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| Author and year | Patient age | Presenting history | Complications | Iatrogenic | Concentration used | Symptom onset | Treatment/recovery period |
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Pumphrey
(1951) [2] | 50 years | Peptic ulcer. Constipation 6 d prior | Abdominal soreness, severe tenesmus, bloody mucus. Fever 103 F. Bowel mucosa covered with gray tenacious membrane, ulcerated, purulent exudate up to 24 cm from dentate line | Yes | 2 : 1 hydrogen peroxide & water | Unknown | Granulation tissue cauterized with silver nitrate. Recovery: 8 m |
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Pumphrey
(1951) [2] | 76 years | Chronic constipation | Developed bloody mucus stools every 30–60 mins. Ulcerative proctosigmoiditis up to 24 cm | No (self) | Full strength hydrogen peroxide | 30 mins | 1 gm sulfasalazine qid, rectal instillations of warm oil, 1 teaspoon of psyllium seed oral bid. Recovery: 3 w |
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Olim and Ciuti
(1954) [1] | 2 days | Meconium ileus due to pancreatic cystic fibrosis | None: meconium evacuated | Yes | 1 : 3 3% hydrogen peroxide & water, via enterotomy | | |
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Ludington et al.
(1958) [3] | 62 years | Peptic ulcer | Abd pain, rebound tenderness, left lower quadrant mild rigidity, decreased sensation on right side. Fever 103 F
2 seromuscular tears along mesenteric borders of sigmoid and transverse colon | Yes | 125 cc hydrogen peroxide in a liter of warm water, retained for 15 mins | Within hours | Laparotomy for seromuscular tears, gangrenous mucosa 4 cm dia. excised and repaired. Recovery: uneventful |
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Sheehan and Brynjolfsson
(1960) [4] | 41 years | Duodenal ulcer, constipation | Severe abd pain, rectal bleeding, vomiting, lost 500 ml of blood. Administered plasma. Died due to hemolytic reaction of unknown causes, followed by anuria, uremia, hemoglobinuric nephrosis | No | Unknown | Immediate | Plasma for blood loss. Died due to following complications |
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Meyer et al.
(1981) [5] | 22 years | Constipation | Small bloody bowel movements every half hour with tenesmus and lower abd pain. Friable necrotic mucosa to 15 cm. Rectal mucosa improved but erythematous post 5 d | No | 10 ml 3% hydrogen peroxide + 30 ml water | 30 mins | Parenteral fluids, antibiotics, and rectal steroids. Recovery: mucosa normal at 10 d, asymptomatic at 1 m |
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Meyer et al.
(1981) [5] | 47 years | Constipation | Lower abd cramps, tenesmus, rectal bleeding over 24 hours. Diffuse, granular, friable mucosa and discrete ulcerations w yellow/green pseudomembrane. Focal acute ulcerations with edema and congestion of lamina propria | No | Enema of methylene blue dye + 1 oz (29 ml) peroxide in 500 ml water | 5 mins | 100 units ACTH over 8 hrs and then 30 mg prednisone for 2 wks. Recovery: no bleeding at 3 d, normal mucosa at 21 d |
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Meyer et al.
(1981) [5] | 28 years | Constipation | Onset of severe abd cramps, loose bloody bowel movements. Fever 102 F, BP 150/90, pulse 110, RR 14. Diffuse ulcerations at 10 cm; congestion and edema in lamina propria | No | Enema of 150 ml 3% hydrogen peroxide and 60 ml food coloring | Few minutes later | Parenteral ACTH 100 units for 5 days, prednisone 30 mg daily. Recovery: 7 d, asymptomatic at 5 w |
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Bollen et al.
(1998) [6] | 13 years | Chronic constipation after being sexually abused | Abd pain, rectal bleeding, no defecation. Hemorrhagic mucosal ulcerations from rectum to splenic angle. 48 hrs, sclerotic lamina propria. Mucosal glands focally destroyed, ischemia, microabscesses with polymorphonuclear leukocytes | Yes | 1 : 1 water & 10% hydrogen peroxide | 1 hr | No oral feeding for 48 hrs. Gradual complete recovery |
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Gan and Price
(2003) [7] | 67 years | Type 2 diabetes, prostate cancer | Profuse diarrhea, initially nonbloody. Later, bloody tenesmus, urgency, soft and nontender abdomen. Normal rectal examination, other than a diffusely hardened prostate. Friable, inflamed mucosa in rectum, several white patches in inflammation area extending to 15 cm. No fibrosis, scarring | No (self) | 100 ml to 200 ml 3.5% hydrogen peroxide enema | 24 hrs | Recovery: 10 d |
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Kirrane and Hoffman
(2007) [8] | 57 years | Abdominal pain, rectal bleeding, tachycardia | Lightheadedness, general weakness, abdominal pain. 12 hours later, multiple episodes of rectal bleeding. Tachycardia (heart rate 110 bpm). Distended abd, discomfort to palpation, no focal tenderness. Distended large bowel, thickened sigmoid colon consistent with colitis. No free air or gas embolization | No | 30 ml 35% hydrogen peroxide + 750 ml water | Within minutes; bleeding post 12 hrs | Recovery: 3 d
Treated with intravenous fluids and oral simethicone |
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Almalouf et al.
(2008) [9] | 19 years | 2 week abdominal pain from chronic cholecystitis, constipation following hydrocodone administration | Post 1 hr, abd pain, rectal bleeding. Acute abd, friable mucosa, leukocytosis, free retroperitoneal air | Yes | Soap suds with hydrogen peroxide (500 ml, unknown conc) | 1 hour | Ceftriaxone, metronidazole. NPO 3 d until white blood cell counts within normal range. Recovery: 7 d |
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Desai and Orledge
(2010) [10] | 43 years | Left-sided abdominal pain, hematochezia | Hematochezia every 30 mins, bowel wall thickening from rectum to distal one-third of transverse colon | No | Commercial sodium phosphate/sodium biphosphate + hydrogen peroxide | Unknown | Recovery: 1 d |
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Kibria et al.
(2010) [11] | 61 years | Constipation unresponsive to milk of magnesia | Abd pain, bloody stools 1 hr later. Left lower quadrant tenderness. Rectosigmoid wall thickening, inflammation
Friable mucosa, discrete ulcerations & yellow/green pseudomembranes up to 40 cm from anus. Focal acute ulcerations, congestion of lamina propria | Yes | Enema with 90 ml each of hydrogen peroxide, sodium phosphate, and docusate sodium | 1 hr | Parenteral fluids, levofloxacin, and metronidazole. Recovery: 3 m |
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Volonte et al.
(2010) [12] | 31 years | Severe constipation following spinal trauma. 4000 ml/wk glycerol enema for defecation | Severe abdominal pain soon after enema. 3 hr later CT showed extensive gas in portal vein. Resolved 48 hr later | Yes | 700 cc hypertonic solution of 5% glycerin and 300 cc of 3% hydrogen peroxide solution | Within hours | Recovery: 3 h |
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Lim et al.
(2011) [13] | 49 years | Abdominal pain | Lower abdominal pain with bloody stools | No | Unknown | 2 hours | NPO, IV fluids, antibiotics. Recovery: 5 d |
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Love et al.
(2012) [14] | 59 years | Hypertension, coronary artery disease, diabetes, chronic kidney disease, constipation | Rectal bleeding, fecal incontinence over 12 hrs. Soft abd with diffuse tenderness on left lateral side. Rectal exam, presacral thickening, diminished anal tone. Colitis extending to 35 cm, edema & hemorrhage in lamina propria with “bubbly” appearance of goblet cells | No | 120 ml hydrogen peroxide (1 : 1 3% hydrogen peroxide & water) | Minutes after | Antibiotic and mesalamine enema. Recovery: 2 d |
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Taş et al.
(2011) [15] | 27 years | Constipation over 2 yrs | Post 2 hrs, abd pain, bloody diarrhea. Mild lower quadrant abd tenderness, painful digital rectal exam. Friable, granular ulcerated rectal mucosa. Rectal histopath exam, mucosal congestion, hemorrhage, necrosis, lymphatic ductal ectasia | No | 200 ml 3% hydrogen peroxide | 2 hours | Enema with budesonide (2 mg). Recovery: 3 d |
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