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Monday 24th October 2016

Enemas deadly in elderly patients

28th February 2012

Elderly patients given enemas containing sodium phosphate seem to get kidney failure and die in many cases, according to a recent Israeli study.


While such enemas are seen as a treatment for constipation, doctors should see them as a risky prospect.

Lead researcher Yaacov Ori, of the Rabin Medical Centre in Petah-Tikva, Israel, wrote that the enemas should only be used in low-risk patients.

Patients given the enema had bad health after only one day of treatment.

In addition to high blood phosphate levels, sypmtoms included low blood pressure, and low calcium levels.

Of the 11 patients studied, five died.

The six patients who survived phosphate enema treatment required hospitalisation in order to recover.

The ages of the study subjects ranged between 61 and 89 years.

In all study subjects, kidney failure directly followed using a sodium phosphate enema.

Theoretically, enemas help patients who are experiencing constipation by hydrating the overly dry stool lodged in their gut.

Most of the patients in the study required the enema to treat constipation, but one patient needed the enema in order to undergo a proctoscopy.

Most of the patients received the standard dose, at only 250 millilitres.

Ori said that sodium phosphate overwhelmed the systems of these patients, overloading the kidneys.

Markus Bitzer, a nephrologist at the University of Michigan, who was not involved in the study, said that kidneys played the role of eliminating excess salt from the body.

He said that, however, many elderly people suffered from chronic kidney disease and did not drink enough fluid, leading to a state of constant oversalinisation of the kidney system.

Concerns about sodium phosphate enemas first emerged nearly 20 years ago, but the ingredient is still in use and easy to procure.

Alternatives exist, but often people are not aware of the dangers of sodium phosphate enemas.

Bitzer said that, after prolonged oversalinisation such is as seen in elderly people, salt crystals would form in the kidneys and cause renal failure.

Ori said that patients should not use sodium phosphate enemas if they had any kidney problems, took anti-cholinergics, or had colitis.

He also said that, in younger patients, having undiagnosed kidney disease could made the enemas dangerous.

Bitzer said that constipation had a lot to do with diet, and that constipated people should make sure they drank enough fluid and got enough dietary fibre.


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