Three case reports of glutaraldehyde-induced chemical colitis.

Currently, chemical colitis in clinical practice is mainly caused by iatrogenic factors. The disinfectant glutaraldehyde is one of the common drugs that can cause chemical colitis, but there are few reports about it. From August 2019 to August 2022, 1457 cases of colonoscopy were performed in the endoscopy room of the Second Affiliated Hospital of Zhejiang University School of Medicine and Songyang County People's Hospital, and 3 cases of chemical colitis caused by glutaraldehyde residue are discussed in this report. All 3 cases occurred on the same endoscopic system and same day. These 3 patients were hospitalized and treated with bowel rest, hydration, peroral Kangfuxin solution, dexamethasone combined with Kangfuxin solution local enema treatment, and empiric antibiotic. In conclusion, standardized management of cleaning and disinfection should be strengthened in departments carrying out enteroscopy, especially those using the concentrated glutaraldehyde immersion solution and cleaning after immersion, to prevent the occurrence of acute chemical enteritis related to disinfectant.

Hydrogen Peroxide Colitis: The Accidental Enema.

Description Chemical colitis is defined as inflammation of the large intestine or colon as a result of exposure from a harsh chemical through an enema or other procedure. In this case, the chemical is hydrogen peroxide, which is commonly used as an antiseptic for minor abrasions. Hydrogen peroxide enemas were once popular for difficult to treat constipation. However, resultant colitis and proctitis limited its use. When administered rectally in a high enough concentration, intense abdominal pain and transient bloody diarrhea can occur, with the majority of affected patients making a full recovery with supportive management. Here we discuss a case of an accidental low concentration hydrogen peroxide enema in an otherwise healthy young adult that emphasized the dangers of hydrogen peroxide damage to mucosal membranes.

Chemical Colitis Induced by Low-dose Hydrogen Peroxide Enema in a Cocaine User.

Home remedies are usually cheap options to alleviate conditions commonly used prior to patients seeking medical advice for their problems, and are sometimes the only option for some populations that have otherwise no healthcare access. Hydrogen peroxide enemas appear to be an easily accessible solution to constipation, with "how to guides" found ubiquitously on the Internet. To our knowledge there are a few case reports exposing its complications. Our case reports complications in a patient who used a lower than average dose of a hydrogen peroxide enema, albeit compounded by cocaine abuse. Our experience suggests that the risks of concurrent use of cocaine and hydrogen peroxide enemas can lead to dangerous vasoconstriction, decreased blood flood to the bowel mucosa, and might lead to significant complications to otherwise tolerable doses of corrosive agents.

Chemical colitis caused by hydrogen peroxide vaginal douche: A case report.

BACKGROUND: Hydrogen peroxide is one of the most common household disinfectants worldwide. Hydrogen peroxide has been documented as a rare cause of chemical colitis. CASE SUMMARY: We present a case of 31 years old lady who presented to our hospital with rectal bleeding and abdominal pain after using hydrogen peroxide vaginal douche as an enema. She underwent colonoscopy which showed findings suggestive of chemical colitis and was managed conservatively. Hydrogen peroxide can induce chemical injury in the colon. Clinical presentation and endoscopic findings of chemical colitis are nonspecific. History taking is an important tool in identifying the underlying etiology. Review of literature showed few case reports, mostly were managed with oral antibiotics and conservative approach. CONCLUSION: Chemical colitis is usually managed conservatively. Complications including perforation, stricture and peritonitis may happen and need aggressive treatment accordingly.

Hydrogen Peroxide Enema-induced Proctitis in a Young Female: A Case Report.

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.

A Case of Hydrogen Peroxide Induced Proctocolitis / 대한소화기내시경학회지

Hydrogen peroxide is commonly used for cleansing superficial wounds because of its antimicrobial action attributed to oxidizing capacity. In the past, hydrogen peroxide was used for the management of meconium ileus and fecal impaction because liberated oxygen tend to break up impaction and initiate peristaltic reflux. During 1980s, hydrogen peroxide was also introduced for disinfection of endoscope but this stronger solution has a caustic action. Several authors reported hydrogen peroxide induced colitis. We report a case of hydrogen peroxide induced chemical colitis in a 28-year-old man who complained bloody stools and lower abdominal pain after introducing hydrogen peroxide solution into the rectum to relieve rectal bleeding. His symptoms were improved with conservative treatment.

A Case of Hydrogen Peroxide Induced Colitis / 대한소화기내시경학회지

Hydrogen peroxide has been used for various medical purposes and also recommended in the disinfection process for endoscopes. However, hydrogen peroxide as a cause of chemical colitis or disinfectant colitis has been infrequently reported. The endoscopic findings of hydrogen peroxide induced colitis revealed pseudomembranous-like enteritis such as white plaques, erythema, foamy liquid, patchy, granularity, and ulcerations, resulting from effervescence caused by the release of oxygen from the breakdown of hydrogen peroxide. A 36 year-old single male, who had 30 ml of 3% hydrogen peroxide inserted into his anus the day before due to sexual reasons, was hospitalized as a result of suffering from hematochezia, tenesmus, and lower abdominal pain. Colonoscopy revealed discrete or confluent white plaques adherent to the colonic mucosa, severe erythema on the surrounding mucosa, patchy granularity, and scattered ulcerations up to 28 cm from the anal verge. Pathologic finding revealed inflammatory cells infiltration, variable sized vacuoles, vascular congestion, hemorrhage, fibrin deposition and ulcerations with regenerating epithelium in the lamina propria, consistent with acute mucosal injury caused by hydrogen peroxide. A case of hydrogen peroxide induced colitis is herein reported.

A Case of Hydrogen Peroxide Enema Induced Chemical Colitis

Hydrogen peroxide solution is commonly used for irrigating and cleaning wounds. When it is applied to tissues, catalase causes its rapid molecular degeneration with the release of oxygen bubbles. We present case report illustrating two hazards ; chemical colitis and oxygen embolus. A 29-year-old previously healthy woman presented to the bloody diarrhea and anal pain after hydrogen peroxide enema. In the colonoscopic examination, severe mucosal edema and ulceration with bleeding was noted from anus to sigmoid colon. With use of anal endosonography, multiple high level echo were noted in the internal and external anal sphincter of the upper anal canal. Microscopically, mononuclear cells were infiltrated in lamina propria and congestion. She had treatment with IV fluid, IV antibiotics and NPO. At 3rd hospital day, anal pain was disappeared. Bloody stool was disappeared next day. At 8th hospital day, mucosal edema and ulceration were disappeared on colonoscopic examination. Recovery was full and the patient was discharged at nine days after the episode.