Local Management of Constipation: Enemas, Suppositories

Kim, Seong-Eun; Shin, Jeong Eun; Hong, Kyoung Sup; Lee, Tae Hee; Lee, Bong Eun; Park, Seon-Young; Hong, Sung Noh; Jung, Kee Wook; Park, Kyung Sik; Choi, Suck Chei

doi:2015.88.1.15

Special Review

The Korean Journal of Medicine 2015;88(1):15-21.
Published online January 1, 2015.
DOI: https://doi.org/10.3904/kjm.2015.88.1.15

Local Management of Constipation: Enemas, Suppositories

Seong-Eun Kim¹, Jeong Eun Shin², Kyoung Sup Hong³, Tae Hee Lee⁴, Bong Eun Lee⁵, Seon-Young Park⁶, Sung Noh Hong⁷, Kee Wook Jung⁸, Kyung Sik Park⁹, Suck Chei Choi¹⁰, Constipation Research Group of the Korean Society of Neurogastroenterology and Motility

¹Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
²Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
³Department of Internal Medicine,Seoul National University College of Medicine, Seoul, Korea
⁴Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea
⁵Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
⁶Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
⁷Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
⁸Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea
⁹Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
¹⁰Department of Internal Medicine and Digestive Disease Research Institute, Wonkwang University School of Medicine, Iksan, Korea

변비의 국소 치료: 관장과 좌약

김성은¹, 신정은², 홍경섭³, 이태희⁴, 이봉은⁵, 박선영⁶, 홍성노⁷, 정기욱⁸, 박경식⁹, 최석채¹⁰, 대한소화기기능성질환ㆍ운동학회 변비 및 항문직장기능 연구회

^¹이화여자대학교 의학전문대학원 내과학교실
^²단국대학교 의과대학 내과학교실
^³서울대학교 의과대학 내과학교실
^⁴순천향대학교 의과대학 소화기연구소
^⁵부산대학교 의과대학 내과학교실
^⁶전남대학교 의과대학 내과학교실
^⁷성균관대학교 의과대학 내과학교실
^⁸울산대학교 의과대학 소화기내과학교실
^⁹계명대학교 의과대학 내과학교실
^¹⁰원광대학교 의과대학 내과학교실 및 소화기질환 연구소

Correspondence:
Jeong Eun Shin, Tel: +82-41-556-3052, Fax: +82-41-556-3256, Email: dreun@dankook.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The treatment for constipation should be individualized and dependent on the cause, coexisting morbidities, and patient’s cognitive status. Although most cases of constipation respond to conservative treatment, including dietary and life-style changes, or mild laxatives, some patients still complain of consistent symptoms and need an assessment of defecatory dysfunction. There is insufficient evidence to support the use of enemas in chronic constipation, although many clinicians and patients find them useful and effective for the treatment of fecal impaction when used with other modalities. In addition, suppositories can be considered as an initial trial for the treatment of defecatory dysfunction, since they help to initiate or facilitate rectal evacuation. The routine use of enemas is typically discouraged, especially sodium phosphate enemas, although tap-water enemas seem safe for more regular use. Soapsuds enemas are not recommended due to possible rectal mucosal damage.

Key Words: Constipation; Enema; Suppository