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Is the cleansing enema a necessary ritual?

  • Giorgio Cittadini

Abstract

“Cleansing enemas are unglamorous and almost surely the most misunderstood and improperly performed procedure in clinical medicine”. These words by Miller [1] point out quite rightly how little attention was paid in the past to the scientific and pragmatic rationale on which this so frequent and important clinical act is based. In fact, when given by inexperienced personnel, five enemas are required on average for a thorough cleansing of the colon [2].

Keywords

Tannic Acid Barium Enema Double Contrast Water Enema Pragmatic Rationale 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Miller RE (1975) The cleansing enema. Radiology 117: 483–485PubMedGoogle Scholar
  2. 2.
    Barnes MR (1969) Clean colons without enemas. Am J Nurs 69: 2128PubMedGoogle Scholar
  3. 3.
    Lee SH, Bartram CI (1990) Determining the minimal interval between cleansing water enema and double-contrast barium enema examination. Clin Radiol 41: 331–332PubMedCrossRefGoogle Scholar
  4. 4.
    Pietila JA, Bondestam S, Hartel GJ et al (1990) The assessment of colonic water retention prior to double-contrast enema. Gastrointest Radiol 15: 164–168PubMedCrossRefGoogle Scholar
  5. 5.
    Bakran A, Bradley JA, Breshnihan E (1977) Whole gut irrigation: An inadequate preparation for double contrast barium enema examination. Gastroenterology 73: 28–30PubMedGoogle Scholar
  6. 6.
    Welin S, Welin G (1976) The double contrast examination of the colon. Experience with the Welin modification. Stuttgart: ThiemeGoogle Scholar
  7. 7.
    Murray L, Janower MD (1965) Tannic acid and the barium enema. Radiology 85: 887Google Scholar
  8. 8.
    Tinetti ME, Stone L, Cooney L et al (1989) Inadequate barium enemas in hospitalized elderly patients. Incidence and risk factors. Arch Intern Med 149: 2014–2016PubMedCrossRefGoogle Scholar
  9. 9.
    Gurwitz JH, Noonan JP, Sanchez M et al (1992) Barium enemas in the frail elderly. Am J Med 92: 41–44PubMedCrossRefGoogle Scholar
  10. 10.
    Plum F, Dunning MF (1957) Enema-induced potassium loss in patients with disease of the spinal cord and cauda equina. Am J Med Sci 233: 387–391PubMedCrossRefGoogle Scholar
  11. 11.
    Welin S, Welin G, Aberg T (1970) Klyxray: a new preparation for excessive emptying of the colon. Br J RadiolGoogle Scholar
  12. 12.
    Oliva L, Cittadini G (1981) Il clisma a doppio contrasto: problemi metodologici e tecnici. Verona: CortinaGoogle Scholar
  13. 13.
    Pietila JA, Kinnunen J, Linden H (1990) The cleansing enema: How many for a good quality double-contrast enema? Acta Radiol 31: 489–492PubMedGoogle Scholar
  14. 14.
    Rosengren JE, Aberg T (1975) Cleansing of the colon without enemas. Radiology 15: 421–426Google Scholar
  15. 15.
    De Lacey G, Benson M, Wilkins R et al (1982) Routine colonic lavage is unnecessary for double-contrast barium enema in outpatients. BMJ 284: 1021–1022PubMedCrossRefGoogle Scholar
  16. 16.
    Hageman MJHH, Goei R (1993) Cleansing enema prior to double-contrast barium enema examination: is it necessary? Radiology 187: 109–112PubMedGoogle Scholar
  17. 17.
    Chakraverty S, Hughes T, Keir MJ et al (1994) Preparation of the colon for double-contrast barium enema: Comparison of Picolax, Picolax with cleansing enema and Citramag (2 sachets)—A randomized prospective trial. Clin Radiol 49: 566–569PubMedCrossRefGoogle Scholar
  18. 18.
    Lee JR, Ferrando JR (1984) Variables in the preparation of the large intestine for double contrast barium enema examination. Gut 25: 69–72PubMedCrossRefGoogle Scholar
  19. 19.
    Mahieu PHG (1989) Compared evaluation of a new cleansing method of the colon before double contrast barium enema: Routine colonic lavage is no longer required. J Belge Radiol 72: 475–479PubMedGoogle Scholar
  20. 20.
    Irwin JP, Peterson GH (1982) Colon preparation for the barium enema: A guide for the radiologist. Gastrointest Radiol 7: 75–78PubMedCrossRefGoogle Scholar
  21. 21.
    Fork FT, Ekberg G, Nilsson G et al (1982) Colon cleansing regimens: A clinical study in 1200 patients. Gastrointest Radiol 7: 383–389PubMedCrossRefGoogle Scholar
  22. 22.
    Gelfand DW, Chen YM, Ott DJ (1988) Colonic cleansing for radiographic detection of neoplasia: Efficacy of the magnesium citrate-castor oil-cleansing enema regimen. AJR 151: 705–708PubMedGoogle Scholar
  23. 23.
    Gelfand DW, Chen YM, Ott DJ (1991) Preparing the colon for the barium enema examination. Radiology 178: 609–613PubMedGoogle Scholar
  24. 24.
    Thoeni RF, Margulis AR (1988) The state of radiographic technique in the examination of the colon: A survey in 1987. Radiology 167: 7–12PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1998

Authors and Affiliations

  • Giorgio Cittadini
    • 1
  1. 1.Department of RadiologyUniversity of Genoa School of Medicine San Martino HospitalGenoaItaly

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