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Hydrogen Peroxide Enema-induced Proctitis in a Young Female: A Case Report
Bayarmaa Mandzhieva1, Muzammil Khan2, Mamoon Ur Rashid1
1Internal Medicine, AdventHealth, Orlando, USA.
Insights
Hydrogen peroxide enemas can cause severe rectal inflammation and ulceration. This case highlights the dangers of using hydrogen peroxide for constipation, leading to proctitis.
Area of Science:
- Gastroenterology
- Toxicology
Background:
- Hydrogen peroxide is a disinfectant with oxidizing properties.
- Historically, it was used to treat meconium ileus due to its effect on peristalsis.
Observation:
- A patient used a hydrogen peroxide enema for constipation, experiencing initial relief followed by rectal burning.
- Colonoscopy revealed severe proctitis with ulceration, erythema, edema, and hemorrhage.
Findings:
- Hydrogen peroxide enema caused significant rectal mucosal damage (proctitis).
- Symptoms resolved with mesalamine treatment.
Implications:
- This case underscores the risks associated with non-medical use of hydrogen peroxide as an enema.
- Medical professionals should be aware of potential hydrogen peroxide toxicity in the lower gastrointestinal tract.
Abstract:
Hydrogen peroxide is a disinfectant commonly used for cleansing superficial wounds due to its oxidizing capacity. In the past, it has also been used for the management of meconium ileus in children as the oxidizing action of hydrogen peroxide potentiates peristalsis that relieves ileus or fecal impaction. The potential dangers were unknown till Pumphrey, in 1951, described the harmful effects of its use as an enema. We present a case of a 32-year-old female who was admitted for complaints of perianal pain. She used an enema, consisting of water and hydrogen peroxide, for constipation. It improved her symptoms but subsequently, she developed a burning sensation in her rectum. The patient had a colonoscopy which revealed severe proctitis up to 15 cm from the anal verge manifested by superficial mucosal ulceration, marked erythema, and edema with friable mucosa and hemorrhage. The patient was subsequently given mesalamine, and the symptoms resolved.
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