The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Local Management of Constipation: Enemas, Suppositories

변비의 국소 치료: 관장과 좌약

  • Kim, Seong-Eun (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Shin, Jeong Eun (Department of Internal Medicine, Dankook University College of Medicine) ;
  • Hong, Kyoung Sup (Department of Internal Medicine,Seoul National University College of Medicine) ;
  • Lee, Tae Hee (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Lee, Bong Eun (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Park, Seon-Young (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Hong, Sung Noh (Department of Internal Medicine, Sungkyunkwan University School of Medicine) ;
  • Jung, Kee Wook (Department of Gastroenterology, University of Ulsan College of Medicine) ;
  • Park, Kyung Sik (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Choi, Suck Chei (Department of Internal Medicine and Digestive Disease Research Institute, Wonkwang University School of Medicine)
  • 김성은 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 신정은 (단국대학교 의과대학 내과학교실) ;
  • 홍경섭 (서울대학교 의과대학 내과학교실) ;
  • 이태희 (순천향대학교 의과대학 소화기연구소) ;
  • 이봉은 (부산대학교 의과대학 내과학교실) ;
  • 박선영 (전남대학교 의과대학 내과학교실) ;
  • 홍성노 (성균관대학교 의과대학 내과학교실) ;
  • 정기욱 (울산대학교 의과대학 소화기내과학교실) ;
  • 박경식 (계명대학교 의과대학 내과학교실) ;
  • 최석채 (원광대학교 의과대학 내과학교실 및 소화기질환 연구소)
  • Published : 20150000
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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.

Keywords