Colonic washout enemas for persistent constipation in children with recurrent urinary tract infections based on...

Area of Science:

• Pediatric Gastroenterology
• Urology
• Colorectal Surgery

Background:

• Dysfunctional voiding in children often coexists with persistent constipation and rectal dilatation.
• Standard oral laxative therapies may be insufficient for managing severe constipation in this population.

Purpose of the Study:

• To evaluate the efficacy and safety of colonic washout enemas for children with persistent constipation and dysfunctional voiding.
• To assess the impact of washout enemas on rectal diameter and associated symptoms.

Main Methods:

• Fifty children with dysfunctional voiding and rectal dilatation, unresponsive to oral laxatives, received colonic washout enemas.
• Treatment involved retrograde rectal filling with water (20 mL/kg), initially daily, then 3 times weekly for 6-12 months.
• Rectal diameter was assessed via ultrasound, and symptom relief was monitored over a 6-month follow-up period.

Main Results:

• Thirty children achieved resolution of urinary tract infections, and 20 experienced partial symptom relief.
• All patients demonstrated normalized rectal diameter on ultrasound post-treatment.
• Washout therapy was successfully discontinued in 33 patients; 17 required intermittent enemas for relapse prevention. Minimal pain was reported, with no significant adverse effects.

Conclusions:

• Colonic washout enemas represent a successful therapeutic option for children with dysfunctional voiding and constipation refractory to oral laxatives.
• The treatment normalizes rectal diameter and can lead to sustained symptom improvement, potentially reducing the need for long-term laxative use.