Gastroenterology & Hepatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Gastroenterology Unit, Perugia General Hospital, Perugia, Italy.
Expert Rev Gastroenterol Hepatol. 2023 Jul-Dec;17(11):1081-1087. doi: 10.1080/17474124.2023.2267968. Epub 2023 Nov 23.
Chronic constipation is a frequent symptom encountered in the daily clinical practice. The treatment of this condition mainly relies on the use of laxatives. However, patients' satisfaction with this approach is limited, and alternative measures are often added to the treatment. Among these, particularly frequent worldwide is the use of enemas, even though literature data on its scientific validity are scarce.
In this article, by an extensive online search of Medline (through PubMed), Scopus, Cochrane CENTRAL, EMBASE, and the Science Citation Index, the available literature data on the use of enemas in adult patients with chronic constipation, also in the perspective of available guidelines on treatment of this pathological condition, were analyzed.
Although the use of enemas remains a frequently employed method and it is considered as useful by many physicians as an adjunctive support for the treatment of chronic constipation in adults, this practice is not substantiated by rigorous scientific data, and some studies are available only for specific instances (fecal impaction, transanal irrigation). Thus, waiting for more robust scientific data, enemas treatment should be carried out on an individual patient's basis, according to the experience of the caring physicians.
慢性便秘是日常临床实践中常见的症状。这种情况的治疗主要依赖于泻药。然而,患者对这种方法的满意度有限,通常会在治疗中加入其他替代措施。其中,灌肠在全世界范围内尤为常见,尽管关于其科学有效性的文献数据很少。
本文通过对 Medline(通过 PubMed)、Scopus、Cochrane CENTRAL、EMBASE 和科学引文索引进行广泛的在线搜索,分析了成人慢性便秘患者使用灌肠的现有文献数据,同时也从治疗这种病理状况的现有指南的角度进行了分析。
尽管灌肠仍然是一种常用的方法,并且许多医生认为它作为成人慢性便秘治疗的辅助手段很有用,但这种做法并没有得到严格的科学数据支持,一些研究仅适用于特定情况(粪便嵌塞、经肛门灌洗)。因此,在等待更有力的科学数据的同时,应根据护理医生的经验,根据个体患者的情况进行灌肠治疗。