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Subject: Re: Effects: recognizing, accepting reactions, and addressing


Author:
Original Jeff
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Date Posted: 03:33:55 07/03/09 Fri
In reply to: Fred4 's message, "Effects: recognizing, accepting reactions, and addressing" on 16:43:32 06/22/09 Mon

I'm not attempting to pull anyone's leg.

See this article from the American Journal of Diseases of children: while published in 1988, the procedure is still very widely performed.

http://www.ncbi.nlm.nih.gov/pubmed/3344724

Some quotes:

"Twenty-four patients with a mean age of 8.1 years (range, 0.8 to 17.6 years) and an average weight of 31.5 kg received polyethylene glycol-electrolyte solution: eight patients with encopresis were given it as treatment for severe fecal retention unresponsive to outpatient management; the other 16 were being prepared for colonoscopy."

and

"The two groups were comparable in age and weight. Polyethylene glycol-electrolyte solution was given at a rate of 14 to 40 mL/kg/h until clear fluid was excreted through the rectum. Intestines were cleaned out successfully in all patients, and side effects were minimal. Children with encopresis required an average of 11.8 L (574 mL/kg) given over 22.5 hours, while the other children needed only 4.0 L (128 mL/kg) given over 7.5 hours."

Note 4 liters (approximately one gallon) in children being prepped for colonoscopy and 11.8 liters (approximately three gallons in children undergoing cleanout of impaction related to encopresis.

The most recent personal knowledge I have of a youngster undergoing this procedure was a 12-year old approximately 2001/2002.

Jeff

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Replies:
[> [> Subject: Re: Effects: recognizing, accepting reactions, and addressing


Author:
Claudia
[Edit]

Date Posted: 08:28:51 07/03/09 Fri

When I was growing up I was exposed to excessive enemas because my mother had the whim that I needed them. They were a humiliation as she would pull me aside when I had a friend over to tell me it was enema time. My friend was invited to stay and watch or wait until mother was finished with me. I had an older sister who became my mother's 'nurse". She sometimes assisted with mother's enema whims on me. My sister was favored I think as she did not get these enemas, at least not as often and I was not asked to help mom give them to her. The result is I do give my son enemas only never in a humiliating manner and not as often as I got them. Sometimes as a kid mother had me stay home from school just to give me three to four enemas. If I complained, the next day would be the same.

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[> [> [> Subject: Letting Go


Author:
samantha
[Edit]

Date Posted: 08:32:25 07/03/09 Fri

Claudia,

The enemas which your Mom gave you, may not have been abuse. Many kids need frequent enema therapy. I was one of those, and I grew up happy, and content.

Yes, I still use enemas because they are very relaxing to me, and they help me avoid difficult bowel movements. In addition, I can 'plan' my BM times, and not often have to use a 'dirty' purblic restroom, for anything other than urination.

Basically, I am happy with my childhood enemas, and I wish I could help you come to grips with them, too.

Sincerely,

Samantha

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[> [> [> [> Subject: Re: Letting Go


Author:
Claudia (to Samantha)
[Edit]

Date Posted: 10:19:14 07/03/09 Fri

I understand about "needing" enemas, and as an adult I do take enemas and give them to my children. It is the method of delivery which changes a kid's attitude from dread to using enemas to stay healthy and enjoy.

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[> [> Subject: Re: Effects: recognizing, accepting reactions, and addressing


Author:
Fred4 to Jeff
[Edit]

Date Posted: 09:26:43 07/03/09 Fri

Okay, Original Jeff, I accept your observation on that report, and I did read it. However, I would observe that the description does not mean that widespread acceptance exist, only that this test of 40 some people was done in this one case and reported. Also, nothing in the article suggests that the Golytely was inserted via a nasal tube.

I did a google search of "encopresis", the condition being described. The following was one of the first references to appear:

http://www.minddisorders.com/Del-Fi/Encopresis.html

It sounds as if this involuntary soiling (and not mere minor residue in underpants) is the problem, and in the vast majority of cases of this relatively rare situation the source of the situation is psychological in origin. If the psychological source of the problem (often I would suspect, parentally induced) is addressed, the problem usually goes away.

This area is totally irrelevant to the question of parents giving uncomfortable, or frequent, or both, enemas to children on a broad basis. I would strongly maintain those should not be done.

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[> [> [> Subject: Re: Effects: recognizing, accepting reactions, and addressing


Author:
Original Jeff
[Edit]

Date Posted: 10:40:37 07/04/09 Sat

"I would observe that the description does not mean that widespread acceptance exist, only that this test of 40 some people was done in this one case and reported."

There are many other reports in the literature, even searchable by Google. Almost all of them require a paid subscription to read the study. You can either believe me or not, this is the most common procedure used today.

"Also, nothing in the article suggests that the Golytely was inserted via a nasal tube."

You are right. It's not mentioned. It's presumed that the medical people who read the literature understand how the soluton is administered. How would you presume that gallons of solution are administered to a two or three year old? Would you expect them to enjoy taking it from a bottle? Again, whether you believe me or not, that's how it's administered.

"I did a google search of "encopresis", the condition being described. The following was one of the first references to appear:

http://www.minddisorders.com/Del-Fi/Encopresis.html

It sounds as if this involuntary soiling (and not mere minor residue in underpants) is the problem, and in the vast majority of cases of this relatively rare situation the source of the situation is psychological in origin. If the psychological source of the problem (often I would suspect, parentally induced) is addressed, the problem usually goes away."

It's not rare at all. And while the origin may be what some people call "psychological" it becomes a physical problem quickly.

A much better resource is available at the major encopresis sites.

There are some good posts on the main encopresis site forum including one by a lady who says she'd consider colonic therapy over the naso-gastric instillation of golytely if it were an option in her area but that she can't find anyone to give the colonic. That's very common; the International Association of Colonic Therapy doesn't treat children, generally because of opinions as your own. Note that I'm absolutely NOT trying to disparage your opinion; just to point out how widespread opinion such as yours prevents valuable therapy from being available. If you want it to not be available, then your opinion is absolutely sound.

"This area is totally irrelevant to the question of parents giving uncomfortable, or frequent, or both, enemas to children on a broad basis. I would strongly maintain those should not be done."

On this we agree. Parents of kids (there are more of them than you think) with bowel problems should be under a doctor's care.

Jeff

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[> [> [> Subject: Re: Effects: recognizing, accepting reactions, and addressing


Author:
Fred4
[Edit]

Date Posted: 12:06:41 07/05/09 Sun

Original Jeff, I don't want to be creating a debate here, since I know virtually nothing about encopresis and will respect your greater knowledge. I would suspect though (admittedly not having done research) that there are differing opinions as to best or least psychologically adverse treatments.

In general, I would acknowledge there are many childhood illnesses requiring physically uncomfortable treatments (certainly cancer would be among them). A key difference though is that the parent's motivation shoul be to be informed of the options and then to choose primarily the most effective, and secondarily an approach of least feasible discomfort to the child.

That is a far cry from a parent just giving a child an enema out of the blue, or one of more than necessary discomfort, if one is truly (and I emphasize "truly", since I think most aren't) needed. There were far too many of these, and the child can sense the difference between these and a medical treatment that is absolutely necessary, or if he can't, then he gets mental images created from those consequences.

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