Abstract
Background
Children presenting to pediatric emergency departments (EDs) are frequently given
enemas for relief of constipation symptoms; there is very little literature guiding
solution selection.
Objective
Our aim was to assess and compare the efficacy of the various enema solutions used
in a pediatric ED, including the “pink lady,” a previously unreported compounded combination
of docusate, magnesium citrate, mineral oil, and sodium phosphate.
Methods
We identified all children who received any enema over a 5-year period in an urban,
quaternary care pediatric ED for inclusion in the study via electronic record review.
Physician investigators retrospectively reviewed routine visit documentation to confirm
the type and dosage of enema and assess comorbidities, indications, efficacy, and
side effects. Subjective descriptions of output were classified as none, small, medium,
or large by reviewer consensus.
Results
There were 768 records included. Median age was 6.2 years (interquartile range 3.3–10.3 years).
Solutions used were sodium phosphate (n = 396), pink lady (n = 198), soap suds (n = 160),
and other (n = 14). There was no significant difference in output by solution type
(p = 0.88). Volume delivered was highest for pink lady, with no significant association
between volume delivered and output (p = 0.48). Four percent of patients had side effects. Soap suds had a significantly
higher rate of side effects (10.6%; p = 0.0003), primarily abdominal pain.
Conclusions
There was no significant difference in reported stool output produced by sodium phosphate,
soap suds, and pink lady enemas in children treated in an ED. Further study via randomized
controlled trials would be beneficial in guiding selection of enema solution.
Keywords
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Article info
Publication history
Published online: October 05, 2019
Accepted:
July 11,
2019
Received in revised form:
July 3,
2019
Received:
February 11,
2019
Footnotes
Ms. Zhang's and Mr. Lunos' work was supported in part by grant number UL1TR000114 from the National Center for Advancing Translational Sciences, United States of the National Institutes of Health, United States.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
