2019 Volume 55 Issue 4 Pages 809-814
Purpose: The fecal disimpaction effect of sodium amidotrizoate meglumine solution (gastrografin®), a water-soluble gastrointestinal contrast medium, has been empirically recognized, but the clinical evidence has not been established. We examined the fecal disimpaction effect of gastrografin® in chronic constipation cases as a prospective observational study (cohort study).
Methods: From May 2015 to July 2016, patients from 1 to 16 years of age, with the chief complaint of constipation and diagnosed on the basis of Rome III criteria, and patients with a rectal diameter of 27 mm or more as determined by ultrasonography were included in this study. Seven to 10 days after gastrografin® enema, defecation was confirmed and the rectal diameter was reevaluated.
Results: Of the 157 patients included, 64 were examined. The median age was 4.2 years, 41 were boys, and the average rectal diameter was 38.1 mm at the first visit. In 33 patients, the rectal diameters were normalized to less than 27 mm and reduced in 57 patients until reexamination. The Bristol stool scale scores were on average 3.2 at the first visit and 4.6 at the return visit, and the feces significantly softened.
Conclusions: In this study, we showed the possibility of gastrografin® having a fecal disimpaction effect. This may be due to the softening of the feces through the osmotic effect. In patients whose ultrasonography revealed fecal impaction and a rectal diameter expanded to 27 mm or more, it is necessary to intervene aggressively from the early stage, and the results of this study showed that gastrografin® enema is useful.
