 0-12 according to the instructions.Drink 10-20 ml for each chair for a child under one year old
2. enterosorbent based on smectite – “Smectite” or “Neosmectin” For every 12 hours of diarrhea, use 1 powder diluted in 50-100 ml of water, which should be given to the child to drink between feedings 10 -20 ml per hour.

No other means should be used WITHOUT a doctor’s prescription and tests.

Treatment of constipation according to traditional Chinese methods

Constipation is a pathological condition in which there is a decrease in stool frequency, difficulty, and sometimes inability to defecate.In traditional European medicine, constipation is called a violation of the function of the large intestine, in which stool occurs three times a week or less, and the patient is forced to strain so that defecation is effective.

Read completely

Constipation

Causes of constipation

It is customary to consider hypodynamia and nutritional disorders as predisposing factors.In addition, constipation can result from intestinal dyskinesia (slowing down the movement of feces through the colon), colitis, hemorrhoids, prolapse of the pelvic organs, and intestinal tumors. Secondary constipation is observed in cholecystitis, gastric ulcer, endocrine and nervous diseases, due to the intake of certain medications.

In the ancient teachings of Chinese medicine, the back yin and the warming function of the kidney qi are responsible for the process of defecation. That is, with a lack of kidney yang energy, a state of “weakness-fire-emptiness of yang” arises and, as a result, constipation.

It is important to understand that prolonged constipation leads to the accumulation of toxic substances in the body, metabolic disorders. Also, at the same time, the process of assimilation of vitamins suffers, and immunity decreases. Constipation also affects the condition of the skin, hair, and is accompanied by impaired memory, sleep and performance.

Types of constipation

Spastic constipation is one of the most common manifestations of stool disorders in children.The main signs of this type of disease are intestinal colic, stool that looks like a sheep’s, bursting pain in the anus, which subside after a bowel movement.

Atonic constipation occurs due to a decrease in the tone of the intestinal tissues with a deterioration in blood circulation, weakness of the diaphragm and abdominal muscles. This type of disease is characterized by formed feces, dense, abundant, defecation is difficult and painful, requires straining. On the surface of the feces, there are often streaks of fresh blood.

Chronic constipation is defined as a violation of the act of defecation continuously for three months or more. Absence of stool for several days, which occurs suddenly, without precursors, is a symptom characteristic of acute constipation. An acute condition can result from the formation of a mechanical obstruction in the intestine or anal area (tumor) or an inflammatory disease.

Treatment of constipation

Often, constipated patients self-medicate for a long time using laxatives or enemas.Unfortunately, behind this lies only the elimination of symptoms, but there is no effect on the problem. In addition, these methods of treatment over time lead to “laziness” of the intestine, which only aggravates the problem, requires a constant increase in the dose of laxatives to restore intestinal motility.

Effective treatment of constipation, first of all, requires identifying the cause of their occurrence and the impact on it. This is the principle used by the Chinese medicine specialists practicing at the TAO clinic.A diet is individually selected for each patient, since the normalization of nutrition is one of the most important conditions for success. In addition, with the help of a special complex of phytotherapy, it is possible to ensure regular and normal intestinal motility. The complex therapy of constipation also includes the procedures of the Chinese therapeutic massage, acupuncture and moxibustion. Almost always, as a result of the competent application of the methods of traditional Chinese medicine, it is possible not only to relieve the patient of constipation, but also to cure a number of concomitant pathologies, to restore the natural function of the digestive organs.I would especially like to note the possibility of safe treatment of constipation in women, for example, during pregnancy, using Chinese methods, since these methods have no contraindications and side effects.

Home enema for constipation

Sometimes there are cases in which neither medicine nor a specially prescribed diet helps to eliminate constipation. In such situations, it is the enema that is the main opportunity for noticeable relief of stool exit.Especially often, such a procedure is required in case of chronic constipation, because sometimes this is the only way to help a suffering person. For the correct administration of an enema, it is imperative to have special knowledge, despite the fact that, at first glance, such a procedure is quite simple. Enema at home with constipation will be most effective only if you put it correctly.

Types of enemas for constipation

First, you definitely need to decide on all types of enemas in order to choose the most suitable one.Distinguish now cleansing, oil and hypertonic. That is why, it is important to know what exactly is the main difference between them.

Oil enema

During effective cleansing of the body using an oil enema, it is necessary to inject oil directly into the rectum. Feces, when mixed with it, will become more slippery, therefore, it will be able to move much faster to the place of exit from the body. In addition, you can also heat the oil to 37-38 degrees, which will help relieve cramps, promoting a quick release of all stool.Also, heat has a more relieving effect during the onset of constipation, especially in diseases of the anorectal region.

Hypertensive enema

When carrying out this type of enema, usually only 10% sodium chloride solution is made, for this you just need to dissolve the salt in water. You can also use 20-30% magnesia, which can provide an effect like sodium chloride. In the case of the introduction of all of the above solutions, an increase in osmotic pressure occurs directly in the intestine.The special liquid effectively draws out all the liquid from all nearby tissues, so all stool becomes much softer. Saline solution can also cause quite strong irritation of the entire rectal mucosa, during which it actively contracts.

You can read about other types of enemas and their actions in specialized publications, which provide complete information that will always help to ensure the most correct procedure is carried out with maximum benefit.

90 045 90 000 7 facts about constipation that no one talks about

According to statistics, every second person on the planet is faced with constipation more often than once a year, and 15-20% of the population generally suffer from its chronic form. At the same time, since many are embarrassed even to tell the doctor about such a problem, there are many false ideas associated with the topic of constipation. Medaboutme.ru has selected 7 important facts that every person should know about.

Fact number 1: the frequency of bowel movements is individual

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In fact, there is no clear norm for the frequency of bowel movements.Frames from 3 times a day to 3 times a week are acceptable. Moreover, the usual rule of one bowel movement a day is not the norm for more than half of people. It depends on the individual characteristics of the digestive tract, age, amount of food, type of food and others. Therefore, the diagnosis of constipation, and even more chronic constipation, should be based, first of all, on the complaints of the patient himself, and then on a medical examination.

Much more important is not how often defecation occurs, but how much it relieves the condition of the gastrointestinal tract (GIT), whether there really is a feeling of bowel movement, whether there is a feeling of heaviness or other unpleasant sensations.

Fact number 2: dietary fiber can not always eliminate constipation

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One of the main causes of constipation is the hardening of stool, and this is directly related to human nutrition. Soft buns, semi-finished products, sweet foods contribute to strong compaction of feces. Therefore, doctors often recommend a diet rich in dietary fiber to eliminate constipation. It should be borne in mind that they are of two types:

• Soluble (bran, fruits, vegetables, oatmeal) have a beneficial effect on the absorption of food, in particular, normalize the level of cholesterol in the blood.But constipation may not be affected.
• Insoluble (wheat, whole grain bread, porridge) increase intestinal peristalsis, have a fairly large volume – normally, make up about a third of the composition of feces.

It is insoluble dietary fiber that is needed to eliminate constipation. However, it must be borne in mind that their sharp increase in the diet can lead to excessive gas production and belching. Therefore, they are added to the diet gradually.The daily intake of fiber per day for an adult is 20 g. Dietary fiber does not have a quick effect (it is not a laxative), but it can help with frequent or chronic constipation.

Fact # 3: Regimen and physical activity reduce the risk of constipation

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The work of the intestines is directly related to the way of life. It has been proven that people with sufficient physical activity are less likely to suffer from constipation. Moreover, this is best seen in elderly patients, because it is known that with age, intestinal atony often develops, which provokes stool retention.In people involved in aerobic sports (running, gymnastics), these aging processes slow down. Yoga, swimming, Pilates, stretching and even the usual regular walks are positively reflected in the work of the intestines.

For people prone to constipation, it is important to follow the regimen. And this applies not only to food, but also to going to the toilet. The most active intestinal peristalsis is manifested in the morning hours, so people with chronic constipation need to focus on this time.

Irregular eating, especially overeating, can affect the frequency of bowel movements, cause hardening of stool and a feeling of heaviness.An abrupt change in diet can end up with indigestion, which is why people often suffer from constipation when traveling.

Fact # 4: Constipation can be caused by stress

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Negative emotions and depression directly affect the work of the digestive tract. It is known that in people who eat food in a nervous mood, it is less well absorbed, and if the stressful situation is prolonged, then stomach diseases, in particular gastritis, can develop.Gastroenterologists say that in almost half of cases of chronic constipation, patients also have a depressed emotional state or depression, for many, work is associated with constant nervous tension.

Constipation in childhood can be caused by fear of defecation. In this case, the baby simply suppresses the urge to use the toilet, which as a result leads to hardening of the stool. Fear can be caused by many reasons, often the decisive factor is the period of potty training and too strict requirements.Such a reaction can be provoked by a past illness (in which the act of defecation caused pain or inconvenience).

Most often the problem occurs between the ages of 2 and 4 years and will go away over time. But if you do not notice progress, it is imperative to consult a psychologist, since such violations can affect the health of the child, and subsequently manifest themselves in adulthood.

Fact # 5: enemas and laxatives can cause constipation

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Despite the fact that enemas and various laxatives, including suppositories, are a common method to solve the problem of constipation, such treatment will be safe only if a doctor prescribes it.The main principle of treatment for chronic constipation is to force the intestines to cope with their functions on their own; similar procedures, on the contrary, wean it out of working in full force. In fact, every new pill or enema you take increases your risk of constipation later on.

In addition, constipation can be a symptom of other problems with the gastrointestinal tract, so taking any medications should be agreed with your doctor, because self-medication can lead to serious complications.An incorrectly placed enema can damage the intestines. This is especially true for children, so this procedure must be treated with caution.

Fact number 6: water is a cure for constipation

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One of the most effective and simple ways to treat constipation is to drink clean water. One of the main reasons for the development of constipation (hardening of feces) is dehydration. For this reason, by the way, people suffering from this delicate problem should not get too carried away with diuretics, including drinks containing caffeine, as they help to remove fluid from the body.

Nutritionists recommend that an adult with a normal body weight and no concomitant kidney disease drink 6-8 glasses of pure water a day. And on hot days, the amount of fluid should be increased. Also, the norm for people with obesity is separately prescribed, and a nutritionist will best of all do this.

Fact number 7: constipation can be a symptom of a number of diseases

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Constipation itself causes considerable discomfort, but besides that, it can be a symptom of other rather dangerous diseases.Among them:

• Hemorrhoids and anal fissures – pain during bowel movements makes a person postpone going to the toilet as much as possible and, as a result, leads to constipation.
• Irritable bowel syndrome – in this case, constipation alternates with diarrhea.
• Diverticulitis and other inflammatory processes in the intestine.
• Colon cancer – the tumor is preventing the passage of feces. In this case, there may be blood in the stool.
• Diseases of the gastrointestinal tract: ulcer, chronic pancreatitis.
• Dysbacteriosis.
• Neurological disorders: Parkinson’s disease, multiple sclerosis, stroke.
• Hirschsprung’s disease (most often diagnosed in the first days of life).
• Endocrine diseases: hypothyroidism, diabetes mellitus.

We will learn how to make an enema for constipation

Human health is very important, it plays an important role. It is always worth watching him, eating right, playing sports, swimming. All this helps to keep the human body in good shape.But sometimes there are various health problems that bring discomfort, one of them being constipation. The problem with defecation is very common these days. What to do? In this matter, an enema can help. And how to do it correctly? This will be discussed in detail in the article. We will also look at the types of enemas, as well as how they work.

Constipation is a problem of our time

Sometimes a person may experience severe constipation, in this case any medications or remedies may be useless.First of all, doctors prescribe a strict diet in which there is no variety in food, fatty foods, and strongly carbonated drinks. But these methods help only slightly alleviate the situation, but do not completely solve this problem. Therefore, an enema for constipation is considered the best remedy. This procedure is relatively quick, simple, and most importantly, it is not expensive at all. It is enough to purchase only the enema itself at the pharmacy, moreover, it is intended for multiple use. At first glance, this procedure seems difficult, but it is easy to make an enema for constipation at home.

What enemas are there?

Before you start using enemas, you need to determine what they are. There are three main types, namely: oil, cleansing and hypertensive enemas. They all differ in their functional abilities, but each of them is very easy to make. When an enema is done for constipation, then there is a certain cleansing of the body from toxic substances accumulated in the human body.

What is an oil enema?

When using an oil enema, use any oil (sunflower, olive or vaseline).The feces are mixed with one of these ingredients, and it is easier for him to go outside. Also, in this case, it will also be easy for a person to get rid of feces, since pain will not be felt in this case. Oil enema has a relief effect especially at the time of anorectal disease. But this type of enema has a significant disadvantage – it is a long wait for the result. In this case, it will take up to twelve o’clock to wait for the desired outcome. Therefore, it is best to put it at night, so that in the morning you can safely get rid of feces.

How does a hypertensive enema affect the body?

If you need to quickly get rid of constipation, then it is worth using a hypertensive enema. It is important that the procedure is carried out accurately and accurately.

A homemade hypertensive enema can also relieve constipation with ease. How to do the correct enema for constipation? You need to use table salt. During the procedure, a saline solution is injected into the rectum, or you can use magnesia, it quickly draws in unnecessary fluids in the body, while the feces become soft in composition and quickly come out without problems.The saline solution irritates the intestines, so you won’t have to wait long for the result. It is better to do such an enema for constipation at home. After the procedure, it is not recommended to go away anywhere.

Most people ask the question: “How to do an enema for constipation?” This question is relevant because many unforeseen situations can happen in life. Note that after applying a hypertensive enema, it will take effect in about 10 minutes.

How does a cleansing enema affect the body?

There is another type – a cleansing enema.This option is best used as a last resort if the methods described above do not help. The work of oil and hypertensive enemas is that they have a direct effect on the intestines, irritating its mucous membrane. At the same time, the intestinal walls are stimulated to contract, and the result is the withdrawal of feces, and cleansing enemas simply wash out all the accumulated mass. This method should be used as a last resort for cleansing. After all, it is necessary if the body refuses to work on the promotion of feces.

How to make a cleansing enema?

So how do you do a cleansing enema? What should be poured into a pear? In order for the emptying to be complete, three drops of glycerin are added to the water. You can also pour a decoction of chamomile or a decoction of any herb that has a cleansing and anti-inflammatory effect.

For a smoother introduction, the tip of the enema should be lubricated with vegetable oil, petroleum jelly or a nourishing cream. Before the introduction, it is imperative to release the air so that it does not enter the intestines and cause discomfort.

Just remember that by doing a cleansing enema, you expose your body to stress, you are interfering with the complex mechanism of the large intestine. Therefore, you should not uncontrollably carry out such procedures when necessary.

Stages and features of the procedure

The procedure can be divided into several stages. Initially, it is necessary to cover the place where the procedure will be carried out. It is best to use oilcloth as the entire area can be stained.After that, you need to decide on the choice of an enema and a solution that will be used directly for the procedure. All this must be prepared in advance and placed side by side.

If it is an oil enema, then you need to take about 100 ml of the selected oil. It should be heated and placed in a rubber bulb of a size that is suitable for insertion into the anus. With a hypertensive enema, you need to take a 10% solution of sodium chloride or you can take a ready-made solution of magnesia, the effect will be the same.To carry out a cleansing enema, you will need a special mug, it resembles a rubber heating pad. You can buy it at any pharmacy; there is a small tip at the end of the hose of such a heating pad. Warm water is placed in the mug, at least 2 liters. After that, you will need to enter it for cleansing. Most of the selected solutions or water used in these procedures must be warmed to body temperature.

During the procedure, it is better to have an assistant nearby. The person should lie on his left side, bend his knees near the abdomen.The tip of the enema is inserted into the anus, water or oil is poured into the intestines. After that, you need to lie down for about 10 minutes. This procedure is not as difficult to execute as it might seem at first glance. It is very easy for an adult to make an enema for constipation at home, it is only important to follow the rules of application, filling it only with proven aqueous or saline solutions.

It is not recommended to give an enema when inflammation or colic occurs in the intestines.If there is damage to the mucous membrane, this method should also not be used. To the question: “Is it possible to do an enema with constipation?” – it is impossible to answer unequivocally. Since it is important to initially determine your diseases and only after an individual consultation to carry out such procedures. When constipation occurs, more often than not, the person’s stomach does not hurt. Most of all, a person can independently discover the fact that he has not cleared his body of harmful substances for a long time. But if there is pain in the abdomen, then you should not do an enema for constipation.

In such a situation, a completely different disease may be to blame, which will be the reason for obtaining a doctor’s consultation and prescribing a treatment method. At the time of exacerbation of hemorrhoids, an enema is also contraindicated.

Can I do it and why

Can I do an enema for constipation? This question should only be answered when visiting a specialized doctor. Since he can individually determine the characteristics of the human body and prescribe the correct diet, food intake and procedures, as well as medication.When a person has a constant need to do an enema, then it is worth urgently contacting a specialist, since this procedure is practically the very last way to remove feces from the body.

Constipation is a small change in the body that disrupts metabolism, after which other problems may arise. Further more serious health problems may appear. Doing an enema at home on your own is easy and simple. This procedure does not require special skills; you can prepare everything you need for an enema very quickly.When one of the types of solutions is introduced into the body, there comes a period when it begins to act. After that, the body is freed from unnecessary feces and relief comes. You can also use laxatives before an enema to enhance and speed up the effect.

Contraindications to the procedure

We have figured out how to give an enema for constipation. But any procedure has contraindications for use.

In this case it is:

• bleeding;
• indigestion;
• chronic ailments in acute form;
• persistent and severe pain in the head;
• general weakness;
• hemorrhoids;
• nausea;
• abdominal pain;
• hernia;
• high temperature.

Oil enema for baby

As mentioned above, such an enema acts rather slowly, so it is better to carry out this procedure before bedtime. It is enough for babies to inject 30 ml of oil, and for older children – from 100 to 300 ml.

The liquid should be slightly cool – about 23 degrees. A small, soft-tipped syringe is used. In all other respects, the procedure for a child is carried out in the same way as for an adult.

Conclusion

An enema is only a temporary measure that allows you to quickly get rid of heaviness in the stomach and discomfort.Be careful, as constipation is often a sign of other ailments. It is not necessary to carry out this procedure very often, as addiction can occur, and then the intestines will not be able to work normally. If you often have constipation, which only an enema helps to get rid of, then you should definitely pay attention to your lifestyle and diet. Consult your doctor, he will be able to make the correct diagnosis, and in no case self-medicate.