The effect of sodium phosphate enema in patients ingested foreign bodies: a prospective, randomized trial——Sodium phosphate enema in patients ingested foreign bodies

Background: Although foreign body ingestion is a common problem, poor knowledge for the treatment still remains a major obstacle, especially in preventing complications. Phosphate enemas were applied for chronic constipation and bowel cleansing for a long period of time. This study aims to evaluate the effect of phosphate enema on bowel movements in patients who suffer from foreign body ingestion. Methods: Forty consecutive patients admitted to our emergency department for foreign body ingestion were randomized into two groups. Cases in Group SP received daily one dose of sodium phosphate enemas, while Group C did not. Patients in both groups were followed up with daily imaging and physical examinations. Demographics, number of X-rays, radiation dose, and period of the foreign body passage were recorded and compared between two groups. Also, data of patients who ingested pins (Group P) were compared with of those who ingested other materials (Group O). Results: There was no statistical difference between groups (Group SP vs. Group C) comparing demographics, number of X-rays, total amount of radiation doses (p > 0.05 for all comparisons). The period of foreign body passage was shorter in Group SP (3.4 ± 1.6 days vs. 6.2 ± 3.8 days; p = 0.005). Also, patients who ingested pins (Group P) were compared to patients who ingested other materials (Group O). Pins were ingested by 23 (65%) patients, these were older (16.6 ± 9.4 years vs. 4.8 ± 3.5 years; p = 0.001) and generally females (78.3% vs. 29.4%; p = 0.006). Contrary to the other materials, pins were less frequently confirmed in stool of patients (p = 0.02). Conclusion: Sodium phosphate enema use may hasten the passage of the foreign bodies. Ingestion of pins is the more common especially in turbaned young females. The evacuation of pins is less recognized with direct examination of the stool, so daily imaging may be necessary for this group of patients.