Microenemas for constipation in a child: a quick solution to the problem or only temporary relief?

Composition and mechanism of action

Microlax is a combination drug belonging to the group of laxatives. Intended for rectal administration. A viscous colorless solution containing air bubbles is placed in a micro enema made of a soft polymer material. The content volume of one tube is 5 ml.

The basis of the medicine is:

• Sorbitol
  . It attracts liquid into the lumen of the small intestine, due to which the feces accumulated in it increase in volume and, accordingly, soften. At the same time, sorbitol irritates the receptors located in the mucous layer of the walls of the large intestine, due to which peristalsis is activated.
• Sodium lauryl sulfoacetate
  . Liquefies the contents in the intestines.
• Sodium citrate
  . Breaks down feces into small particles and displaces water from them.

The complex composition of Microlax ensures rapid dilution of feces and enhances peristalsis, which determines the laxative effect of the drug. Defecation occurs in most cases within 15 minutes.

Rectal administration of the drug does not lead to penetration of its components inside. That is, Microlax acts only at the local level, which ensures its safety and the possibility of use to eliminate constipation in newborns, pregnant women in the early and late stages of pregnancy and lactating women, people with chronic pathologies.

Microlax is produced by the Swiss company McNeil AB. One package contains 4 mini enemas. Their total cost is about 300 rubles. However, in pharmacies you can often purchase one microenema.

Tablets and drops

Laxatives available in tablets or drops can cause irritation to the intestinal wall. By doing this, they are able to stimulate peristalsis during atony and accelerate the removal of contents out. It is usually recommended to take such laxatives at night, so that you can go to the toilet normally in the morning. Thus, their duration of action can last up to several hours, which is not always convenient for acute constipation.

Some of them are prohibited from being taken in the first trimester of pregnancy, since, together with the intestinal wall, they can increase the tone of the walls of the uterus, and this will lead to the threat of miscarriage. In later stages, this probability decreases, but in case of complicated pregnancy it is still not recommended to take such drugs.

Also, not all substances included in laxative tablets and drops may be safe for the fetus. Since they must be taken orally, there is a possibility of the substance being absorbed into the bloodstream and passing through the placenta to the baby, and the effect of such drugs on the fetus has been practically unstudied.

When can you use Microlax?

The instructions for use of the drug indicate constipation, which has a different cause, as indications. Doctors often prescribe microenemas for those whose long-term absence of stool is accompanied by encopresis, that is, fecal incontinence. The drug is suitable for eliminating constipation in pregnant girls, regardless of gestational age. You can also use it while breastfeeding, since the active ingredients do not pass into breast milk.

Microlax for bowel cleansing is prescribed before sigmoidoscopy, X-ray and endoscopic examinations of the gastrointestinal tract. Often, a mini enema is used instead of a regular cleansing enema before childbirth and abdominal surgery.

Microlax facilitates bowel movements and, accordingly, relieves discomfort from hemorrhoids. The use of an enema for this disease allows you to avoid the formation of hemorrhoids due to straining and their descent below the anus.

Microenema does not eliminate the main cause of the lack of stool, so this remedy can only be used as an emergency drug.

Microenemas can be prescribed to children immediately after birth. Parents often resort to its use in cases where the newborn cannot relieve himself due to the transition to artificial nutrition, with colic and problems with digestion of food.

How long does it take for Microlax to work in adults? This question primarily concerns those whose bowel movements are accompanied by discomfort and pain. The relaxation effect, as reviews show, in most cases begins to appear after 15-20 minutes. But sometimes bowel movements occur after 40-60 minutes. This is considered normal and does not require any other measures.

If after 1-2 hours there is no result, then an adult can repeat the microenema. However, it must be borne in mind that the components of the medication act only if there is fecal content in the rectum. When following strict diets and fasting, the flow of food debris into the large intestine slows down, and the body may need to defecate once every 3-5 days.

Features of performing an enema for children

If your baby suffers from constipation, it is quite possible to give him an enema. Only hypertensive enema is prohibited. You can do either cleansing or oil. The volume of water for cleaning procedures varies depending on the age of the child. For infants, 30 ml is enough. Older children are given 100 ml. For younger schoolchildren, 300 ml can be administered.

There is no need to heat the enema composition. The temperature should be between 25 - 27° C. A syringe with a rubber tip is used as a device for introducing liquid. Other details coincide with the procedure in adults.

Benefits of an enema

Laxatives intended for oral use begin to act after at least 4-5 hours. In contrast, rectal placement of Microlax leads to defecation almost immediately, which accordingly quickly improves well-being and allows you to eliminate discomfort in the shortest possible time. But this is not the only advantage of Microlax. Other advantages of the drug include:

• no toxic effects on internal organs;
• the possibility of using microenemas in any trimester of pregnancy;
• no age restrictions - the drug is suitable for eliminating constipation in infants and young children;
• a small number of contraindications;
• Convenience of administering an enema - a thin and semi-rigid applicator allows you to insert it into the anus correctly and quickly

Microlax is not addictive and can be used periodically for occasional constipation. Short courses of daily use of the drug are also permitted, but it must be borne in mind that in order to fully restore intestinal function, it may be necessary to take other medications.

Microlax is also convenient because each container contains a single dose, so there is no need to determine the amount of the drug.

Microlax does not interact with systemic medications. This is due to the fact that the components of the drug act only at the intestinal level and do not enter the blood. When using other drugs intended for rectal administration at the same time, you must wait until you have emptied before administering them. All components of Microlax are excreted along with the feces. After which you can safely insert suppositories with anti-inflammatory, regenerating or analgesic properties.

Patient reviews

Patients themselves also often write on forums about their experience of using enemas - some use regular water enemas, some buy special ones with a solution (for example, Enema), while others call a specialist and choose the optimal composition of the liquid with him.

Maria, 25 years old, had her bowel lavaged before going for an endoscopy: “It’s the hardest thing to cleanse yourself properly, you’re always afraid of doing something wrong. She called the nurse and was even surprised that the enema was administered without discomfort. Fast and no problems, I recommend.”

Andrey D. shared another experience, a little less pleasant: “I had to give an enema before a visit to the proctologist, but for me it was the first experience of such a procedure - as a result, a lot of unpleasant sensations and damage to the mucous membrane. The doctor said that coming “unprepared” is not critical, it’s better not to harm the body and ask a specialist for help.”

Christina N. says: “For a couple of years now, my grandmother has been bedridden and moves little—hence the problems with stool. Recently we tried to give an enema with the help of a nurse, the result was excellent, I calmly emptied after half an hour. It’s a good method, and there’s no need to poison an elderly person with laxatives, she already has a lot of pills.”

From their impressions it is clear: constipation cannot always be prevented, because it appears from stress, from travel, and from unusual cuisine. An enema is a simple and affordable way to cleanse the intestines, so there are a lot of positive reviews.

Rules for giving an enema

The effectiveness of using Microlax is largely determined by full compliance with the rules for administering a laxative solution. Before the procedure, you need to remove the enema from the refrigerator 10-15 minutes before or warm it up a little in your hands, this will reduce the likelihood of discomfort in the anus and rectum during administration.

The following recommendations should then be followed:

• rinse the anal area with warm water and dry the skin;
• treat your hands with an antiseptic or wash them well with soap;
• break off the protective seal on the tip of the tip;
• squeeze a drop of solution out of the package and lubricate the pipette with it;

• insert the tip along its entire length into the rectum (for adults);
• squeeze out the contents by pressing on the tube;
• remove the enema without releasing pressure on the tube body.

The enema is administered mainly while lying on your side. Some people find it more convenient to place the medicine in a supine position with their knees bent. It is also possible to position the device while squatting. That is, you can choose any convenient method of administering a mini enema, applicable at home.

After the procedure, you need to restrain the urge to defecate for at least 5 minutes. This will completely soften all accumulated masses, which means that during bowel movements the intestines will be freed of all contents. After a microenema, repeated urges are possible; they usually stop within an hour.

What are the dangers of an enema?

The following diseases are contraindications for the procedure: colitis, proctitis and some others. Any violations of the mucous membrane, the inner surface of the gastrointestinal tract, neoplasms, cracks are also reasons why you cannot do an enema.

Pain during constipation can indicate that there are intestinal diseases. It is prohibited to carry out such procedures during exacerbation of hemorrhoids. Therefore, it is advisable to consult a specialist before using enemas.

Providing microenemas for children

Preparing a child for the administration of Microlax is practically no different from the recommendations for adults. The baby also needs to wash the anus area and dry it. Be sure that mom or dad needs to thoroughly disinfect their hands. For children over 3 years old, the tip of the tube is inserted completely.

Children under three years old need to insert the applicator halfway, that is, up to the mark marked in the middle of the pipette.

The dosage for young children is selected individually, but usually pediatricians advise children under 3 years to administer half the contents of the tube.

Before the procedure, you need to put the baby on his tummy and bend his legs at the knees. The tip is inserted carefully, without sudden movements. After squeezing out, the compressed tube is removed. Then the child needs to squeeze the buttocks, this will prevent the solution from escaping before it begins to work. To enhance the effect, you can do a light tummy massage in a clockwise direction.

Contraindications and adverse reactions

An absolute contraindication to administering Microlax microenemas is hypersensitivity to one or more components of the drug. Proctologists do not recommend using any laxatives for:

• intestinal obstruction;
• rectal bleeding;
• dehydration.

Caution when using the drug should be exercised by persons on a sodium-restricted diet and with severe kidney and heart disease. Intestinal obstruction is indicated by the absence of stool and gas for several days, severe cramping pain in the lower abdomen, weakness, sweating, drop in blood pressure, and vomiting.

Adverse reactions during an enema rarely develop. Most often, patients note a burning sensation in the rectal area. In rare cases, rashes appear on the skin around the anus and irritation occurs.

The burning sensation does not require discontinuation of the drug; it completely disappears after the intestinal contents are released. If other adverse reactions are noted, you should stop using Microlax further. To reduce the intensity of symptoms, you need to rinse the anus with warm water, dry it and lubricate it with an ointment with regenerating or antihistamine properties.

Special conditions

A sealed tube of Microlax should be stored at a temperature no higher than 25 degrees. It can be stored in the refrigerator, but before giving the enema, it is better to warm it to room temperature. The shelf life of the medicine from the date of release is 5 years.

If the medicine is not completely used, it should be thrown away immediately, since the therapeutic activity of the contents when the package is opened is significantly reduced.

You should not get carried away with frequent mini-enemas. The manufacturer recommends using Microlax 1 or, at least, 2 times a day. Increasing the frequency of delivery of the rectal remedy leads to the development of “lazy bowel syndrome”.

This is a condition in which peristalsis occurs only after stimulation of the receptors. For persistent and prolonged constipation, it is necessary to undergo an examination to determine the main cause of the problem, and then, based on it, select a treatment.

Constipation in children

Constipation is a common problem in children (up to 53%)1, impairing quality of life2. Symptoms of constipation include: a decrease in the frequency of the child going to the toilet less than 3 times a week; hard, scanty stool; a feeling of incomplete emptying of the intestines and the need for additional efforts (prolonged, sometimes unsuccessful straining) 3. Constipation can also contribute to the occurrence of pain, inflammation of the intestines, changes in its microflora and decreased immunity3.

Analogues and substitutes

There are no analogues of Microlax that are completely identical in composition. When choosing substitutes, preference is given to those products that help quickly solve the problem, this mainly applies to rectal suppositories. Instead of Microlax, you can use suppositories:

• Glycerin;
• Glycelax;
• Bisacodyl;
• Sea buckthorn.

Glycelax and glycerin suppositories are suitable for relieving constipation in infants. Starting from three months.

Microclysters-substitutes for Microlax

Not all of the microclyster analogues listed above can be used to relieve constipation in children. Therefore, before purchasing them, you need to carefully study the indications and contraindications for the chosen product.