Control of Ammonia Production in the Colon with Neomycin Enemas

The ammonia that occurs in the blood originates mainly in the colon, where it is produced as a result of the action of intestinal bacteria on nitrogenous substances.1,2Sterilization of the intestine by the use of orally administered antibiotics greatly reduces the amount of ammonia in the venous blood from the colon.3,4Neomycin has been shown both experimentally5and clinically6,7to be the most effective currently available antibiotic to reduce ammonia production in the gastrointestinal tract. During the course of treatment of some patients with ammonia intoxication it may be impossible to give the antibiotic by mouth; therefore, the following experimental and clinical investigations of the effectiveness and safety of the administration of neomycin by enema were done. Methods and Material In 12 dogs laparotomies were performed and polyethylene catheters were sutured into their portal veins. The distal ends of these catheters were placed in easily