Mechanical enemas can lead to intestinal @entity3137 and bowel barrier damage, presenting as electrolyte disturbances and functional @entity1944 . Most researchers believe that the mechanism of injury is related to osmolality, volume and temperature of the solution, infusion pressure, and the composition of the enema tube. We hypothesized that the pH of the enema solution may also contribute to intestinal damage. We administered enema solutions-normal saline, soapsuds, or vinegar (neutral, alkaline, or acidic solutions, respectively)-to three groups of @entity95 (n = 20 per group). The solutions were standardized for volume and temperature and the soapsuds and vinegar solutions were adjusted to be isotonic with normal saline or deionized water. We also included a control group (n = 20) in which the enema tubes were inserted but no solution was administered. We biopsied 3 sites (rectum and distal and proximal colon). Damage to intestinal mucosa was observed by light microscopy and transmission electron microscopy. In order to explore the detection of damage using noninvasive methods, @entity12050 gene expression was measured in the exfoliated cells gathered from postenema defecation. Epithelial loss, inflammatory reaction, and cellular microstructure damage was increased in the vinegar and soapsuds groups. Also, exfoliated cells in these groups had higher @entity12050 expression than the normal saline group. The acidic and alkaline enema solutions thus caused more severe damage to the intestinal mucosa compared to the neutral liquid, supporting our hypothesis. Further, the detection of @entity12050 expression shows promise as a noninvasive method for estimating enema-induced damage.

Relationship Between the pH of Enema Solutions and Intestinal Damage in XXXX .

@entity1944 :: ('MESH:D007410', 'Disease') :: ['intestinal disorders'] @entity95 :: ('9986', 'Species') :: ['rabbits'] @entity3137 :: ('MESH:D009059', 'Disease') :: ['mucosal injuries'] @entity12050 :: ('808233(Tax:9986)', 'Gene') :: ['COX-2', 'cyclooxygenase (COX)-2']
@entity95 :: (9986,Species) :: ['Rabbits']
