Journal of Korean Medicine Rehabilitation (한방재활의학과학회지)

The society of Korean Medicine Rehabilitation (한방재활의학과학회)
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A Case of Ischemic Colitis Presenting as Bloody Diarrhea after Glycerin Enema in a Patient on Modified Fasting Therapy

절식요법 중 글리세린 관장 직후 혈성 설사로 발현한 허혈성 대장염 1예

  • Choi, Hyo-Jeong (Dept. of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Park, Hyun-Gun (Dept. of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Maeng, Tae-Ho (Dept. of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Yoo, Duk-Joo (Dept. of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Kim, Sung-Soo (Dept. of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung-Hee University) ;
  • Chung, Won-Suk (Dept. of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung-Hee University)
  • 최효정 (경희대학교 한의과대학 한방재활의학과교실) ;
  • 박현건 (경희대학교 한의과대학 한방재활의학과교실) ;
  • 맹태호 (경희대학교 한의과대학 한방재활의학과교실) ;
  • 유덕주 (경희대학교 한의과대학 한방재활의학과교실) ;
  • 김성수 (경희대학교 한의과대학 한방재활의학과교실) ;
  • 정원석 (경희대학교 한의과대학 한방재활의학과교실)
  • Published : 2013.04.30
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Abstract

Case of ischemic colitis after enema for bowel cleansing have been rarely reported, but there has been no case report of a patient on modiefied fasting therapy. A 26-year old male patient with obesity admitted Korean medical hospital of Kyung Hee university for losing weight. He is on a special diet called modiefied fasting therapy, only took the fermented herbal drink. At 2nd day, he received an enema for bowel cleansing. A few hours after enema, he had a bloody diarrhea with lower abdominal pain. His colonoscopic and histologic findings presented ischemic colitis. He was advised to fast for two days and couldn't complete his diet program. We suggest 4 possible reasons : Increased intraluminal pressure by enema, vascular spasm caused by room-temperature glycerin solution colder than intraluminal temperature, predisposition to bleeding disturbances by taking selective serotonin reuptake inhibitor(SSRI) for depression history and mucosal injury by osmotic effect of glycerin solution itself. For reducing the risk of bowel cleansing, glycerin enema should be carefully prescribed and practiced concerning the condition of each patient.

본 증례에서는 절식치료 중인 환자에 있어 글리세린 관장을 실시한 직후 발생한 허혈성 대장염 1례에 대해 고찰하여, 관장으로 인한 장관 내압 상승, 상온의 체온보다 낮은 관장액으로 인한 혈관 경련, 선택적 세로토닌 재흡수 억제제에 의한 출혈 경향 증가 및 글리세린 용액의 화학적 삼투작용으로 인한 점막 손상 가능성 등을 제시하였다. 관장으로 인한 이와 같은 부작용을 예방하기 위하여 임상의들의 주의가 요구된다.

Keywords

References

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