| Theme |
Chronic Constipation : A New Classification, Pathophysiology, Diagnosis, Treatment |
| Title |
Enemas, Suppositories, Manual Fragmentation, Retrograde Continence Enema |
| Author |
Akira Mizuki |
Department of Internal Medicine, Keiyu Hospital |
| [ Summary ] |
As treatment of chronic constipation, enemas, suppositories, disimpaction and retrograde continence enema are all effective. We recommend using these modalities for patients with evacuation difficulty, a subgroup of functional constipation. Suppositories (glycerin or bisacodyl) are the first choice, since they liquify feces, thereby overcoming obstructive defecation. Use of enema and retrograde continence enema requires caution, as they complicate rectal perforation, and retention of "stopper" and others has been reported. In addition, modification of living habits for improving bowel movements is recommended. Long‒term use of suppositories and enemas requires caution because it causes side effects and addiction. We should gradually reduce or stop them after recovery of defecation rhythm is acknowledged. |