Hydrogen peroxide injury to the colon

Successful Conservative Treatment of an Elderly Patient with Corrosive Proctocolitis

Corrosive proctocolitis has occurred after accidental contamination of endoscopes in most patients. But accidental administration of corrosive agents for bowel cleansing can occur. The agents implicated for chemical colitis is 15% hydrochloric acid and 2% ethoxylated alcohol. We present a case of corrosive proctocolitis, present with anal pain and bloody diarrhea. Endoscopy revealed edema, erythema, and friability of the colonic mucosa. An experience of successful nonoperative treatments has been demonstrated.

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.

An Emergency Department Presentation of Severe Colitis After a Home Hydrogen Peroxide Enema

BACKGROUND

Health information found on open access Internet platforms is often unscrutinized, unreliable, and can lead to considerable morbidity for patients and their presentation to the emergency department. Currently, home treatments for constipation and other gastrointestinal ailments featuring the use of hydrogen peroxide (H₂O₂) enemas are readily available.

CASE REPORT

We present a case of a 48-year-old female with a history of fibroids who presented to the emergency department with acute abdominal pain after self-administering a 3% H₂O₂ enema, which she learned about on the Internet as a treatment for constipation. She subsequently developed a severe colitis with evidence of pneumatosis and focal perforation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although toxicity from oral ingestions of H₂O₂ is well described in the literature, there are few reports of the sequelae related to rectal administration. Due to its significant morbidity and the public health concerns related to this mechanism of toxicity, emergency physicians are at the frontlines for diagnosing and properly managing these patients. This case report reviews the patient's presentation, findings, and management.