From the Guidelines
Fleet enemas are contraindicated in patients with certain conditions, including suspected bowel obstruction, acute abdominal pain of unknown cause, inflammatory bowel conditions, recent colorectal or gynaecological surgery, and severe colitis or infection of the abdomen, as stated in the guidelines by 1. The use of enemas, such as Fleet enemas, involves risks of perforation of the intestinal wall, rectal mucosal damage, and bacteraemia, as noted in the study by 1. Some key contraindications for enemas include:
- Neutropaenia or thrombocytopaenia
- Paralytic ileus or intestinal obstruction
- Recent colorectal or gynaecological surgery
- Recent anal or rectal trauma
- Severe colitis, inflammation, or infection of the abdomen
- Toxic megacolon
- Undiagnosed abdominal pain
- Recent radiotherapy to the pelvic area, as outlined in the guidelines by 1. It is essential to consider these contraindications to prevent potential complications and ensure safe treatment of constipation. In patients with these conditions, alternative methods for managing constipation, such as glycerin suppositories, mineral oil enemas, or oral laxatives, may be safer options, depending on the specific situation, as suggested by the study by 1.
From the Research
Contraindications for Fleet Enema
The following are contraindications for Fleet enema:
- Older age 2, 3, 4
- Bowel obstruction 2, 5
- Small intestinal disorders 2
- Poor gut motility 2
- Renal disease 2, 4
- Gastrointestinal and/or renal abnormalities in children 6
- Suspected small-bowel obstruction, except when barium enema is used to localize obstruction in the colon rather than small bowel 5
- Large-bowel obstruction with perforation or cecum measuring 10 cm or larger in diameter 5
Special Considerations
Fleet enema should be administered with caution in high-risk patients, and alternative enema preparations such as simple tap water or saline solution enemas may be recommended to prevent fatal complications 2, 3, 4. Guidelines for the safe and effective use of hypertonic sodium phosphate enema solutions, such as Fleet enema, should be established and followed 3, 6.