An enema, also known as a clyster, is an injection of fluid into the
lower bowel by way of the
rectum
The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...
.
[Cullingworth, ''A Manual of Nursing, Medical and Surgical'':155] The word enema can also refer to the liquid injected,
as well as to a device for administering such an injection.
In standard medicine, the most frequent uses of enemas are to relieve constipation and for bowel cleansing before a medical examination or procedure;
also, they are employed as a
lower gastrointestinal series
A lower gastrointestinal series is a medical procedure used to examine and diagnose problems with the human colon of the large intestine. Radiographs (X-ray pictures) are taken while barium sulfate, a radiocontrast agent, fills the colon via an ...
(also called a barium enema),
to treat
traveler's diarrhea
Travelers' diarrhea (TD) is a stomach and intestinal infection. TD is defined as the passage of unformed stool (one or more by some definitions, three or more by others) while traveling. It may be accompanied by abdominal cramps, nausea, fever, ...
,
as a vehicle for the administration of food, water or medicine, as a stimulant to the general system, as a local application and, more rarely, as a means of reducing temperature,
as treatment for
encopresis
Encopresis is voluntary or involuntary passage of feces outside of toilet-trained contexts (fecal soiling) in children who are four years or older and after an organic cause has been excluded. Children with encopresis often leak stool into thei ...
, and as a form of
rehydration therapy
The management of dehydration typically involves the use of Oral rehydration therapy, oral rehydration solution (ORS). Standard home solutions such as salted rice water, salted yogurt drinks, vegetable and chicken soups with salt can be given. Hom ...
(proctoclysis) in patients for whom
intravenous therapy
Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutri ...
is not applicable.
In other contexts, enemas are used by some alternative health therapies, used for enjoyment, chiefly as part of sexual activities, but also in
BDSM
BDSM is a variety of often erotic practices or roleplaying involving bondage, discipline, dominance and submission, sadomasochism, and other related interpersonal dynamics. Given the wide range of practices, some of which may be engaged ...
, as well as simply for pleasure, used to intoxicate with alcohol, used to administer drugs for both recreational and religious reasons, and used for punishment.
Medical usage
The principal medical usages of enemas are:
Bowel cleansing
Acute treatments
As
bowel
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...
stimulants, enemas are employed for the same purposes as orally administered
laxative
Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation.
Laxatives vary as to how they work and the side effects they may have. Certain stimulant, lubri ...
s: To relieve
constipation
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...
; To treat
fecal impaction
A fecal impaction is a solid, immobile bulk of feces that can develop in the rectum as a result of chronic constipation.
A related term is fecal loading which refers to a large volume of stool in the rectum of any consistency. Fecal impaction i ...
; To empty the colon prior to a medical procedure such as a
colonoscopy
Colonoscopy () or coloscopy () is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It can provide a visual diagnosis (''e. ...
. When oral laxatives are not indicated or are not sufficiently effective, enemas may be a sensible and necessary measure.
A large volume of enema can be given to cleanse as much of the colon as possible of feces.
However, a low enema is generally useful only for stool in the rectum, not in the intestinal tract.
Such enemas' mechanism consists of the volume of the liquid causing rapid expansion of the intestinal tract in conjunction with, in the case of certain solutions, irritation of the intestinal
mucosa
A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is ...
which stimulates peristalsis and lubricates the stool to encourage a bowel movement.
[ An enema's efficacy depends on several factors including the volume injected and the temperature and the contents of the infusion.] In order for the enema to be effective the patient should retain the solution for five to ten minutes, as tolerated.[ or, as some nursing textbooks recommend, for five to fifteen minutes or as long as possible.][
]
= Large volume enemas
=
For emptying the entire colon as much as feasible deeper and higher enemas are utilized to reach large sections of the colon. The colon dilates and expands when a large volume of liquid is injected into it, and the colon reacts to that sudden expansion with general contractions, peristalsis
Peristalsis ( , ) is a radially symmetrical contraction and relaxation of muscles that propagate in a wave down a tube, in an anterograde direction. Peristalsis is progression of coordinated contraction of involuntary circular muscles, which ...
, propelling its contents toward the rectum.
Soapsuds enema is a frequently used synonym for a large volume enema (although soap is not necessary for effectivity).
For relieving occasional constipation, a large volume enema may be used in a home setting, although for recurring or severe cases of constipation medical care may be required.
Water-based solutions
Plain water can be used, simply functioning mechanically to expand the colon, thus prompting evacuation.
Normal saline
Saline (also known as saline solution) is a mixture of sodium chloride (salt) and water. It has a number of uses in medicine including cleaning wounds, removal and storage of contact lenses, and help with dry eyes. By injection into a vein it ...
is least irritating to the colon. Like plain water, it simply functions mechanically to expand the colon, but having a neutral concentration gradient, it neither draws electrolyte
An electrolyte is a medium containing ions that is electrically conducting through the movement of those ions, but not conducting electrons. This includes most soluble salts, acids, and bases dissolved in a polar solvent, such as water. Upon dis ...
s from the body, as happens with plain water, nor draws water into the colon, as occurs with phosphates. Thus, a salt water solution can be used when a longer period of retention is desired, such as to soften an impaction.
Castile soap
Castile soap is an olive oil based hard soap made in a style similar to that originating in the Castile region of Spain.
History
The origins of Castile soap go back to the Levant, where Aleppo soap-makers have made hard soaps based on olive ...
is commonly added because its irritation of the colon's lining increases the urgency to defecate. However, liquid handsoaps and detergents should not be used.[
]Glycerol
Glycerol (), also called glycerine in British English and glycerin in American English, is a simple triol compound. It is a colorless, odorless, viscous liquid that is sweet-tasting and non-toxic. The glycerol backbone is found in lipids known ...
is a specific bowel mucosa irritant serving to induce peristalsis via a hyperosmotic effect. It is used in a dilute solution, e.g., 5%.
Other solutions
Equal parts of milk and molasses heated together to slightly above normal body temperature have been used. Neither the milk sugars and proteins nor the molasses are absorbed in the lower intestine, thus keeping the water from the enema in the intestine. Studies have shown that milk and molasses enemas have a low complication rate when used in the emergency department
An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of pati ...
and are safe and effective with minimal side effects.
Mineral oil
Mineral oil is any of various colorless, odorless, light mixtures of higher alkanes from a mineral source, particularly a distillate of petroleum, as distinct from usually edible vegetable oils.
The name 'mineral oil' by itself is imprecise, ...
functions as a lubricant and stool softener, but may have side effects including rectal skin irritation and leakage of oil.
= Micro-enemas
=
ATC codes for drugs for constipation — enemas
:A06AG01 Sodium phosphate
Sodium phosphate is a generic term for a variety of salts of sodium (Na+) and phosphate (PO43−). Phosphate also forms families or condensed anions including di-, tri-, tetra-, and polyphosphates. Most of these salts are known in both anhydrou ...
:A06AG02 Bisacodyl
Bisacodyl (INN) is an organic compound that is used as a stimulant laxative drug. It works directly on the colon to produce a bowel movement. It is typically prescribed for relief of episodic and chronic constipation and for the management of n ...
:A06AG03 Dantron
Dantron (INN), also known as chrysazin or 1,8-dihydroxyanthraquinone, is an organic substance, formally derived from anthraquinone by the replacement of two hydrogen atoms by hydroxyl groups (–OH). It is used in some countries as a stimulant la ...
, including combinations
:A06AG04 Glycerol
Glycerol (), also called glycerine in British English and glycerin in American English, is a simple triol compound. It is a colorless, odorless, viscous liquid that is sweet-tasting and non-toxic. The glycerol backbone is found in lipids known ...
:A06AG06 Oil
An oil is any nonpolar chemical substance that is composed primarily of hydrocarbons and is hydrophobic (does not mix with water) & lipophilic (mixes with other oils). Oils are usually flammable and surface active. Most oils are unsaturated ...
:A06AG07 Sorbitol
Sorbitol (), less commonly known as glucitol (), is a sugar alcohol with a sweet taste which the human body metabolizes slowly. It can be obtained by reduction of glucose, which changes the converted aldehyde group (−CHO) to a primary alcohol g ...
:A06AG10 Docusate sodium
Docusate is the common chemical and pharmaceutical name of the anion bis(2-ethylhexyl) sulfosuccinate, also commonly called dioctyl sulfosuccinate (DOSS).
It is on the World Health Organization's List of Essential Medicines.
Salts of this anion ...
, including combinations
:A06AG11 Sodium lauryl sulfoacetate
Sodium citrate/sodium lauryl sulfoacetate/glycerol sold under the brandname Microlax and Micolette Micro enema, among others, is a small tube of liquid gel that is used to treat constipation.
The main active ingredients are sodium lauryl sulfoacet ...
, including combinations
:A06AG20 Combinations
Single substance solutions
''In alphabetical order''
Arachis oil (peanut oil) enema is useful for softening stools which are impacted higher than the rectum.
Bisacodyl
Bisacodyl (INN) is an organic compound that is used as a stimulant laxative drug. It works directly on the colon to produce a bowel movement. It is typically prescribed for relief of episodic and chronic constipation and for the management of n ...
stimulates enteric nerves to cause colonic contractions.
Dantron
Dantron (INN), also known as chrysazin or 1,8-dihydroxyanthraquinone, is an organic substance, formally derived from anthraquinone by the replacement of two hydrogen atoms by hydroxyl groups (–OH). It is used in some countries as a stimulant la ...
is a stimulant drug and stool softener used alone or in combinations in enemas. Considered to be a carcinogen
A carcinogen is any substance, radionuclide, or radiation that promotes carcinogenesis (the formation of cancer). This may be due to the ability to damage the genome or to the disruption of cellular metabolic processes. Several radioactive substan ...
its use is limited, e.g., restricted in the UK to patients who already have a diagnosis of terminal cancer and not used at all in the USA
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country Continental United States, primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., ...
.
Docusate
Docusate is the common chemical and pharmaceutical name of the anion bis(2-ethylhexyl) sulfosuccinate, also commonly called dioctyl sulfosuccinate (DOSS).
It is on the World Health Organization's List of Essential Medicines.
Salts of this anion ...
Glycerol has a hyperosmotic effect and can be used as a small-volume (2–10 ml) enema (or suppository).[
]Mineral oil
Mineral oil is any of various colorless, odorless, light mixtures of higher alkanes from a mineral source, particularly a distillate of petroleum, as distinct from usually edible vegetable oils.
The name 'mineral oil' by itself is imprecise, ...
is used as a lubricant because most of the ingested material is excreted in the stool rather than being absorbed by the body.
Sodium phosphate
Sodium phosphate is a generic term for a variety of salts of sodium (Na+) and phosphate (PO43−). Phosphate also forms families or condensed anions including di-, tri-, tetra-, and polyphosphates. Most of these salts are known in both anhydrou ...
. Also known by the brand name Fleet. Available at drugstores; usually self-administered. Buffered sodium phosphate
Sodium phosphate is a generic term for a variety of salts of sodium (Na+) and phosphate (PO43−). Phosphate also forms families or condensed anions including di-, tri-, tetra-, and polyphosphates. Most of these salts are known in both anhydrou ...
solution draws additional water from the bloodstream into the colon to increase the effectiveness of the enema. But it can be rather irritating to the colon, causing intense cramping or "griping." Fleet enemas usually causes a bowel movement in 1 to 5 minutes. Known adverse effects
An adverse effect is an undesired harmful effect resulting from a medication or other intervention, such as surgery. An adverse effect may be termed a "side effect", when judged to be secondary to a main or therapeutic effect. The term complica ...
.
Sorbitol
Sorbitol (), less commonly known as glucitol (), is a sugar alcohol with a sweet taste which the human body metabolizes slowly. It can be obtained by reduction of glucose, which changes the converted aldehyde group (−CHO) to a primary alcohol g ...
pulls water into the large intestines causing distention, thereby stimulating the normal forward movement of the bowels. Sorbitol is found in some dried fruits and may contribute to the laxative effects of prunes. and is available for taking orally as a laxative. As an enema for constipation, the recommended adult dose is 120 mL of 25-30% solution, administered once. Note that Sorbitol is an ingredient of the MICROLAX Enema.
Compounded from multiple ingredients
''In alphabetical order of the original brand names''
Klyx contains docusate sodium
Docusate is the common chemical and pharmaceutical name of the anion bis(2-ethylhexyl) sulfosuccinate, also commonly called dioctyl sulfosuccinate (DOSS).
It is on the World Health Organization's List of Essential Medicines.
Salts of this anion ...
1 mg/mL and sorbitol solution (70%) (crystallising) 357 mg/mL and is used for faecal impaction or constipation or for colon evacuation prior medical procedures, developed by Ferring B.V.
Micralax (not to be confused with MICROLAX®)
MICROLAX® (not to be confused with Micralax) combines the action of sodium citrate Sodium citrate may refer to any of the sodium salts of citric acid (though most commonly the third):
* Monosodium citrate
* Disodium citrate
* Trisodium citrate
The three forms of salt are collectively known by the E number E331.
Applications
F ...
, a peptidising agent which can displace bound water present in the faeces, with sodium alkyl sulphoacetate, a wetting agent, and with glycerol, an anal mucosa irritant and hyperosmotic. However, also sold under the name "Micralax", is a preparation containing sorbitol
Sorbitol (), less commonly known as glucitol (), is a sugar alcohol with a sweet taste which the human body metabolizes slowly. It can be obtained by reduction of glucose, which changes the converted aldehyde group (−CHO) to a primary alcohol g ...
rather than glycerol; which was initially tested in preparation for sigmoidoscopy
Sigmoidoscopy (from the Greek term for letter " s/ς" + "eidos" + "scopy": namely, to look inside an "s"/"ς"-like object) is the minimally invasive medical examination of the large intestine from the rectum through to the nearest part of the col ...
.
Micolette Micro-enema® contains 45 mg sodium lauryl sulphoacetate, 450 mg per 5 ml sodium citrate BP, and 625 mg glycerol BP and is a small volume stimulant enema suitable where large-volume enemas are contra-indicated.[
]
Chronic treatments
= Transanal irrigation
=
''TAI'', also termed ''retrograde irrigation'', is designed to assist evacuation using a water enema as a treatment for persons with bowel dysfunction, including fecal incontinence
Fecal incontinence (FI), or in some forms encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents, both liquid stool elements and mucus, or solid feces. When this loss includes flatus (gas), it is referred ...
or constipation, especially obstructed defecation
Obstructed defecation syndrome (abbreviated as ODS, with many synonymous terms) is a major cause of functional constipation (primary constipation), of which it is considered a subtype. It is characterized by difficult and/or incomplete emptying of ...
. By regularly emptying the bowel using transanal irrigation,
Consensus review of best practice of transanal irrigation in adults A V Emmanuel et al. Spinal Cord 2013. controlled bowel function is often re-established to a high degree, thus enabling development of a consistent bowel routine. Its effectiveness varies considerably, some individuals experiencing complete control of incontinence but others reporting little or no benefit.
An international consensus on when and how to use transanal irrigation for people with bowel problems was published in 2013, offering practitioners a clear, comprehensive and simple guide to practice for the emerging therapeutic area of transanal irrigation.
The term ''retrograde irrigation'' distinguishes this procedure from the Malone antegrade continence enema
A Malone antegrade continence enema is a surgical procedure used to create a continent pathway proximal to the anus that facilitates fecal evacuation using enemas.
Description
The operation involves connecting the appendix to the abdominal wall ...
, where irrigation fluid is introduced into the colon proximal to the anus via a surgically created irrigation port.
= Bowel management
=
Patients who have a bowel disability, a medical condition which impairs control of defecation
Defecation (or defaecation) follows digestion, and is a necessary process by which organisms eliminate a solid, semisolid, or liquid waste material known as feces from the digestive tract via the anus. The act has a variety of names ranging f ...
, e.g., fecal incontinence or constipation, can use bowel management techniques to choose a predictable time and place to evacuate. Without bowel management, such persons might either suffer from the feeling of not getting relief, or they might soil themselves.
While simple techniques might include a controlled diet
Diet may refer to:
Food
* Diet (nutrition), the sum of the food consumed by an organism or group
* Dieting, the deliberate selection of food to control body weight or nutrient intake
** Diet food, foods that aid in creating a diet for weight loss ...
and establishing a toilet routine, a daily enema can be taken to empty the colon, thus preventing unwanted and uncontrolled bowel movements that day.[Peña A, Guardino K, Tovilla JM, Levitt MA, Rodriguez G, Torres R Bowel management for fecal incontinence in patients with anorectal malformations Pediatr. Surg. 33:1 133–7 1998]
Contrast (X-ray)
In a lower gastrointestinal series
A lower gastrointestinal series is a medical procedure used to examine and diagnose problems with the human colon of the large intestine. Radiographs (X-ray pictures) are taken while barium sulfate, a radiocontrast agent, fills the colon via an ...
an enema that may contain barium sulfate
Barium sulfate (or sulphate) is the inorganic compound with the chemical formula Ba SO4. It is a white crystalline solid that is odorless and insoluble in water. It occurs as the mineral barite, which is the main commercial source of barium an ...
powder or a water-soluble contrast agent is used in the radiological
In physics, radiation is the emission or transmission of energy in the form of waves or particles through space or through a material medium. This includes:
* ''electromagnetic radiation'', such as radio waves, microwaves, infrared, visib ...
imaging of the bowel. Called a ''barium enema'', such enemas are sometimes the only practical way to ''view'' the colon in a relatively safe manner.
Failure to expel all of the barium may cause constipation or possible impaction and a patient who has no bowel movement for more than two days or is unable to pass gas rectally should promptly inform a physician and may require an enema or laxative.
Medication administration
The administration of substances into the bloodstream. This may be done in situations where it is undesirable or impossible to deliver a medication by mouth, such as antiemetic
An antiemetic is a drug that is effective against vomiting and nausea. Antiemetics are typically used to treat motion sickness and the side effects of opioid analgesics, general anaesthetics, and chemotherapy directed against cancer. They may ...
s given to reduce nausea
Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...
(though not many antiemetics are delivered by enema). Additionally, several anti-angiogenic agents, which work better without digestion, can be safely administered via a gentle enema.
The topical administration of medications into the rectum, such as corticosteroids
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are involve ...
and mesalazine
Mesalazine, also known as mesalamine or 5-aminosalicylic acid (5-ASA), is a medication used to treat inflammatory bowel disease, including ulcerative colitis and Crohn's disease. It is generally used for mildly to moderately severe disease. It ...
used in the treatment of inflammatory bowel disease
Inflammatory bowel disease (IBD) is a group of inflammation, inflammatory conditions of the colon (anatomy), colon and small intestine, Crohn's disease and ulcerative colitis being the principal types. Crohn's disease affects the small intestine a ...
. Administration by enema avoids having the medication pass through the entire gastrointestinal tract
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organ (biology), organs of the digestive syste ...
, therefore simplifying the delivery of the medication to the affected area and limiting the amount that is absorbed into the bloodstream.
Rectal corticosteroid enemas are sometimes used to treat mild or moderate ulcerative colitis. They also may be used along with systemic (oral or injection) corticosteroids or other medicines to treat severe disease or mild to moderate disease that has spread too far to be treated effectively by medicine inserted into the rectum alone.
Inhibiting pathological defecation
* Traveller's diarrhea
Travelers' diarrhea (TD) is a stomach and intestinal infection. TD is defined as the passage of unformed stool (one or more by some definitions, three or more by others) while traveling. It may be accompanied by abdominal cramps, nausea, fever, ...
's symptoms treated with an enema of sodium butyrate
Sodium butyrate is a compound with formula Na(C3H7COO). It is the sodium salt of butyric acid. It has various effects on cultured mammalian cells including inhibition of proliferation, induction of differentiation and induction or repression of ...
, organic acid
An organic acid is an organic compound with acidic properties. The most common organic acids are the carboxylic acids, whose acidity is associated with their carboxyl group –COOH. Sulfonic acids, containing the group –SO2OH, are rel ...
s, and A-300 silicon dioxide
Silicon dioxide, also known as silica, is an oxide of silicon with the chemical formula , most commonly found in nature as quartz and in various living organisms. In many parts of the world, silica is the major constituent of sand. Silica is one ...
can be successfully decreased with lack of observed side effects.[
* ]Shigellosis
Shigellosis is an infection of the intestines caused by ''Shigella'' bacteria. Symptoms generally start one to two days after exposure and include diarrhea, fever, abdominal pain, and feeling the need to pass stools even when the bowels are emp ...
treatment benefits from adjunct therapy with butyrate enemas, promoting healing of the rectal mucosa and inflammation, but not helping in clinical recovery from shigellosis. Use of an 80 ml of a sodium butyrate isotonic enema administered every 12 hours has been studied and found effective.
Other
* There have been a few cases in remote or rural settings, where rectal fluids have been used to rehydrate a person. Benefits include not needing to use sterile fluids.
* Introducing healthy bacterial flora through infusion of stool, known as a fecal microbiota transplant
Fecal microbiota transplant (FMT), also known as a stool transplant, is the process of transferring fecal bacteria and other microbes from a healthy individual into another individual. FMT is an effective treatment for ''Clostridioides diffici ...
, was first performed in 1958 employing retention enemas. Enemas remained the most common method until 1989, when alternative means of administration were developed. As of 2013, colonoscope
Colonoscopy () or coloscopy () is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It can provide a visual diagnosis (' ...
implantation has been preferred over fecal enemas because by using the former method, the entire colon and ileum can be inoculated, but enemas reach only to the splenic flexure
In the anatomy of the human digestive tract, there are two colic flexures, or curvatures in the transverse colon. The right colic flexure is also known as the hepatic flexure, and the left colic flexure is also known as the splenic flexure. Note ...
.
* A patient unable to be fed otherwise can be nourished by an enteral administration
Enteral administration is food or drug administration via the human gastrointestinal tract. This contrasts with parenteral nutrition or drug administration (Greek ''para'', "besides" + ''enteros''), which occurs from routes outside the GI tract ...
of predigested foods, which is known as a nutrient enema
A nutrient enema, also known as feeding per rectum, rectal alimentation, or rectal feeding, is an enema administered with the intent of providing nutrition when normal eating is not possible. This treatment is ancient, dating back at least to the s ...
. This treatment is ancient, dating back at least to the second century CE when documented by Galen
Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be one of ...
,[ and commonly used in the Middle Ages,] remaining a common technique in 19th century, and as recently as 1941 the U. S. military's manual for hospital diets prescribes their use. Nutrient enemas have been superseded in modern medical care by tube feeding
Tube or tubes may refer to:
* Tube (2003 film), ''Tube'' (2003 film), a 2003 Korean film
* The Tube (TV series), ''The Tube'' (TV series), a music related TV series by Channel 4 in the United Kingdom
* "Tubes" (Peter Dale), performer on the Socce ...
and intravenous feeding
Parenteral nutrition (PN) is the feeding of nutritional products to a person intravenously, bypassing the usual process of eating and digestion. The products are made by pharmaceutical compounding companies. The person receives a nutritional mix ...
.
* Enemas have been used around the time of childbirth; however, there is no evidence for this practice and it is now discouraged.
Adverse effects
Improper administration of an enema can cause electrolyte imbalance (with repeated enemas) or ruptures to the bowel or rectal tissues resulting in internal bleeding
Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vag ...
. However, these occurrences are rare in healthy, sober
In cryptography, SOBER is a family of stream ciphers initially designed by Greg Rose of QUALCOMM Australia starting in 1997. The name is a contrived acronym for ''S''eventeen ''O''ctet ''B''yte ''E''nabled ''R''egister. Initially the cipher wa ...
adults. Internal bleeding or rupture may leave the individual exposed to infections from intestinal bacteria. Blood resulting from tears in the colon may not always be visible, but can be distinguished if the feces are unusually dark or have a red hue. If intestinal rupture is suspected, medical assistance should be obtained immediately. Frequent use of enemas can cause laxative dependency.
The enema tube and solution may stimulate the vagus nerve
The vagus nerve, also known as the tenth cranial nerve, cranial nerve X, or simply CN X, is a cranial nerve that interfaces with the parasympathetic control of the heart, lungs, and digestive tract. It comprises two nerves—the left and right ...
, which may trigger an arrhythmia
Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults ...
such as bradycardia
Bradycardia (also sinus bradycardia) is a slow resting heart rate, commonly under 60 beats per minute (BPM) as determined by an electrocardiogram. It is considered to be a normal heart rate during sleep, in young and healthy or elderly adults, a ...
.
Enemas should not be used if there is an undiagnosed abdominal pain
Abdominal pain, also known as a stomach ache, is a symptom
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than ...
since the peristalsis of the bowel can cause an inflamed appendix to rupture
Rupture may refer to:
General
* Rupture (engineering), a failure of tough ductile materials loaded in tension
Anatomy and medicine
* Abdominal hernia, formerly referred to as "a rupture"
* Achilles tendon rupture
* Rupture of membranes, a "wate ...
.
There are arguments both for and against colonic irrigation in people with diverticulitis
Diverticulitis, specifically colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—which can develop in the wall of the large intestine. Symptoms typically include lower abdominal ...
, ulcerative colitis
Ulcerative colitis (UC) is a long-term condition that results in inflammation and ulcers of the colon and rectum. The primary symptoms of active disease are abdominal pain and diarrhea mixed with blood (hematochezia). Weight loss, fever, and a ...
, Crohn's disease
Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, abdominal distension ...
, severe or internal hemorrhoids
Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term ''hemo ...
or tumors
A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
in the rectum or colon, and its usage is not recommended soon after bowel surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
(unless directed by one's health care provider
A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices. Health care providers often receive ...
). Regular treatments should be avoided by people with heart disease
Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, hea ...
or kidney failure
Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...
. Colonics are inappropriate for people with bowel, rectal or anal pathologies
Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in t ...
where the pathology contributes to the risk of bowel perforation
Gastrointestinal perforation, also known as ruptured bowel, is a hole in the wall of part of the gastrointestinal tract. The gastrointestinal tract includes the esophagus, stomach, small intestine, and large intestine. Symptoms include severe abd ...
.
Recent research has shown that ozone water, which is sometimes used in enemas, can immediately cause microscopic colitis
Microscopic colitis refers to two related medical conditions which cause diarrhea: collagenous colitis and lymphocytic colitis. Both conditions are characterized by the presence of chronic non-bloody watery diarrhea, normal appearances on colonosco ...
.
A recent case series of 11 patients with five deaths illustrated the danger of phosphate enemas in high-risk patients.
History
Etymology
''Enema'' entered the English language c. 1675 from Latin in which, in the 15th century,[ it was first used in the sense of a rectal injection,][ from Greek ἔνεμα (énema), "injection", itself from ἐνίηναι (enienai) "to send in, inject", from ἐν (en), "in" + ἱέναι (hienai), "to send, throw".
''Clyster'' entered the English language in the late 14th century from Old French or Latin, from Greek κλυστήρ (klyster), "syringe", itself from κλύζειν (klyzein), "to wash out", also spelled ''glister'' in the 18th century, is a generally archaic word used more particularly for enemas administered using a ''clyster syringe''.
]
Ancient and medieval
Africa
The first mention of the enema in medical literature is in the Ancient Egyptian Ebers Papyrus ( BCE). One of the many types of medical specialists was an Iri, the Shepherd of the Anus. Many medications were administered by enemas. There was a Keeper of the Royal Rectum who may have primarily been the pharaoh's enema maker. The god Thoth
Thoth (; from grc-koi, Θώθ ''Thṓth'', borrowed from cop, Ⲑⲱⲟⲩⲧ ''Thōout'', Egyptian: ', the reflex of " eis like the Ibis") is an ancient Egyptian deity. In art, he was often depicted as a man with the head of an ibis or a ...
, according to Egyptian mythology, invented the enema.
In parts of Africa the calabash
Calabash (; ''Lagenaria siceraria''), also known as bottle gourd, white-flowered gourd, long melon, birdhouse gourd, New Guinea bean, Tasmania bean, and opo squash, is a vine grown for its fruit. It can be either harvested young to be consumed ...
gourd is used traditionally to administer enemas. On the Ivory Coast the narrow neck of the gourd filled with water is inserted the patient's rectum and the contents are then injected by means of an attendant's forcible oral inflation, or, alternatively, a patient may self-administer the enema by using suction to create a negative pressure in the gourd, placing a finger at the opening, and then upon anal insertion, removing the finger to allow atmospheric pressure to effect the flow. Along the upper Congo River an enema apparatus is made by making a hole in one end of the gourd for filling it, and using a resin to attach a hollow cane to the gourd's neck. The cane is inserted into the anus of the patient who is in a posture that allows gravity to effect infusion of the fluid.
Americas
The Olmec
The Olmecs () were the earliest known major Mesoamerican civilization. Following a progressive development in Soconusco, they occupied the tropical lowlands of the modern-day Mexican states of Veracruz and Tabasco. It has been speculated that t ...
from their middle preclassic period (10th through 7th centuries BCE) through the Spanish Conquest used trance-inducing substances ceremonially, and these were ingested via, among other routes, enemas administered using jars.
As further described below in religious rituals
Religion is usually defined as a social-cultural system of designated behaviors and practices, morals, beliefs, worldviews, texts, sanctified places, prophecies, ethics, or organizations, that generally relates humanity to supernatural, tran ...
, the Maya
Maya may refer to:
Civilizations
* Maya peoples, of southern Mexico and northern Central America
** Maya civilization, the historical civilization of the Maya peoples
** Maya language, the languages of the Maya peoples
* Maya (Ethiopia), a populat ...
in their late classic age (7th through 10th centuries CE) used enemas for, at least, ritual purposes, Mayan sculpture and ceramics from that period depicting scenes in which, injected by syringes made of gourd and clay, ritual hallucinogenic enemas were taken. In the Xibalban court of the God D, whose worship included ritual cult paraphernal, the Maya illustrated the use of a characteristic enema bulb syringe by female attendants administering clysters ritually.
For combating illness and discomfort of the digestive tract, the Mayan also employed enemas, as documented during the colonial period, e.g., in the Florentine Codex
The ''Florentine Codex'' is a 16th-century ethnographic research study in Mesoamerica by the Spanish Franciscan friar Bernardino de Sahagún. Sahagún originally titled it: ''La Historia General de las Cosas de Nueva España'' (in English: ''The ...
.[
The ]indigenous peoples of North America
The Indigenous peoples of the Americas are the inhabitants of the Americas before the arrival of the European settlers in the 15th century, and the ethnic groups who now identify themselves with those peoples.
Many Indigenous peoples of the Am ...
employed tobacco smoke enema
The tobacco smoke enema, an Insufflation (medicine), insufflation of tobacco smoke into the rectum by enema, was a medical treatment employed by European physicians for a range of ailments.
Tobacco was recognised as a medicine soon after it was ...
s to stimulate respiration, injecting the smoke using a rectal tube.
A rubber bag connected with a conical nozzle, at an early period, was in use among the indigenous peoples of South America
The Indigenous peoples of South America or South American Indigenous peoples, are the pre-Colombian peoples of South America and their descendants. These peoples contrast with South Americans of European ancestry and those of African descent.
...
as an enema syringe, and the rubber enema bag with a connecting tube and ivory tip remained in use by them while in Europe a syringe was still the usual means for conducting an enema.
Asia
In Babylonia, by 600 BCE, enemas were in use, although it appears that initially they were in use because of a belief that the demon of disease would, by means of an enema, be driven out of the body.[Friedenwald & Morrison, Part I:77] Babylonian and Assyrian tablets c. 600 BCE bear cuneiform inscriptions referring to enemas.
In China, c. 200 CE, Zhang Zhongjing
Zhang Zhongjing (; 150–219), formal name Zhang Ji (), was a Chinese pharmacologist, physician, inventor, and writer of the Eastern Han dynasty and one of the most eminent Chinese physicians during the later years of the Han dynasty. He estab ...
Redirected from Chang Chung-ching, the name used in the reference---> was the first to employ enemas. "Secure a large pig's bile and mix with a small quantity of vinegar. Insert a bamboo tube three or four inches long into the rectum and inject the mixture" are his directions, according to Wu Lien-teh
Wu Lien-teh (; Goh Lean Tuck and Ng Leen Tuck in Minnan and Cantonese transliteration respectively; 10 March 1879 – 21 January 1960) was a Malayan physician renowned for his work in public health, particularly the Manchurian plague of 1910 ...
.
In India, in the fifth century BCE, Sushruta
Sushruta, or ''Suśruta'' (Sanskrit: सुश्रुत, IAST: , ) was an ancient Indian physician. The ''Sushruta Samhita'' (''Sushruta's Compendium''), a treatise ascribed to him, is one of the most important surviving ancient treatises on ...
enumerates the enema syringe among 121 surgical instruments described. Early Indian physicians' enema apparatus consisted of a tube of bamboo, ivory, or horn attached to the scrotum of a deer, goat, or ox.[
In Persia, ]Avicenna
Ibn Sina ( fa, ابن سینا; 980 – June 1037 CE), commonly known in the West as Avicenna (), was a Persian polymath who is regarded as one of the most significant physicians, astronomers, philosophers, and writers of the Islamic G ...
(980–1037 A. D.) is credited with the introduction of the "clyster-purse" or collapsible portion of an enema outfit made from ox skin or silk cloth and emptied by squeezing with the hands.[
]
Europe
Hippocrates
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...
(460–370 BCE) frequently mentions enemas, e.g., "if the previous food which the patient has recently eaten should not have gone down, give an enema if the patient be strong and in the prime of life, but if he be weak, a suppository should be administered, should the bowels be not well moved on their own accord."
In the first century BCE the Greek physician Asclepiades of Bithynia
Asclepiades ( el, Ἀσκληπιάδης; c. 129/124 BC – 40 BC), sometimes called Asclepiades of Bithynia or Asclepiades of Prusa, was a Greek physician born at Prusias-on-Sea in Bithynia in Anatolia and who flourished at Rome, where he pr ...
wrote "Treatment consists merely of three elements: drink, food, and the enema". Also, he contended that indigestion is caused by particles of food that are too big and his prescribed treatment was proper amounts of food and wine followed by an enema which would remove the improper food doing the damage.
In the second century CE the Greek physician Soranus prescribed, among other techniques, enemas as a safe abortion
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...
method, and the Greek philosopher Celsus
Celsus (; grc-x-hellen, Κέλσος, ''Kélsos''; ) was a 2nd-century Greek philosopher and opponent of early Christianity. His literary work, ''The True Word'' (also ''Account'', ''Doctrine'' or ''Discourse''; Greek: grc-x-hellen, Λόγ ...
recommended an enema of pearl barley in milk or rose oil with butter as a nutrient for those with dysentery and unable to eat, and also Galen mentions enemas in several contexts.
In medieval times appear the first illustrations of enema equipment in the Western world
The Western world, also known as the West, primarily refers to the various nations and state (polity), states in the regions of Europe, North America, and Oceania. , a clyster syringe consisting of a tube attached to a pump action bulb made of a pig bladder.
A simple piston syringe
A syringe is a simple reciprocating pump consisting of a plunger (though in modern syringes, it is actually a piston) that fits tightly within a cylindrical tube called a barrel. The plunger can be linearly pulled and pushed along the inside ...
clyster was in use from the 15th through 19th centuries. This device had its rectal nozzle connected to a syringe with a plunger rather than to a bulb.
Modern western
Beginning in the 17th century enema apparatus was chiefly designed for self-administration at home and many were French as enemas enjoyed wide usage in France.
In 1694 François Mauriceau
François Mauriceau (1637 – 17 October 1709) was a French obstetrician.
__TOC__ Life
Born in Paris, he received his training in obstetrics at the Hôtel-Dieu. He was a leading obstetrician in 17th-century Europe — in 1668 he published, ...
in his early-modern treatise, ''The Diseases of Women with Child,'' records that both midwives and man-midwives commonly administered clysters to labouring mothers just prior to their delivery.
Clysters were administered for symptoms of constipation and, with more questionable effectiveness, stomach aches and other illnesses.
In 1753 an enema bag prepared from a pig's or beef's bladder attached to a tube was described by Johann Jacob Woyts as an alternative to a syringe.
In the 18th century Europeans began emulating the indigenous peoples of North America's use of tobacco smoke enemas to resuscitate drowned people. Tobacco resuscitation kits consisting of a pair of bellows and a tube were provided by the Royal Humane Society of London and placed at various points along the Thames. Furthermore, these enemas came to be employed for headaches, respiratory failure, colds, hernias, abdominal cramps, typhoid fever, and cholera outbreaks.[
Clysters were a favourite medical treatment in the ]bourgeoisie
The bourgeoisie ( , ) is a social class, equivalent to the middle or upper middle class. They are distinguished from, and traditionally contrasted with, the proletariat by their affluence, and their great cultural and financial capital. They ...
and nobility
Nobility is a social class found in many societies that have an aristocracy (class), aristocracy. It is normally ranked immediately below Royal family, royalty. Nobility has often been an Estates of the realm, estate of the realm with many e ...
of the Western world up to the 19th century. As medical knowledge was fairly limited at the time, purgative clysters were used for a wide variety of ailment
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
s, the foremost of which were stomach ache
Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues.
Common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome. About 15% of people have a m ...
s and constipation.
According to the duc de Saint-Simon, clysters were so popular at the court of King Louis XIV of France
, house = Bourbon
, father = Louis XIII
, mother = Anne of Austria
, birth_date =
, birth_place = Château de Saint-Germain-en-Laye, Saint-Germain-en-Laye, France
, death_date =
, death_place = Palace of Versa ...
that the duchess of Burgundy had her servant give her a clyster in front of the King (her modesty being preserved by an adequate posture) before going to the comedy
Comedy is a genre of fiction that consists of discourses or works intended to be humorous or amusing by inducing laughter, especially in theatre, film, stand-up comedy, television, radio, books, or any other entertainment medium. The term o ...
. However, he also mentions the astonishment of the King and Mme de Maintenon that she should take it before them.
In the 19th century many new types of enema administration equipment were devised. Devices allowing gravity to infuse the solution, like those mentioned above used by South American indigenous people and like the enema bag described by Johann Jacob Woyts, came into common use. These consist of a nozzle at the end of a hose which connects a reservoir, either a bucket or a rubber bag, which is filled with liquid and held or hung above the recipient.
In the early 20th century the disposable microenema, a squeeze bottle, was invented by Charles Browne Fleet
Charles Browne Fleet (September 18, 1843 – May 12, 1916) was a pharmacist and inventor of the laxative and chapstick. His company, C.B. Fleet, was founded in Lynchburg, Virginia, and still operates producing laxatives, douches, micro-enemas, ...
.
Society and culture
Alternative medicine
Relatively benign
= Colonic irrigation
=
The term "colonic irrigation" is commonly used in gastroenterology
Gastroenterology (from the Greek gastḗr- “belly”, -énteron “intestine”, and -logía "study of") is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the gastrointestinal tract ...
to refer to the practice of introducing water through a colostomy or a surgically constructed conduit as a treatment for constipation. The Food and Drug Administration
The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
has ruled that colonic irrigation equipment is not approved for sale for the purpose of general well-being and has taken action against many distributors of this equipment, including a Warning Letter.
= Colon cleansing
=
The same term is also used in alternative medicine
Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and alt ...
where it may involve the use of substances mixed with water in order to detoxify the body. Practitioners believe the accumulation of fecal matter in the large intestine leads to ill health. This resurrects the old medical concept of ''autointoxication'' which was orthodox doctrine up to the end of the 19th century but which has now been discredited.
=Kellogg's enemas
=
In the late 19th century Dr. John Harvey Kellogg
John Harvey Kellogg (February 26, 1852 – December 14, 1943) was an American medical doctor, nutritionist, inventor, health activist, eugenicist, and businessman. He was the director of the Battle Creek Sanitarium in Battle Creek, Michigan. The ...
made sure that the bowel of each and every patient was plied with water, from above and below. His favorite device was an enema machine ("just like one I saw in Germany") that could run fifteen gallons of water through a person's bowel in a matter of seconds. Every water enema was followed by a pint of yogurt—half was eaten, the other half was administered by enema "thus planting the protective germs where they are most needed and may render most effective service." The yogurt served to replace "the intestinal flora" of the bowel, creating what Kellogg claimed was a completely clean intestine.
Dangerous
= Bleach enemas
=
Chlorine dioxide
Chlorine dioxide is a chemical compound with the formula ClO2 that exists as yellowish-green gas above 11 °C, a reddish-brown liquid between 11 °C and −59 °C, and as bright orange crystals below −59 °C. It is usually ...
enemas have been fraudulently marketed as a medical treatment, primarily for autism
The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental condition (or conditions) characterized by difficulti ...
. This has resulted, for example, in a six-year-old boy needing to have his colon removed and a colostomy bag fitted, complaints to the FDA reporting life-threatening reactions, and even death.
Proponents falsely claim that administering autistic children these enemas results in the expulsion of parasitic worms ("rope worms
"Rope worms" (or "ropeworms") is a pseudoscientific term for long thin pieces of damaged intestinal epithelium or other bowel content that have been misidentified as human parasitic worms. "Rope worms" were reported in 2013 in two self-publishe ...
"), which actually are fragments of damaged intestinal epithelium
Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellul ...
that are misinterpreted as being human pathogens. Oral and rectal use of the solution has also been promoted as a cure for HIV
The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
, malaria
Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...
, viral hepatitis
Viral hepatitis is liver inflammation due to a viral infection. It may present in acute form as a recent infection with relatively rapid onset, or in chronic form.
The most common causes of viral hepatitis are the five unrelated hepatotropic v ...
, influenza
Influenza, commonly known as "the flu", is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These symptoms ...
, common cold
The common cold or the cold is a viral infectious disease of the upper respiratory tract that primarily affects the respiratory mucosa of the nose, throat, sinuses, and larynx. Signs and symptoms may appear fewer than two days after exposu ...
s, acne
Acne, also known as ''acne vulgaris'', is a long-term Cutaneous condition, skin condition that occurs when Keratinocyte, dead skin cells and Sebum, oil from the skin clog hair follicles. Typical features of the condition include comedo, black ...
, cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
, Parkinson's
Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms becom ...
, and much more.
Chlorine dioxide is a potent and toxic bleach that is relabeled for "medicinal purposes" to a variety of brand names including, but not limited, to MMS, Miracle Mineral Supplement
Miracle Mineral Supplement, often referred to as Miracle Mineral Solution, Master Mineral Solution, MMS or the CD protocol, is a branded name for an aqueous solution of chlorine dioxide, an industrial bleaching agent, that has been falsely ...
, and CD protocol. For oral use, the doses recommended on the labeling can cause nausea, vomiting, diarrhea, and potentially life-threatening dehydration.
No clinical trials have been performed to test the health claims made for chlorine dioxide, which originate from former Scientologist
Scientology is a set of beliefs and practices invented by American author L. Ron Hubbard, and an associated movement. It has been variously defined as a cult, a Scientology as a business, business, or a new religious movement. The most recent ...
Jim Humble in his 2006 self-published
Self-publishing is the publication of media by its author at their own cost, without the involvement of a publisher. The term usually refers to written media, such as books and magazines, either as an ebook or as a physical copy using POD (pri ...
book, ''The Miracle Mineral Solution of the 21st Century'' and from anecdotal reports. The name MMS was coined by Humble. Sellers sometimes describe MMS as a water purifier
Water (chemical formula ) is an inorganic, transparent, tasteless, odorless, and nearly colorless chemical substance, which is the main constituent of Earth's hydrosphere and the fluids of all known living organisms (in which it acts as a s ...
so as to circumvent medical regulations. The rejected "in the strongest terms" reports by promoters of MMS that they had used the product to fight malaria.
= Coffee enemas
=
Well documented as having no proven benefits and considered by medical authorities as rash and potentially dangerous is an enema of coffee
Coffee is a drink prepared from roasted coffee beans. Darkly colored, bitter, and slightly acidic, coffee has a stimulant, stimulating effect on humans, primarily due to its caffeine content. It is the most popular hot drink in the world.
S ...
.
A coffee enema can cause numerous maladies including infections
An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmiss ...
, sepsis
Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...
(including campylobacter
''Campylobacter'' (meaning "curved bacteria") is a genus of Gram-negative bacteria. ''Campylobacter'' typically appear comma- or s-shaped, and are motile. Some ''Campylobacter'' species can infect humans, sometimes causing campylobacteriosis, a d ...
sepsis), severe electrolyte imbalance
Electrolyte imbalance, or water-electrolyte imbalance, is an abnormality in the concentration of electrolytes in the body. Electrolytes play a vital role in maintaining homeostasis in the body. They help to regulate heart and neurological function, ...
, colitis
Colitis is swelling or inflammation of the large intestine ( colon). Colitis may be acute and self-limited or long-term. It broadly fits into the category of digestive diseases.
In a medical context, the label ''colitis'' (without qualification) ...
, polymicrobial enteric sepsis, proctocolitis
Proctocolitis is a general term for inflammation of the rectum and colon. Signs and symptoms
Cause
Proctocolitis has many possible causes. Common infectious causes of proctocolitis include Chlamydia trachomatis, LGV (Lymphogranuloma venereum), ...
, salmonella
''Salmonella'' is a genus of rod-shaped (bacillus) Gram-negative bacteria of the family Enterobacteriaceae. The two species of ''Salmonella'' are ''Salmonella enterica'' and ''Salmonella bongori''. ''S. enterica'' is the type species and is fur ...
, brain abscess
Brain abscess (or cerebral abscess) is an abscess caused by inflammation and collection of infected material, coming from local (ear infection, dental abscess, infection of paranasal sinuses, infection of the mastoid air cells of the temporal bone ...
, and heart failure, and deaths related to coffee enemas have been documented.
Gerson therapy
Max Gerson (October 18, 1881 – March 8, 1959) was a German-born American physician who developed the Gerson Therapy, a dietary-based alternative cancer treatment that he claimed could cure cancer and most chronic, degenerative diseases.
...
includes administering enemas of coffee, as well as of castor oil
Castor oil is a vegetable oil pressed from castor beans.
It is a colourless or pale yellow liquid with a distinct taste and odor. Its boiling point is and its density is 0.961 g/cm3. It includes a mixture of triglycerides in which about ...
and sometimes of hydrogen peroxide
Hydrogen peroxide is a chemical compound with the formula . In its pure form, it is a very pale blue liquid that is slightly more viscous than water. It is used as an oxidizer, bleaching agent, and antiseptic, usually as a dilute solution (3% ...
or of ozone
Ozone (), or trioxygen, is an inorganic molecule with the chemical formula . It is a pale blue gas with a distinctively pungent smell. It is an allotrope of oxygen that is much less stable than the diatomic allotrope , breaking down in the lo ...
.
Some proponents of alternative medicine have claimed that coffee enemas have an anti-cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
effect by "detoxifying" metabolic products of tumors but there is no medical scientific evidence to support this.
Recreational usage
Pleasure
Enjoyment of enemas is known as klismaphilia
Klismaphilia (or ''klysmaphilia''), from the Greek words ("enema", from , "deluge, flood") and ("love"), is a paraphilia involving enjoyment of, and sexual arousal from, enemas.
History
The term ''klismaphilia'' was coined in 1973 by Dr. Jo ...
, which medically is classified as a paraphilia. A person with klismaphilia is a ''klismaphile''.
Both women and men may enjoy sexual enema play, heterosexually and homosexually, experiencing sexual arousal from enemas which they find gratifying or sensual[Agnew, 1982] and which can be an auxiliary to, or even a substitute for, genital Human sexual activity, sexual activity.
Klismaphiles may perceive pleasure from a large, water distended belly or the feeling of internal pressure. An enema fetish may include the sexual attraction to the equipment, processes, environments, situations, or scenarios, Klismaphiles can gain satisfaction of enemas through fantasies, by actually receiving or giving one, or through the process of eliminating steps to being administered one (e.g., under the pretence of being constipated).
That some women use enemas while masturbating was documented by Alfred Kinsey in "Sexual Behavior in the Human Female." He stated, "There still [are] other masturbatory techniques which were regularly or occasionally employed by some 11 percent of the females in the sample ... enemas, and other anal insertions, ... were employed."
Other sexually related uses
Besides klismaphilia, the intrinsic enjoyment of enemas, there are other uses of enemas in sexual play.[, ''Klismaphilia'':76]
= BDSM
=
Enemas are sometimes used in sadomasochism, sadomasochistic activities for erotic humiliation or for physical discomfort.
= Rectal douching
=
Another sexual use for enemas is to empty the rectum as a prelude to other anal sexual activities such as anal sex, anilingus, and Pegging (sexual practice), pegging,[Agnew, 2000:76] possibly reducing risk of infection.
This is different from klismaphilia, in which the enema is enjoyed for itself and as a part of sexual arousal and gratification.
Rectal douching is a common practice among people who take a receptive role in anal sex although rectal douching before anal sex may increase the risk of transferring HIV
The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
, hepatitis B, and other diseases.
Intoxication
Noting that deaths have been reported from alcohol poisoning via enemas, an alcohol enema can be used to very quickly instill alcohol into the bloodstream, absorbed through the membranes of the colon. However, great care must be taken as to the amount of alcohol used. Only a small amount is needed as the intestine absorbs the alcohol far more quickly than the stomach.
Preceding an enema for administration of drugs or alcohol, a cleansing enema may first be used for cleaning the colon to help increase the rate of absorption.
Religious rituals
All across Mesoamerica ritual enemas were employed to consume psychoactive substances, e.g., balché, alcohol (drug), alcohol, tobacco, peyote, and other Psychedelics, dissociatives and deliriants, hallucinogenic drugs and entheogens, most notably by the Maya
Maya may refer to:
Civilizations
* Maya peoples, of southern Mexico and northern Central America
** Maya civilization, the historical civilization of the Maya peoples
** Maya language, the languages of the Maya peoples
* Maya (Ethiopia), a populat ...
, thus attaining more intense trance states more quickly, and Mayan classic-period sculpture and ceramics depict hallucinogenic enemas used in rituals.[ Some tribes continue the practice in the present day.][; pp. 201]
With historical roots in the Indian subcontinent, enemas in Ayurveda, called Basti (Panchakarma), Basti or Vasti, form part of Panchakarma procedure in which Herbalism, herbal medicines are introduced rectally.
Punitive usage
Enemas have also been forcibly applied as a means of punishment.
In the vastly influential Argentine text Facundo, ''Facundo, or Civilization and Barbarism'', for example, Domingo Faustino Sarmiento describes the use of Chili pepper, pepper and turpentine enemas by police forces as a way of discouraging political dissent in post-independence Argentina. Turpentine enemas are very harsh purgatives.
In the Guantanamo Bay detention camp#Torture, Guantanamo Bay Detention Camp, the Senate Intelligence Committee report on CIA torture documented instances of enemas being used by the Central Intelligence Agency in order to ensure "total control" over detainees. Enemas, officials said, are uncomfortable and degrading, The CIA forced nutrient enema on detainees who attempted hunger strikes, documenting "With head lower than torso … sloshing up the large intestines … [what] I infer is that you get a tube up as you can … We used the largest Ewal tube we had" wrote an officer, and "violent enemas" is how a detainee described what he received.
In arts and literature
Written literature
In the Theatre of Dionysus, Dionysus' satyr play ''Limos'', Silenus attempts to give an enema to Heracles.
In Shakespeare's play ''Othello'' (Act II, Scene I) Iago says, "Yet again your fingers to your lips? would they were clyster-pipes for your sake!"
In Miguel de Cervantes, Cervantes' Don Quixote, a narrative to Sancho includes “The Knight of the Sun ... bound hand and foot ... was administered a clyster of snow water and sand that almost disracted him"
In the 17th century, satirists made physicians a favorite target, resembling Molière's caricature whose prescription for anything was "clyster, bleed, purge," or "purge, bleed, clyster".
In Molière's play The Imaginary Invalid, Argan, a severe hypochondriac, is addicted to enemas as indicated by such lines as when Bĕralde asks, "Can't you be one moment without a purge?"
In George Orwell's novel ''Nineteen Eighty-Four'', the narrator notes, "Sexual intercourse was to be looked on as a slightly disgusting minor operation, like having an enema."
In Grace Metalious's novel Peyton Place (novel), Peyton Place, the town doctor tells of "a young boy with the worst case of dehydration I ever saw. It came from getting too many enemas that he didn't need. Sex, with a capital S-E-X.". As a teenager, the boy enjoys receiving enemas from his mother.
In Flora Rheta Schreiber's book Sybil (Schreiber book), Sybil, Sybil's psychiatrist asks her "What's Mama been doing to you, dear?...I know she gave you the enemas."
In Anne Roiphe's novel ''Torch Song'', Marjorie, not knowing how to otherwise address her dysphonia, reminisces on unhappy memories, one of which is her German nurse inflicting on her painful enemas.
In Anne Sexton's poem "Cripples And Other Stories", is the couplet "Oh the enemas of childhood, reeking of outhouses and shame!"
Film
In ''The Right Stuff (film), The Right Stuff'', during flight training astronaut Alan Shepard retains a barium enema, given two floors away from a toilet, embarrassedly riding a public elevator wearing a hospital gown and holding the enema bag with its tip still inserted in him.
''Water Power (film), Water Power'' is a film loosely based on the real-life exploits of Michael H. Kenyon, an United States, American criminal who pleaded guilty to a decade-long series of armed robbery, armed robberies of female victims, some of which involved sexual assaults in which he would give them enemas.
In ''Sybil (1976 film), Sybil'', Sybil's psychiatrist, while having taken her for a picnic in the country, heard her re-experience, among other things, her mother having bound her with a broom handle on the kitchen table and suspended her by her feet from the hanging light, in preparation for forcing her to take an enema.
Song
The lyrics of Frank Zappa's song ''The Illinois Enema Bandit'' are concerned with Michael H. Kenyon's sexual assaults which included administering involuntary enemas.
Monument
A brass statue of a syringe enema bulb held aloft by three cherubs stands in front of the "Mashuk" spa in the settlement of Zheleznovodsk in Russia. Inspired by the 15th century Renaissance painter Botticelli, it was created by a local artist who commented that "An enema is an unpleasant procedure as many of us may know. But when cherubs do it, it's all right." When unveiled on 19 June 2008, posted on one of the spa's wall was a banner declaring "Let's beat constipation and sloppiness with enemas." The spa lying in the Caucasus Mountains region, known for dozens of spas that routinely treat digestive and other complaints with enemas of mineral spring water, the director commented "An enema is almost a symbol of our region." It is the only known monument to the enema.
See also
* Alcohol enema
* Bowel management
* Coffee enema
* Colon cleansing
* Dry enema
* Fecal microbiota transplant
* Klismaphilia
* Murphy drip
* Nutrient enema
* Rectal douching
* Tobacco smoke enema
* Transanal irrigation
References
Sources
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External links
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Alternative medicine
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