The usefulness of olive oil enema in children with severe chronic constipation

•Olive oil enemas are a safe and effective remedy for chronic constipation.•Olive oil enemas followed by glycerin enemas are useful for fecal disimpaction.•Olive oil enemas are effective in patients with various underlying disorders requiring bowel management. Few reports have determined the efficacy of olive oil enemas for severe constipation. Here, we review our experience with olive oil enemas in children with severe chronic constipation. In our outpatient pediatric surgery department, the charts of 118 patients prescribed with olive oil enemas between January 2010 and November 2019 were retrospectively reviewed. A 1–2 ml/kg olive oil enema was given either alone or followed several hours later by a glycerin enema. Ratings included “very effective (VE),” “effective (E),” “limited (L),” “ineffective (I),” and “unknown (U).” One hundred and fifteen (97.5%) patients were able to use olive oil enemas at home. Forty-nine had functional constipation; 43 had anorectal malformation; 40 had Hirschsprung disease; 12 had spina bifida; and 10 had other maladies. Used as an enema, olive oil was effective in treating fecal impaction in 77.6% of patients; as a lubricant, it was effective in treating 76.9% of patients. Efficacy for fecal disimpaction was similar among patients with different underlying disorders. Olive oil enemas are useful for more than three-quarters of children with severe chronic constipation. Further study is warranted to add olive oil enemas as an adjunctive treatment in the management of severe constipation.