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CC BY-NC-ND 4.0 · Journal of Coloproctology 2023; 43(01): 001-006
DOI: 10.1055/s-0043-1764192
Original Article

Colonoscopic Laxative Instillation for the Fecal-loaded Colon: A Case Series[*]

Suhas D. Wagle 
1   Head GI unit, Department of Medicine, King Edward Memorial Hospital, Pune, Maharashtra, India
,
Aneeta S. Wagle
2   Department of Radiology, King Edward Memorial Hospital, Pune, Maharashtra, India
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Abstract

Context Postoperative, critically ill, and elderly patients often have fecal loading or impaction. In a few such patients, disimpaction of fecalomas and colon cleansing are difficult. Bowel obstruction, megacolon, lower gastrointestinal bleeding, and gut perforation are complications that may ensue. Oral laxatives or enemas may only be partially effective. Surgical intervention may be needed for salvage or to treat complications.

Series and Design Fourteen hospitalized cases with defecation disorder due to fecal loading of the colon were enrolled for retrospective analysis. Colonoscopic instillation of mannitol and/or lactulose was undertaken as an intervention when the use of oral laxatives was either ineffective or unfeasible, and enema had yielded poor results.

Results Ten patients had satisfactory outcomes for fecal clearance, whereas four patients with poor or incomplete responses underwent repeat interventions or surgery. No significant complications were encountered due to this therapy.

Conclusion Colonoscopic instillation of mannitol or lactulose in fecal-loaded critically ill patients results in a safe and satisfactory fecal clearance.

Keywords

obstipation - impaction - fecaloma - megacolon - volvulus

Ethical Statement

We undertook this retrospective study after formal approval by the KEM Hospital Research Centre Ethics Committee. All information provided herein is original, and there is no reproduction of data, figures, tables, or text from other authors. The 14 patients/close relatives gave informed verbal consent to publish their data. The privacy of patients is preserved, and their name or identity has not been revealed.


Author Contributions

S. D. W.: Endoscopy procedures, data retrieval, data study, literature review and references, and manuscript drafting and finalization.


A. S. W.: X-ray evaluations and reviews, data retrieval, data study, literature review and references, and manuscript finalization.


Source of Funding

None.


* This article has been previously published as preprint on Research Square. Available at: https://assets.researchsquare.com/files/rs-1916216/v1/cbbf8cb9-d953-4ba2-8d54-685ee14f4c30.pdf?c=1666856669.




Publikationsverlauf

Eingereicht: 24. November 2022

Angenommen: 23. Januar 2023

Artikel online veröffentlicht:
22. März 2023

© 2023. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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