Article

Diseases of the Colon & Rectum

, Volume 22, Issue 3, pp 195-199

Ritual-enema-induced colitis

  • Isdor SegalAffiliated withDepartment of Gastroenterology, Baragwanath HospitalSouth African Institute for Medical Research, Johannesburg General HospitalUniversity of the Witwatersrand
  • , Leonard Ou TimAffiliated withDepartment of Gastroenterology, Baragwanath HospitalSouth African Institute for Medical Research, Johannesburg General HospitalUniversity of the Witwatersrand
  • , Donald G. HamiltonAffiliated withDepartment of Gastroenterology, Baragwanath HospitalSouth African Institute for Medical Research, Johannesburg General HospitalUniversity of the Witwatersrand
  • , Hugh H. LawsonAffiliated withDepartment of Gastroenterology, Baragwanath HospitalSouth African Institute for Medical Research, Johannesburg General HospitalUniversity of the Witwatersrand
  • , Albert SolomonAffiliated withDepartment of Gastroenterology, Baragwanath HospitalSouth African Institute for Medical Research, Johannesburg General HospitalUniversity of the Witwatersrand
  • , Frederick KalkAffiliated withDepartment of Gastroenterology, Baragwanath HospitalSouth African Institute for Medical Research, Johannesburg General HospitalUniversity of the Witwatersrand
  • , Stanley A. R. CookeAffiliated withDepartment of Gastroenterology, Baragwanath HospitalSouth African Institute for Medical Research, Johannesburg General HospitalUniversity of the Witwatersrand

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Summary and Conclusions

Enemas are routinely used in South Africa for various reasons including for ritual purposes; as an aperient, aphrodisiac or emetic; and for the treatment of impotence, febrile symptoms, abdominal pains, dysmenorrhea and dysentery. Substances used include herbal medicines, Dettol, vinegar, caustics, soap, potassium dichromate, copper sulfate, potassium permanganate, and brown sugar. Eleven patients in whom colitis developed following enema administration are described. Peritonitis and rectal bleeding are the clinical hallmarks. Features demonstrated by roentgenogram vary from ostensibly normal to fistula and stricture formation. In mild cases, there are occasionally neutrophils in the lamina propria; in severe cases, complete necrosis of the bowel wall is observed. Conservative therapy is advocated for the mild cases. The type of operative treatment performed depends on the complication observed.