This article needs additional citations for verification. An enema is the injection of fluid into the lower bowel by way of the rectum. In other contexts, enemas are used as part of some alternative health therapies, as part of sexual activities, and to administer drugs for recreational or religious reasons. To empty the colon prior to a medical procedure such as a colonoscopy. 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, resulting in powerful peristalsis and a feeling of extreme fecal urgency. Plain water can be used, simply functioning mechanically to expand the colon, thus prompting evacuation. Castile soap is commonly added because its irritation of the colon’s lining increases the urgency to defecate.
Likewise, mild hand soap can be dissolved in the water. However, liquid handsoaps and detergents should not be used. Glycerol is a specific bowel mucosa irritant serving to induce peristalsis via a hyperosmotic effect. It is used in a dilute solution, e. Buffered sodium phosphate solution draws additional water from the bloodstream into the colon to increase the effectiveness of the enema, but can be rather irritating to the colon, causing intense cramping or “griping. Normal saline is least irritating to the colon, at the opposite end of the spectrum. Like plain water, it simply functions mechanically to expand the colon, but having a neutral concentration gradient, it neither draws electrolytes from the body, as happens with plain water, nor draws water into the colon, as occurs with phosphates. 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. Mineral oil functions as a lubricant and stool softener, but often has the side effect of sporadic seepage from the patient’s anus which can soil undergarments for up to 24 hours. 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 or constipation, especially obstructed defecation. The term retrograde irrigation distinguishes this procedure from the Malone antegrade continence enema, where irrigation fluid is introduced into the colon proximal to the anus via a surgically created irrigation port. Patients who have a bowel disability, a medical condition which impairs control of defecation, e. While simple techniques might include a controlled diet and establishing a toilet routine, a daily enema can be taken to empty the colon, thus preventing unwanted and uncontrolled bowel movements that day.
In a lower gastrointestinal series an enema that may contain barium sulfate powder or a water-soluble contrast agent is used in the radiological imaging of the bowel. The administration of substances into the bloodstream. 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 and mesalazine used in the treatment of inflammatory bowel disease. Rectal corticosteroid enemas are sometimes used to treat mild or moderate ulcerative colitis. 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.
Enemas have been used around the time of childbirth however there is no evidence for this practice and it is now discouraged. However, these occurrences are rare in healthy, sober adults. Internal bleeding or rupture may leave the individual exposed to infections from intestinal bacteria. The enema tube and solution may stimulate the vagus nerve, which may trigger an arrhythmia such as bradycardia. Recent research has shown that ozone water, which is sometimes used in enemas, can immediately cause microscopic colitis. A recent case series of 11 patients with five deaths illustrated the danger of phosphate enemas in high-risk patients. The latter avoided the need for a second party to attend an embarrassing procedure.
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, according to Egyptian mythology, invented the enema. Spanish Conquest used trance-inducing substances ceremonially, and these were ingested via, among other routes, enemas administered using jars. Xibalban court of the God D whose worship included ritual cult paraphernalia. It is hypothesized that these enemas were for ritual purification and the ingestion of intoxicants and hallucinogens.
In the first century BC the Greek physician Asclepiades of Bithynia wrote “Treatment consists merely of three elements: drink, food, and the enema”. In the second century CE the Greek philosopher Celsus recommended an enema of pearl barley in milk or rose oil with butter as a nutrient for those suffering from dysentery and unable to eat and Galen mentions enemas in several contexts. In medieval times appear the first illustrations of enema equipment, a clyster syringe consisting of a tube attached to a pump action bulb made of a pig bladder and the 15th century Simple piston syringe clysters came into use. Beginning in the 17th century enema apperatus was chiefly designed for self-administration at home and many were French as enemas enjoyed wide usage in France. Another invention was syringes equipped with a special bent nozzle, which enabled self-administration, thereby eliminating the embarrassment. Clysters were administered for symptoms of constipation and, with more questionable effectiveness, stomach aches and other illnesses.
In his early-modern treatise, The Diseases of Women with Child, François Mauriceau records that both midwives and man-midwives commonly administered clysters to labouring mothers just prior to their delivery. In the 16th century, satirists made physicians a favorite target, resembling Molière’s caricature whose prescription for anything was “clyster, bleed, purge,” or “purge, bleed, clyster. In Roper’s biography of his father-in-law Sir Thomas More, he tells of Thomas More’s eldest daughter falling sick of the sweating sickness. She could not be awakened by doctors. There straightway it came into his mind that a clyster would be the one way to help her, which when he told the physicians, they at once confessed that if there were any hope of health, it was the very best help indeed, much marveling among themselves that they had not afore remembered it. In the 18th century tobacco smoke enemas were used 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. Clysters were a favourite medical treatment in the bourgeoisie and nobility of the Western world up to the 19th century. Molière, in several of his plays, introduces characters of incompetent physicians and apothecaries fond of prescribing this remedy, also discussed by Argan, the hypochondriac patient of Le Malade Imaginaire. In the 19th century many new types of enema administration equipment were devised, including the bulb enema. Later there came to be a device to allow gravity to infuse the solution into the recipient, consisting of a rubber bag or bucket connected to a hose with a nozzle at the other end to insert into the patient’s anus, the bag or bucket being held or hung above the patient. In the late 20th century the microenema was invented, this being a disposable squeeze bottle with contents that cause the body to draw water into the colon, e. Nutrient enemas were administered with the intent of providing nutrition when normal eating is not possible. The term “colonic irrigation” is commonly used in gastroenterology to refer to the practice of introducing water through a colostomy or a surgically constructed conduit as a treatment for constipation. The same term is also used in alternative medicine 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. Although well documented, the procedure of inserting coffee through the anus to cleanse the rectum and large intestines is considered by most medical authorities to be unproven, rash and potentially dangerous. In the Gerson therapy, coffee enemas are administered. Some proponents of alternative medicine have claimed that coffee enemas have an anti-cancer effect by “detoxifying” metabolic products of tumors but there is no medical scientific evidence to support this. In the late 19th century Dr. John Harvey Kellogg made sure that the bowel of each and every patient was plied with water, from above and below. Specialty nozzles, in a variety of sizes, styles, and materials, are common for non-medical usage. An inflatable nozzle which, after insertion, is inflated to a size than can not be expelled, allowing administration of such an enema that could not otherwise be retained, either for pleasure or as part of BDSM activities. Shown here in an optional harness.
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If there is pain or discharge from the Pilonidal sinus, cNHC qualified from Cambridge University with local anaesthetic cream for hemorrhoids in Natural Sciences, administration at home and many were French as enemas enjoyed wide usage in France.