Background and Importance Constipation is a common complication during hospitalisation due to the presence of risk factors such as bed rest, diseases causing reduced bowel motility or administration of medications (opioids, anticholinergic drugs…). The standard therapy is laxative drugs. Murphy’s enema (ME) is used for the treatment of constipation and faecal impaction when patients do not respond to laxatives. It consist of administering an evacuating solution (milk 300 mL, liquid vaseline 100 mL, oxygenated water 200 mL and saline solution 500 mL) through a rectal probe during 6 hours (53 drops/min), leading to a softening of the stool and osmotic evacuation. Although this is a common clinical practice in our hospital, we have not found any published study evaluating its effectiveness and safety.
Aim and Objectives To assess the effectiveness and safety of ME for the treatment of constipation and faecal impaction.
Material and Methods We performed a descriptive, retrospective study of effectiveness and safety of the administration of ME in patients with admitted in a tertiary hospital. We included patients who received ME from June-2020 to August-2022. We registered data of comorbidities, defecation achievement and adverse events related to the administration. Data were obtained from the electronic prescription program and the electronic health records.
Results We included 33 patients, 18 women and 15 men, with a mean age of 76 years. Two patients were readmitted, therefore a total of 37 ME were administrated. The most frequent comorbidities were hypertension (40,5%), chronic constipation (33,3%), diabetes mellitus II (21,2%), heart failure (18,1%), atrial fibrillation (18,1%), dyslipidemia (12,1%), cognitive impairment (12,1%) and kidney failure (12,1%). The indication of ME was constipation (67,5%), faecal impaction (27,2%) and paralytic ileum (5,4%). ME was effective in the 64,8% of cases, with defecation achievement after administration. ME was overall well tolerated; one case of hypotension, one of nausea and one of abdominal pain were registered.
Conclusion and Relevance ME constitutes a safe and effective alternative for patients with constipation and faecal impaction not responding to the usual therapies. Furthermore, there is no published evidence regarding this practice, so this study may constitute a starting point for the development of further studies with larger sample sizes.
Conflict of Interest No conflict of interest
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