Enemas

Bisacodyl (9) is a contact laxative that may be given orally or rectaHy. It is often used for evacuation of the bowel prior to surgery or diagnostic examination. It may obviate the need for a cleansing enema. 

ASA appears to be the active component of sulfasalazine without the sulfa component, and is free of the serious side effects seen with sulfasalazine. It is used orally, in a delay-release formulation, as a retention enema, and as a suppository. It is well tolerated in most patients. 

Rectum. Local treatment of conditions and diseases of the rectum, including hemorrhoids and local inflammation, usually involves dmg-containing suppositories or enemas. 

Klystier, n. (Med.) enema, clyster, k.M., abbrev. (kommenden Monats) of the coming month, of next month,... 

The therapeutic utility of systemically administered ASON had been limited by their short plasma half life (sometimes even less than 3 min). This is due to their sensitivity to nuclease digestion. When the first-generation ASON were chemically modified, e.g., by replacing the oxygen in the phosphodiester bond with sulfur (phosphorothiorate) they obtained an increased stability in biological fluids while their antisense effect has been maintained. First-generation agents can be delivered via intravitreal injection, parenterally, by topical cream, enema, and inhaled aerosol. These antisense... 

CONSTIPATION The nurse checks the bowel elimination pattern daily because constipation can occur with repeated doses of a narcotic. The nurse keeps a daily record of bowel movements and informs the primary health care provider if constipation appears to be a problem. Most patients should begin taking a stool softener or laxative with the initial dose of a narcotic analgesic. Many patients need to continue taking a laxative as long as the narcotic analgesic is taken. If the patient is constipated despite the use of a stool softener, the primary health care provider may prescribe an enema or another means of relieving constipation. 

Humans Hydrogen peroxide has been used as an enema or as a cleaning agent for endoscopes and may cause mucosal damage when applied to the surface of the gut wall. Hydrogen peroxide enteritis can mimic an acute ulcerative, ischaemic or pseudomembranous colitis, and ranges from a reversible, clinically inapparent process to an acute, toxic fulminant colitis associated with perforation and death (Bilotta and Waye, 1989). It is conceivable that anecdotal reports of exacerbation of IBD by iron supplementation (Kawai et al. 1992) are mediated by hydroxyl radical production by the Fenton reaction. 

Sodium polystyrene sulfonate 15-60 g in 20% sorbitol suspension enterally. As an enema, prepare 50 g in 70% sorbitol plus 100 mL tap water. This solution should be retained for 30-60 min... 

Magnesium administration (IV, enteral, and enemas) ° Milk-alkali syndrome... 

Example, sodium-rich medications, sodium bicarbonate, hypertonic IV fluids, nutrition, enemas, dialysis, plasma products (sodium citrate content)... 

Treatment of distal intestinal obstruction syndrome (DIOS) consists of oral or nasogastric administration of polyethylene glycol electrolyte (PEG) solutions. Enemas may also be used to facilitate stool clearance. IV fluids are often required to correct dehydration due to vomiting or decreased oral intake. Re-evaluation of enzyme compliance and dosing is essential to prevent further episodes. Patients with recurrent symptoms may require daily PEG administration (Miralax ).5 Severe presentations of DIOS or initial meconium ileus may require surgical resection. 

Mesalamine Rowasa Enema 4 g/60 mL 4g Distal left colon and rectum... 

Treatment of acute episodes of ulcerative colitis is dictated by the severity and extent of disease, and first-line therapy of mild to moderate disease involves oral or topical aminosalicylate derivatives. Topical suppositories and enemas are preferred for active distal UC (left-sided disease and proctitis), as they deliver mesalamine directly to the site of inflammation. Topical mesalamine is superior to both topical corticosteroids and oral aminosalicylates for inducing remission in active mild to moderate UC.1,33,34 Enemas are appropriate for patients with... 

Left-sided disease Mesalamine enema 1 g rectally daily, or Mesalamine 2.4-4.8 g/day or sulfasalazine 4-6 g/day orally May reduce enema frequency to 1 g every other day, or Taper to mesalamine 1.6-2.4 g/day or sulfasalazine 2-4 g/day orally... 

Maintenance of remission of ulcerative colitis may be achieved with oral or topical aminosalicylates. Mesalamine suppositories 1 g daily may prevent relapse in up to 90% of patients with proctitis.1 Mesalamine enemas are appropriate for left-sided disease and may often be dosed three times weekly. Oral mesalamine at lower doses (e.g., 1.6 g per day) may be combined with topical therapies to maintain remission. Topical or oral corticosteroids are not effective for maintaining remission of distal UC and should be avoided. 

Barium enema, sigmoidoscopy, or colonoscopy maybe indicated in the presence of red flag symptoms (fever, weight loss, bleeding, and anemia, which maybe accompanied by persistent severe pain), which often point to a potentially serious non-IBS problem. A barium enema may identify polyps, diverticulosis,... 

It is critically important to recognize that the treatments of hyperkalemia discussed thus far are transient, temporizing measures. They are intended to provide time to institute definitive therapy aimed at removing excess potassium from the body. Agents that increase potassium excretion from the body include sodium polystyrene sulfonate, loop diuretics, and hemodialysis or hemofiltration (used only in patients with renal failure). Sodium polystyrene sulfonate (Kayexalate , various manufacturers) can be given orally, via NG tube, or as a rectal retention enema and is dosed at 15 to 60 grams in four divided doses per day. 

Bowel symptoms in MS patients can include both fecal incontinence and constipation. Fecal incontinence is difficult to treat. Some patients may have improvement if they use a regular schedule for emptying the bowel with laxative suppositories or enemas. Alternatively, antidiarrheal medications such as loperamide can be used.14... 

In circumstances where oral therapy cannot be given, intravenous metronidazole (500 mg every 6-8 hours), vancomycin retention enemas (500 mg every 4-8 hours), or vancomycin via colonic catheter should be considered.38 Antiperistaltic agents should not be given because the use of these agents is associated with the development of toxic megacolon. 

One of the following after age 50 Sigmoidoscopy every 5 years Colonoscopy every 10 years Barium enema every 5-10 years... 

ALFT Abnormal liver function test BE Barium enema... 

Barium enema A diagnostic test using x-ray examination to view the lower gastrointestinal tract (colon and rectum) after oral ingestion of barium sulfate, a chalky liquid contrast medium. 

Rapid transit through this region suggests that the area is empty of colonic contents most of the time, and so the opportunity for topical treatment is consequently limited. If the exposure to a drug such as mesalazine is calculated on the basis of these data, the results show that treatment is probably inadequate. For example, the dose per day is approximately 3 g (800-1200 mg, t.d.s.), and so in active disease the effective dose would be about 300 mg on the basis of this regimen. Doses of 500-1000 mg are often given as a enema, but these doses are more effectively delivered and not sequestered within a viscous, partially dehydrated stool, as would be the case following oral administration. 

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