Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 523

The use of enemas in the treatment of constipation is typically limited to the acute situation and institutionalized patients to help with rectal evacuation and prevent faecal impaction. There is no medical evidence to support the routine use of phosphate enemas in the treatment of constipation.⁶⁶ The use of phosphate enemas is well described to cause serious hyperphosphatemia, especially in patients with renal insufficiency.⁶⁷ Any enema must be used with caution owing to the risk of colonic perforation.⁶⁸ Soap suds enemas should not be used. Small‐volume tap water enemas may be helpful in emptying the rectum. Larger‐volume tap water enemas may be used on occasion, but even these can result in hyponatraemia.⁶⁹ Although generally considered beneficial, there is currently no trial evidence evaluating the use of arachis oil enemas. Retention enemas containing arachis oil both lubricate and soften impacted faeces and are routinely given at night. The patient’s allergy status must be checked as they contain nut oils.