Uses of mineral oil

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Fleet Mineral Oil Enema (rectal)

Generic Name: mineral oil (rectal) (MIN er al OYL)
Brand Name: Fleet Mineral Oil Enema, Leader Mineral Oil Enema

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What is Fleet Mineral Oil Enema?

Fleet Mineral Oil Enema is a lubricant laxative that works by coating the waste matter inside your intestines to help seal in water. When too much water seeps out of your stools they can become hard and cause constipation.

Fleet Mineral Oil Enema rectal (applied in the rectum) is used to treat constipation.

Fleet Mineral Oil Enema is sometimes used to remove barium residue from your colon after you have undergone a CT scan or other radiologic (x-ray) examination of your intestines.

Fleet Mineral Oil Enema may also be used for purposes not listed in this medication guide.

Important Information

People with eating disorders (such as anorexia or bulimia) should not use this medication without the advice of a doctor.

Ask a doctor or pharmacist if it is safe for you to use Fleet Fleet Mineral Oil Enema Enema if you have severe stomach pain, nausea or vomiting, a bowel obstruction or severe constipation, a sudden change in bowel habits lasting 2 weeks or longer, or if you have used any other laxative within the past 7 days.

Do not give this medicine to a child younger than 2 years old.

If you do not get any results after using Fleet Mineral Oil Enema, call your doctor before using another dose.

Do not use more than 1 Fleet Mineral Oil Enema enema in a 24-hour period. Do not use Fleet Mineral Oil Enema for longer than 1 week without your doctor’s advice.

Before taking this medicine

People with eating disorders (such as anorexia or bulimia) should not use this medication without the advice of a doctor.

Ask a doctor or pharmacist if it is safe for you to use this medicine if you have:

  • severe stomach pain;

  • nausea, or vomiting;

  • a bowel obstruction or severe constipation;

  • a sudden change in bowel habits lasting 2 weeks or longer; or

  • if you have used any other laxative within the past 7 days.

It is not known whether Fleet Mineral Oil Enema will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether mineral oil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to a child younger than 2 years old.

How should I use Fleet Mineral Oil Enema?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Do not take the rectal enema by mouth. It is for use only in your rectum.

To use the enema, lie down on your left side with your knees bent. If someone else is giving you the enema, you may kneel down and then lower your head to the floor. Stay resting on the side of your face while the enema is given.

Remove the cap from the applicator tip and gently insert the tip into your rectum. Slowly squeeze the bottle to empty the contents into the rectum. Do not force the liquid into the rectum.

The Fleet Mineral Oil Enema enema should produce a bowel movement within 2 to 15 minutes after use.

For best results, stay lying down until you feel the urge to have a bowel movement. Do not hold in the enema for longer than 15 minutes.

If you do not get any results after using Fleet Mineral Oil Enema, call your doctor before using another dose. Do not use more than 1 Fleet Mineral Oil Enema enema in a 24-hour period.

Each single use bottle of Fleet Fleet Mineral Oil Enema Enema is for one use only. Throw away after one use, even if there is still some medicine left in it after using the enema.

Do not use Fleet Mineral Oil Enema for longer than 1 week unless your doctor has told you to.

Store at room temperature away from moisture, heat, and light. Do not freeze.

What happens if I miss a dose?

Since Fleet Fleet Mineral Oil Enema Enema is used as needed, you will not be on a frequent dosing schedule. Do not use a Fleet Mineral Oil Enema enema more than one time in a 24-hour period.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Fleet Mineral Oil Enema?

Do not use other laxatives while using this medication, unless your doctor has told you to.

Fleet Mineral Oil Enema side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Fleet Mineral Oil Enema and call your doctor at once if you have a serious side effect such as:

  • rectal bleeding;

  • no bowel movement after use;

  • blood in your stools; or

  • severe and worsening stomach pain, cramping, or bloating.

Less serious side effects may include:

  • bloating, gas;

  • mild diarrhea; or

  • stomach cramps.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Fleet Mineral Oil Enema?

There may be other drugs that can interact with Fleet Mineral Oil Enema. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 1.02.

Medical Disclaimer

More about Fleet Mineral Oil Enema (mineral oil)

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  • Constipation

Mineral Oil rectal enema

What is this medicine?

MINERAL OIL (MIN-ah-rel OIL) is a laxative. This medicine is used to relieve occasional constipation or stool impaction.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

  • abdominal pain

  • blood in your stool (black or tarry stools) or if you have blood in your vomit

  • stomach or intestinal problems

  • an unusual or allergic reaction to mineral oil, other medicines, foods, dyes, or preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

How should I use this medicine?

This medicine is for rectal use only. Do not take by mouth. Follow the directions on the label. Wash your hands before and after use. Remove tip from enema. Gently insert enema tip into the rectum as directed. Squeeze the enema until the prescribed dose has been given. Gently remove enema tip from the rectum. Throw away any leftover medicine in the enema; do not reuse. Do not use more often than directed. Do not use for longer than 1 week without advice of your health care professional.

Talk to your pediatrician regarding the use of this medicine in children. While this medicine may be used in young children, they do not receive the full enema dose and precautions do apply. Use only if advised by your pediatrician.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.

What may interact with this medicine?

  • docusate

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Tell your doctor or health care professional if your symptoms do not start to get better or get worse. Do not use this medicine for longer than directed by your doctor or health care professional. This medicine can be habit-forming. Long-term use can make your body depend on the laxative for regular bowel movements, damage the bowel, cause malnutrition, and problems with the amounts of water and salts in your body. If your constipation keeps returning, check with your doctor or health care professional.

Drink fluids as directed to prevent dehydration and to assist stool passage.

If stools become loose or you have diarrhea, discontinue use and consult your doctor or health care professional for advice, if necessary.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

  • diarrhea that is severe

  • difficulty breathing or shortness of breath

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • leakage of oil from rectum or rectal skin irritation

  • loose stools

  • lower stomach discomfort or cramps

  • nausea

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

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Mineral Oil

Mineral oil is a very refined, clear liquid distilled from petroleum.

It’s available over-the-counter (OTC) to treat a variety of ailments, including constipation, minor skin irritations, scalp conditions, ear-wax buildup, and others.

A liquid form of mineral oil is taken by mouth, applied to the skin or scalp, and used in the ears. For enemas, you should use mineral oil made specifically for that purpose.

It can be used alone or mixed with other oils, depending on what you are using it for.

Mineral oil is also a common ingredient in many creams, baby lotions, ointments, and cosmetics.

Mineral Oil for Constipation

Mineral oil is commonly used as a laxative.

For this purpose, the oil can be taken by mouth or applied in the rectum in an enema, although there are different products for each.

Mineral oil works as a laxative in two ways: It helps your stool retain water, and it acts as a lubricant.

By coating the lining of your intestines, it stops your bowel from absorbing the water in your stool, which helps prevent your stool from hardening.

It also lubricates your intestines, helping hard and rough stool slide more easily.

It’s generally safer than other laxatives, which work either by stimulating your bowels or by creating conditions that induce your intestines to release water into your stool.

When taken by mouth, the remedy typically produces a bowel movement in six to eight hours. The enemas produce stool in 15 minutes or faster.

Mineral Oil for Skin and Hair

Mineral oil is also used to treat certain scalp conditions, including dandruff, cradle cap, or scalp psoriasis.

The oil may also be used to treat dry skin, diaper rash, or skin burns caused by radiation.

It helps moisturize and prevent evaporation of water from the surface of the skin.

Mineral Oil Warnings

You shouldn’t use mineral oil to relieve constipation without first talking to your doctor if you:

  • Are allergic to any of the ingredients in the product
  • Have a blockage in your intestines
  • Are bedridden
  • Have heart failure
  • Have kidney problems
  • Have appendicitis
  • Have difficulty swallowing
  • Have an eating disorder such as anorexia or bulimia
  • Have severe stomach pain, severe constipation, nausea, vomiting, or a bowel obstruction
  • Have had a sudden change in bowel habits that lasts two weeks or longer
  • Have used any other laxative within the past seven days

Children under 6 years old should not be treated with mineral oil for constipation.

You shouldn’t take more than one mineral oil enema in a 24-hour period.

Also, don’t use mineral oil for longer than a week without talking to your doctor. Using mineral oil for a long period of time may result in a loss of normal bowel function.

You should stop using mineral oil and tell your doctor if you experience rectal bleeding or if you don’t have a bowel movement after use.

Don’t take other laxatives or stool softeners while using mineral oil unless your doctor tells you to do so.

Pregnancy and Mineral Oil

If you are pregnant or plan to become pregnant, talk to your doctor about the risks and benefits of using mineral oil during pregnancy.

It’s not known whether the oil is secreted in breast milk. Ask your doctor before using this produce while breastfeeding.

You’re likely familiar with a colon cleanse, even if you’ve never done one. But did you know a salt water flush is a simple, safe and effective way to detox the body and cleanse the colon from the comfort of your own home? It’s true.

By drinking a beneficial mixture of real sea salt dissolved in water (sometimes along with a little lemon juice), you’re able to push waste through the body, release toxins and improve digestion.

Sound a bit crazy? This method of colon and stomach cleansing has actually been used for many years, and it appears to be a lot safer than many commercial colon-cleansing drugs, laxative teas or diuretics. Below, we explore why this is and how to perform a salt water flush.

What Is a Salt Water Flush?

A salt water flush, also sometimes referred to as a “salt water cleanse” or a “master cleanse,” is designed to help you cleanse your colon and digestive system by bringing on a forced bowel movement.

Salt itself is needed for many biochemical processes, including (but not limited to): adrenal gland/thyroid gland function, cell wall stability, muscle contractions, nutrient absorption, nerve stimulation, pH, and water balance regulation.

The official salt water flush has become more popular over the past decade as a “hack” to facilitate digestion and cleansing as part of a kick-start when doing a “master cleanse” program. The idea is that drinking a salt mixture ignites the body’s own mechanism of natural detoxification and waste elimination, helping to get your digestive system back on track and in the process making you feel lighter, less sluggish and less weighed-down.

Maybe you’re wondering if it’s really necessary to cleanse your colon and detox with salt. The fact is that for many people — especially those eating poor diets — toxins, heavy metals and waste build up in the colon over time due to insufficient and infrequent bowel movements. This leads to digestive issues and can contribute to inflammation, low energy and possibly even disease development.

Nearly 20 percent of the adult American population reports suffering from very frequent constipation. While taking an herbal laxative such as slippery elm from time-to-time can help to produce a bowel movement, a saltwater flush is a safe, simple and effective way to clear things out entirely now and then. (1)

Why Do a Salt Water Colon Cleanse?

While they’ve existed forever, salt water flushes have gained notoriety as more people have started to do “detoxes.” Not familiar with the master cleanse? The master cleanse (also called the “lemonade diet”) has been in the media over the past few years, since supposedly some celebrities turn to this “hack” to quickly lose weight for upcoming roles.

The master cleanse is a liquid-only juice fast, which means it’s extremely low in calories and also lacks any dietary fiber, which is necessary for healthy digestion. When you only consume liquids for a certain amount of time and don’t actually eat any foods with fiber — vegetables, fruit, nuts, seeds or beans, for example — you’re likely to have a lot of trouble going to the bathroom.

During the master cleanse, people have a daily detox drink — only a concoction of water, fresh lemon juice, maple syrup and cayenne pepper.

The result? For many people, this kind of juice fast can cause constipation, low energy and bloated stomach (not to mention other complications from consuming too little nutrients/calories). Fiber is partially responsible for igniting the process of peristalsis, which is the series of muscle contractions in our digestive tracts that allow us to poop — exactly the reason that people with low-fiber, highly processed diets often suffer from constipation.

Unfortunately, this is pretty much the opposite of what most people hope to accomplish when they sign up for a “detox.” This is where the salt water flush comes in. It basically forces your digestive system to release stored waste in the toxins, however little (or a lot) there might be.

Salt can also help clear up fluid retention, despite what most people think. Real sea salt (not the processed kind that’s stripped of minerals) helps you lose extra fluid weight by properly balancing out electrolyte/mineral levels in the body, releasing retained water your cells hold onto.

What Does Sea Salt Do to Your Body?

Sodium and salt often get a bad name, but real sea salt is loaded with dozens of minerals and is definitely part of a healthy diet. Keep in mind there’s a big difference between regular table salt, which is iodinated, and pure sea salt. The processed salts in sodium foods, especially in processed, packaged or fast foods, along with the sodium usually contribute too much salt to people’s diets and pose the most health risks (like high blood pressure).

It’s necessary and natural to have some real salt in your diet, so there’s nothing to worry about when it comes to ingesting some salt. Of course, if you did nothing but drink salt water, you would become extremely dehydrated. In fact, you would die because your kidneys and bladder would cause you to lose more water than you’re taking in. But as long as you do a sea salt flush or use pure sea salt in moderation along with an otherwise healthy diet, you shouldn’t suffer any negative consequences.

Salt water has many uses and benefits, including helping to ease sore throats, cleansing wounds, lowering pain in inflamed muscles (which is why salt is used in many detox bath recipes) and providing trace minerals (not to mention making your food taste better). A little known benefit of sea salt is that it affects muscle and nerves functions. It helps contract muscles in the digestive tract that push waste out through the colon. This forces out toxins that have been trapped inside your system and are contributing to sluggishness and constipation.

Real sea salt does have lots of sodium, but it’s balanced out with other minerals like magnesium, calcium, potassium and more than 60 other trace minerals. Salt activates enzymes needed for proper digestive processes and is required by the parietal cells of the stomach wall to make hydrochloric acid.

Salt also helps balance hormones, facilitates with metabolic processes and establishes an optimal pH level in the body. That’s because your stomach acid is naturally very acidic, but salt (sodium chloride) counteracts some of the effects of acids. Salt supports “hyperosmolarity” of extracellular fluids, which has positive effects on your metabolism because it helps with the breakdown of proteins and glucose. Plus, a diet that’s very low in salt causes more aldosterone to be synthesized, which can have effects like lowering potassium and magnesium levels in the body — the opposite of what most people need.

Is a Sea Salt Cleanse Dangerous?

It’s possible that salt water flushes can cause symptoms like nausea, vomiting or weakness in some people, but most of the time heavy metal detoxes and cleanses using salt water are safe. If you have a history of serious digestive issues or high blood pressure, you might want to talk to your doctor before doing a salt flush (not because real salt will raise blood pressure on its own, but just to be on the safe side).

While very low-calorie, juice-only detoxes like the master cleanse can be harmful in some situations and aren’t recommended for everybody, you can safely use the same practice of a sea salt flush if you suffer from occasional constipation but aren’t dieting. If you do a salt water flush as part of a juicing or cleansing program, make sure you pay attention to your body’s feedback and give yourself enough rest/nutrients in the process.

Many people safely use a warm salt water cleanse to help clear up problematic digestive issues like constipation, bloating and gas. And sea salt colon cleanse is much less likely to cause side effects that are common when using laxative teas or cleansing pills — like slowly forming a dependency on them or experiencing electrolyte imbalances, water retention afterward and having trouble eating normally.

Many detox programs, including the master cleanse, promote the use of both sea salt water flushes and also potentially dangerous laxative teas, without warning people about complications that can occur. If you have a hard time going to the bathroom for whatever reason, sea salt flushes are a much better option and more gentle on your system longterm. For example, the master cleanse’s own website states that “laxative tea is like a deep down purge scrubbing, digging into corners, where the salt water flush is more like power car wash blasting away surface grit and grime.”

When properly performing a sea salt flush, you use warm water and real sea salt that have been fully blended together, so your body easily absorbs the salt’s minerals. When it’s properly prepared you won’t see any granules of sea salt, just a cloudy mixture that’s uniform in terms of color and texture.

This is important because when the sea salt fully dissolves into the water it helps your digestive organs process the mixture most effectively and safely. Your kidneys won’t pull out the water and leave behind only salt, while high amounts of salt won’t end up in your bloodstream, which can raise blood pressure.

When it comes to safety, salt water flushes appear to be both safe and effective — working just as well as other types of “colon cleansing” products, even the kinds that are prescribed by doctors for patients prior to undergoing a colonoscopy.

Certain studies examining the effects of salt water on cleansing the digestive tract have found that oral sodium mixtures are well-tolerated and even more effective than certain colon-cleansing blends, such as Picoprep. One study done by the Department of Colorectal Surgery at Royal Melbourne Hospital in Australia found that salt mixtures seem to cause similar side effects as other colon cleansers (like cramps, some nausea, etc.), but 91 percent of people who used the oral sodium mixture reported that it worked and they would use it again. (2)

How to Cleanse Your Colon with a Salt Water Flush

The salt water flush is most effective if you perform it first thing in the morning on an empty stomach. If you do it later in the day, just make sure you haven’t eaten anything in the past one to two hours. Ideally, perform the flush before you eat breakfast, but be careful if you plan to leave the house or exercise in the morning — you’ll have a strong desire to go to the bathroom shortly after and might have a queasy stomach after the flush.

Give yourself enough time to use the bathroom several times after the flush before leaving the house, and keep in mind that you will likely want to shower afterward. Plan for most likely at least about a one-to-two-hour duration (possibly longer) from the time you drink the flush until you’ve completed emptying your bowels.

Some people recommend doing the flush around 7 a.m., but this depends when you wake up and what your schedule is like. The key here is to drink the mixture (check out my homemade salt water flush recipe, which only takes about five minutes to prepare) when there’s not much else in your system. This way you absorb the solution as much as possible and get the most “cleansing” effects.

How often should you perform a salt cleanse? You can do an initial period of several flushes in a row if you’d like — but not every day. Occasionally doing a salt flush can be a safe and therapeutic way to cleanse your system, but doing it too often will result in problems balancing electrolytes and side effects that can be dangerous (dehydration, dizziness, blood pressure changes, muscle weakness, fatigue, etc.). Every few weeks seems to be best, which gives your body enough time to recalibrate and repopulate your microbiome with good bacteria afterward. Check with your health care provider first if you have any health conditions or if you are taking medications.

Trouble-Shooting a Sea Salt Flush

Did you perform a salt colon cleanse and found that it didn’t work well for you? Here’s a few reasons that might be the case, plus how to perform a more effective flush next time:

  • Adjust when you perform the flush: Make sure your system is pretty empty and try doing it the morning if you didn’t the first time.
  • Adjust how much salt you used: If you use too much or too little salt, it might not work well or might cause side effects.
  • Make sure you use pure salt (not iodinated): It’s possible to use the wrong kind of salt without realizing, which will effect how it’s absorbed. Recheck that you use un-iodized organic sea salt. Look for pink Himalayan salt or grayish-colored Celtic sea salt, not the white type that is cheap and sold in most grocery stores.

Salt Water Flush Takeaways

  • By drinking a beneficial mixture of real sea salt dissolved in water, you’re able to push waste through the body, release toxins and improve digestion.
  • A salt water flush is designed to help you cleanse your colon and digestive system by bringing on a forced bowel movement.
  • Nearly 20 percent of the adult American population reports suffering from very frequent constipation.
  • The master cleanse is a liquid-only juice fast and can cause constipation.
  • A saltwater flush forces your digestive system to release stored waste in the toxins.
  • Real sea salt helps you lose extra fluid weight by properly balancing out electrolytes/minerals levels in the body.
  • Salt water has many uses and benefits, including helping to ease sore throats, cleansing wounds, lowering pain in inflamed muscles and providing trace minerals.
  • Salt helps balance hormones, facilitates with metabolic processes and establishes an optimal pH level in the body.
  • A sea salt colon cleanse is much less likely to cause side effects that are common when using laxative teas or cleansing pills.

Read Next: The Benefits of Lemon Water: Detox Your Body & Skin

Making the most of currently available bowel preparations for colonoscopy

OTHER BOWEL PREPARATION AGENTS AND ADJUNCTS

Magnesium citrate

Like sodium phosphate, magnesium citrate is a hyperosmotic agent that promotes bowel cleansing by increasing intraluminal fluid volume. Since magnesium is eliminated solely by the kidney, it should be used with extreme caution in patients with renal insufficiency or renal failure.

Adding magnesium citrate as an adjunct to polyethylene glycol has been shown to reduce the amount of polyethylene glycol solution required (2 L) for the same result.17

For patients who cannot tolerate polyethylene glycol, a reasonable alternative is magnesium citrate (1 bottle, around 300 mL) the evening before the procedure plus either bisacodyl tablets at the same time as the magnesium citrate or rectal pulsed irrigation immediately before the procedure.7

Saline laxatives that include sodium picosulfate and magnesium citrate in combination are available primarily in the United Kingdom for bowel preparation for colonoscopy. Sodium picosulfate acts locally in the colon as a stimulant laxative and by increasing the force of laxatives, whereas magnesium citrate acts as an osmotic laxative by retaining fluids in the colon to clear the colon and rectum of fecal contents. The combination has been found to have similar efficacy and tolerability as sodium phosphate but is not currently available in the United States.26

Enemas

Enemas are sufficient for flexible sigmoidoscopy, but when used alone they do not clean out the proximal colon enough for adequate visualization during colonoscopy. They are best used as adjuncts to other bowel preparation agents when patients present with poor distal colon preparation for colonoscopy.7,27 Enemas are also useful in washing out the distal segment of bowel in patients with a proximal stoma. The common types of enemas used are tap water, sodium biphosphate (Fleet), and mineral oil.

Tap water enemas distend the rectum and mimic the natural distention by the stool to allow the rectum to empty itself. Tap water (1 L) has fewer adverse effects than sodium biphosphate or mineral oil but is less effective.

Sodium biphosphate (Fleet) enemas draw fluid into the bowel by osmotic action, prompting contraction. One or two bottles are commonly used for bowel cleansing before sigmoidoscopy. However, as with oral sodium phosphate, sodium biphosphate enemas should be avoided in the elderly and in those with renal failure because of the risk of hyperphosphatemia and subsequent hypocalcemia.

In a head-to-head comparison,28 sodium biphosphate enema was found to provide significantly better bowel preparation than the sodium picosulfate-magnesium citrate combination (currently not available in the United States) for flexible sigmoidoscopy, being judged adequate or better in 93% of procedures as opposed to 74%.28

Oil-based enemas such as cottonseed oil plus docusate (Colace) and diatrizoate sodium (Hypaque) are powerful lubricant laxatives that work by slowing the absorption of water from the bowel, so that the stool is softer. However, they have a number of adverse effects, such as severe allergic reactions (including angioedema and anaphylaxis), muscle cramps, and sporadic seepage that can soil the patient’s undergarments for up to 24 hours. Also, their safety in children less than 2 years of age and in pregnant and breastfeeding mothers is not established.

Oil-based enemas are usually reserved for short-term use in refractory constipation, especially to soften feces that has become hardened within the rectum (as in fecal impaction).27

Adjuncts

Diet. Dietary modifications alone, such as a clear liquid diet, are inadequate for colonoscopy, but they may be beneficial as adjuncts to other cleansing methods by decreasing the formation of solid residue. Clear liquids also help maintain adequate hydration during bowel preparation and are recommended with all bowel preparation regimens.

Hyperosmolar or stimulant laxatives. Bisacodyl (two to four tablets of 5 mg each), magnesium citrate (one bottle, about 300 mL), and low-dose senna (36 mg, about four 8.6-mg Sennakot tablets) have been used as adjuncts to low-volume polyethylene glycol solution, achieving results similar to those with full-volume polyethylene glycol. Depending on the type of study to be done, these agents are taken within 2 to 6 hours of starting the polyethylene glycol solution.

In contrast, the routine use of nonabsorbable carbohydrates such as mannitol and lactulose is not favored for bowel preparation, since the hydrogen gas produced by bacterial fermentation of the nonabsorbed carbohydrates increases the risk of explosion during electrosurgical procedures.29

Antiemetic agents. Metoclopramide (5–10 mg), a dopamine antagonist gastroprokinetic that sensitizes tissues to the action of acetylcholine, is commonly used to prevent nausea or vomiting associated with bowel preparation agents.7,30

Antifoaming agent. Simethicone (three tablets of 80 mg each, total dose 240 mg), an anti-flatulent, anti-gas agent, is prescribed by many gastroenterologists in an attempt to reduce bubbles during colonoscopy and improve visibility. It works by reducing the surface tension of air bubbles and causing small bubbles to coalesce into larger ones that pass more easily with belching or flatulence.

Nasogastric or orogastric tubes have been used to instill colonic preparations, especially for inpatients unable to drink polyethylene glycol solutions or for patients who are unresponsive or mechanically ventilated. This method can also be useful for rapid bowel cleansing (within 2 to 3 hours) for patients with lower gastrointestinal bleeding. However, routine use of a nasogastric tube solely for bowel preparation is discouraged as it can lead to severe complications, such as aspiration and trauma during insertion.7

PMC

DISCUSSION

Chronic constipation is a very common problem in the paediatric population, and is a particularly frequent issue in the management of the neurologically impaired child. The use of mineral oil in the treatment of constipation has been well accepted because of its efficacy and infrequent side effects. Acute or chronic aspiration of mineral oil leading to lipoid pneumonitis is well documented in the paediatric and adult medical literature (1,2). Ciliary clearance is disrupted by mineral oil, and the bland nature of this compound makes it well tolerated by the airways, thus, eliciting little protective cough (3). The spectrum of disease varies widely. Deposition of mineral oil in the lung may be associated with an asymptomatic, incidentally discovered pulmonary infiltrate (4), or may lead to severe lung disease and death (5).

In the past, the diagnosis of lipoid pneumonitis has usually depended on finding lipid laden macrophages on broncho-alveolar lavage specimens or open lung biopsy (6); however, both computed tomography and magnetic resonance imaging have demonstrated specific signs of lipid infiltration of pulmonary parenchyma (7,8). These diagnostic modalities may obviate the need for more invasive procedures in the right clinical scenario, as occurred in the present case.

Treatment of lipoid pneumonitis has been supportive in nature, with retrospective case series demonstrating no benefit to the use of corticosteroids, and there is significant morbidity and mortality secondary to pulmonary fibrosis and cor pulmonale (9). Antibiotics only have a role to play in the treatment of secondary or intercurrent infections. There was a report of the successful use of whole lung lavage in one child with a more acute lipoid pneumonitis; however, spontaneous improvement has been documented in acute lipid pneumonitis when the offending agent is withdrawn (10).

This case is an addition to the body of existing literature, and serves to highlight the rare but potentially disastrous complications of an over-the-counter preparation that is used very commonly. In light of how common the problem of chronic constipation is, especially in the neurologically impaired child, there is an under-recognition of the potential problems associated with the use of mineral oil. Its use does not require a prescription and many preparations do not have a warning label relating to adverse side effects. The Compendium of Pharmaceuticals and Specialties (CPS) (11) does contain a caution relating to the possibility of fat-soluble vitamin deficiency with the prolonged use of mineral oil (even though mineral oil has been used extensively in children with cystic fibrosis and exocrine pancreatic deficiency), but the CPS does not caution against the use of mineral oil in patients with a swallowing dysfunction. The CPS also notes that “administration of a single dose at night upon retiring is usually recommended” (11), even though this practice may increase the risk of aspiration.

Treatment for Constipation in Children

In this section:

  • How can I treat my child’s constipation?
  • How do doctors treat constipation in children?
  • How can I treat my child’s constipation complication?
  • How do doctors treat the complications of constipation in children?
  • How can I prevent my child from becoming constipated?

How can I treat my child’s constipation?

You can most often treat your child’s constipation at home by doing the following:

Change what your child eats and drinks

Changing what your child eats and drinks may make his or her stools softer and easier to pass. To help relieve symptoms, have him or her

  • eat more high-fiber foods
  • drink plenty of water and other liquids if your child eats more fiber

Read about what your child should eat and drink to help relieve constipation.

Have your child drink plenty of water and other liquids to help prevent constipation.

Change your child’s behavior

Changing your child’s bowel movement patterns and behaviors may help treat constipation.

  • Ask your potty-trained child to use the toilet after meals to build a routine.
  • Use a reward system when your child uses the bathroom regularly.
  • Take a break from potty training until the constipation stops.

How do doctors treat constipation in children?

Your child’s doctor may recommend giving your child an enema or laxative to help treat his or her constipation. Most laxatives are over-the-counter medicines taken by mouth until your child’s bowel movements are normal. Your child’s doctor may recommend stopping the laxative once your child has better eating and bowel habits. You should not give a child a laxative unless told to do so by a doctor.

If your child is taking an over-the-counter or prescription medicine or supplement that can cause constipation, your child’s doctor may recommend stopping it, changing the dose, or switching to a different one. Talk with your child’s doctor before stopping any medicines.

How can I treat my child’s constipation complication?

Your doctor may recommend treating your child’s hemorrhoids or anal fissures by

  • making changes in his or her diet to prevent constipation
  • using an over-the-counter enema or laxative suggested by your child’s doctor
  • having him or her take warm tub baths to soothe the area

Changing your child’s bowel movement patterns and behaviors may help treat constipation.

How do doctors treat the complications of constipation in children?

Doctors may be able to treat complications of constipation in children during an office visit. Your child’s doctor may recommend at-home treatments, too.

For a child age 2 or older, your doctor may recommend giving mineral oil. Your child will take the mineral oil by mouth or through an enema.

Your child’s doctor may be able to treat rectal prolapse during an office visit by manually pushing the rectum back through the child’s anus. Helping a child prevent constipation is the best way to prevent rectal prolapse.

How can I prevent my child from becoming constipated?

You can help prevent constipation in your child with the same things that treat constipation

  • provide enough fiber in your child’s diet
  • have your child drink plenty of water and other liquids
  • make having a bowel movement part of your child’s routine

Learn more about how you can help prevent constipation in your child by changing what he or she eats and drinks.

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Fecal impaction

Definition

A fecal impaction is a large lump of dry, hard stool that stays stuck in the rectum. It is most often seen in people who are constipated for a long time.

Alternative Names

Impaction of the bowels; Constipation – impaction; Neurogenic bowel – impaction

Causes

Constipation is when you are not passing stool as often or as easily as is normal for you. Your stool becomes hard and dry. This makes it difficult to pass.

Fecal impaction often occurs in people who have had constipation for a long time and have been using laxatives. The problem is even more likely when the laxatives are suddenly stopped. The muscles of the intestines forget how to move stool or feces on their own.

You are at more risk for chronic constipation and fecal impaction if:

  • You not move around much and spend most of your time in a chair or bed.
  • You have a disease of the brain or nervous system that damages the nerves that go to the muscles of the intestines.

Certain drugs slow the passage of stool through the bowels:

  • Anticholinergics, which affect the interaction between nerves and muscles of the bowel
  • Medicines used to treat diarrhea, if they are taken too often
  • Narcotic pain medicine, such as methadone, codeine, and oxycontin

Symptoms

Common symptoms include:

  • Abdominal cramping and bloating
  • Leakage of liquid or sudden episodes of watery diarrhea in someone who has chronic (long-term) constipation
  • Rectal bleeding
  • Small, semi-formed stools
  • Straining when trying to pass stools

Other possible symptoms include:

  • Bladder pressure or loss of bladder control
  • Lower back pain
  • Rapid heartbeat or lightheadedness from straining to pass stool

Exams and Tests

The health care provider will examine your stomach area and rectum. The rectal exam will show a hard mass of stool in the rectum.

You may need to have a colonoscopy if there has been a recent change in your bowel habits. This is done to check for colon or rectal cancer.

Treatment

Treatment for the condition starts with removal of the impacted stool. After that, steps are taken to prevent future fecal impactions.

A warm mineral oil enema is often used to soften and lubricate the stool. However, enemas alone are not enough to remove a large, hardened impaction in most cases.

The mass may have to be broken up by hand. This is called manual removal:

  • A provider will need to insert one or two fingers into the rectum and slowly break up the mass into smaller pieces so that it can come out.
  • This process must be done in small steps to avoid causing injury to the rectum.
  • Suppositories inserted into the rectum may be given between attempts to help clear the stool.

Surgery is rarely needed to treat a fecal impaction. An overly widened colon (megacolon) or complete blockage of the bowel may require emergency removal of the impaction.

Most people who have had a fecal impaction will need a bowel retraining program. Your provider and a specially trained nurse or therapist will:

  • Take a detailed history of your diet, bowel patterns, laxative use, medicines, and medical problems
  • Examine you carefully.
  • Recommend changes in your diet, how to use laxatives and stool softeners, special exercises, lifestyle changes, and other special techniques to retrain your bowel.
  • Follow you closely to make sure the program works for you.

Outlook (Prognosis)

With treatment, the outcome is good.

Possible Complications

Complications may include:

  • Tear (ulceration) of the rectal tissue
  • Tissue death (necrosis) or rectal tissue injury

When to Contact a Medical Professional

Tell your provider if you have chronic diarrhea or fecal incontinence after a long period of constipation. Also tell your provider if you have any of the following symptoms:

  • Abdominal pain and bloating
  • Blood in the stool
  • Sudden constipation with abdominal cramps, and an inability to pass gas or stool. In this case, do not take any laxatives. Call your provider right away.
  • Very thin, pencil-like stools

Review Date: 9/29/2017
Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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A fecal impaction is a large lump of dry, hard stool that remains stuck in the rectum. It is most often seen in patients with long-term constipation.

Impaction of the bowels

Constipation is when you are not passing stool as often as you normally do. Your stool becomes hard and dry, and it is difficult to pass.

Fecal impaction is often seen in people who have had constipation for a long time and have been using laxatives. Impaction is even more likely when the laxatives are stopped suddenly. The muscles of the intestines forget how to move stool or feces on their own.

Persons at risk for chronic constipation and fecal impaction include those who:

  • Do not move around much and spend most of their time in a chair or bed
  • Have diseases of the brain or nervous system that damage the nerves that go to the muscles of the intestines

Certain drugs slow the passage of stool through the bowels:

  • Anticholinergics, which affect the interaction between nerves and muscles of the bowel
  • Medicines used to treat diarrhea, if they are taken too often
  • Narcotic pain medication, such as methadone and codeine

Common symptoms include:

  • Abdominal cramping and bloating
  • Leakage of liquid or sudden episodes of watery diarrhea in someone who has chronic constipation
  • Rectal bleeding
  • Small, semi-formed stools
  • Straining when trying to pass stools

Other possible symptoms include:

  • Bladder pressure or loss of bladder control
  • Lower back pain
  • Rapid heartbeat or light-headedness from straining to pass stool

The health care provider will examine your stomach area and rectum. The rectal exam will reveal a hard mass of stool in the rectum.

If there has been a recent change in your bowel habits, your doctor may recommend a colonoscopy to evaluate for colon or rectal cancer.

Treating a fecal impaction involves removing the impacted stool. After that, measures are taken to prevent future fecal impactions.

Often a warm mineral oil enema is used to soften and lubricate the stool. However, enemas alone are usually not enough to remove a large, hardened impaction.

The mass may have to be broken up by hand. This is called manual removal:

  • A health care provider will need to insert one or two fingers into the rectum and slowly break up the mass into smaller pieces so that it can come out.
  • This process must be done in small steps to avoid causing injury to the rectum.
  • Suppositories inserted into the rectum may be given between attempts to help clear the stool.

Surgery is rarely needed to treat a fecal impaction. An overly widened colon (megacolon) or complete blockage of the bowel may require emergency removal of the impaction.

Almost anyone who has had a fecal impaction will need a bowel retraining program. Your doctor and a specially trained nurse or therapist will:

  • Take a detailed history of your diet, bowel patterns, laxative use, medications, and medical problems
  • Examine you carefully
  • Recommend changes in your diet, how to use laxatives and stool softeners, special exercises, lifestyle changes, and other special techniques to retrain your bowel
  • Follow you closely to make sure the program works for you

With treatment, the outcome is good.

  • Tear (ulceration) of the rectal tissue
  • Tissue death (necrosis) or rectal tissue injury

Tell your health care provider if you are experiencing chronic diarrhea or fecal incontinence after a long period of constipation. Also notify your health care provider if you are experiencing any of the following symptoms:

  • Abdominal pain and bloating
  • Blood in the stool
  • Sudden constipation with abdominal cramps, and an inability to pass gas or stool. In this case, do not take any laxatives. Call your health care provider immediately.
  • Very thin, pencil-like stools

Review Date: 1/31/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsements of those other sites. © 1997-2012 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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