Editing Enema (section)

== Society and culture ==

=== Alternative medicine ===

==== Relatively benign ====

===== Colonic irrigation =====

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.<ref name="pmid11113099">{{cite journal |last1=Locke |first1=G.Richard |last2=Pemberton |first2=John H. |last3=Phillips |first3=Sidney F. |title=AGA technical review on constipation |journal=Gastroenterology |date=December 2000 |volume=119 |issue=6 |pages=1766–1778 |doi=10.1053/gast.2000.20392 |pmid=11113099 |doi-access=free }}</ref> The [[Food and Drug Administration]] has ruled that colonic irrigation equipment is not approved for sale for general well-being<ref>{{cite web |title = Subpart F—Therapeutic Devices Sec. 876.5220 Colonic irrigation system |website = Code of Federal Regulations, Title 21 Food and Drugs, Subchapter H – Medical Devices, Part 876 – Gastroenterology-Urology Devices |date = 1 April 2007 |url = http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=876.5220 |archive-url = https://web.archive.org/web/20021130060154/http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?FR=876.5220 |url-status = dead |archive-date = 30 November 2002 |publisher = FDA }}</ref> and has taken action against many distributors of this equipment, including a [[FDA Warning Letter|Warning Letter]].<ref>{{cite web |author = Department of Health and Human Services |title = Warning letter to Dotolo Research Corp |url = https://www.casewatch.net/fdawarning/prod/1999/dotolo.shtml |format = reprint by Casewatch |date = 21 July 1999 |publisher = FDA |access-date = 31 December 2007 }}</ref>

===== Colon cleansing =====
{{Main|Colon cleansing}}

The same term is also used in [[alternative medicine]] where it may involve the use of substances mixed with water to [[Detoxification (alternative medicine)|detoxify]] the body. Practitioners believe the accumulation of fecal matter in the large intestine leads to ill health.<ref name="pmid11124189">{{cite journal |author = Whorton J |title = Civilisation and the colon: constipation as the "disease of diseases" |journal = BMJ |volume = 321 |issue = 7276 |pages = 1586–9 |year = 2000 |pmid = 11124189 |pmc = 1119264 |doi = 10.1136/bmj.321.7276.1586 }}</ref>  This resurrects the old medical concept of ''autointoxication'' which was orthodox doctrine until the end of the 19th century but has now been discredited.<ref name=Ernst>{{cite journal |last1=Ernst |first1=E. |title=Colonic Irrigation and the Theory of Autointoxication: A Triumph of Ignorance over Science |journal=Journal of Clinical Gastroenterology |date=June 1997 |volume=24 |issue=4 |pages=196–198 |doi=10.1097/00004836-199706000-00002 |pmid=9252839 |doi-access=free }}</ref><ref>{{cite journal |author = Kaiser |title = The Case Against Colonic Irrigation |journal = California Morbidity |issue = 38 |year = 1985 }}</ref><ref name = Chen>{{cite journal |vauthors = Chen TS, Chen PS |title = Intestinal autointoxication: a medical leitmotif |journal = Journal of Clinical Gastroenterology |volume = 11 |issue = 4 |pages = 434–41 |year = 1989 |pmid = 2668399 |doi = 10.1097/00004836-198908000-00017 }}</ref>

=====Kellogg's enemas=====

In the late 19th century, Dr. [[John Harvey Kellogg]] made sure that every patient's bowel 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 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.<ref>{{cite web |url=http://www.museumofquackery.com/amquacks/kellogg.htm |title=Dr. John Harvey Kellogg |website=Great American Quacks |publisher=Museum of Quackery |access-date=12 February 2018}}</ref>

==== Dangerous ====

===== Bleach enemas =====

[[Chlorine dioxide#Pseudomedicine|Chlorine dioxide]] enemas have been fraudulently marketed as a medical treatment, primarily for [[autism]]. This has resulted, for example, in a six-year-old boy needing to have his colon removed and a colostomy bag fitted,<ref>{{cite web |url=https://www.mirror.co.uk/news/uk-news/secret-facebook-group-reveals-how-10944477 |title=Secret Facebook group reveals how parents use bleach enemas on autistic children in bid to 'cure' disability |author=Sophie Norri |author2=Lucy Clarke-Billings |date=2017-08-08 |work=[[Daily Mirror]] |publisher=[[Reach plc]] |access-date=2019-03-24 }}</ref><ref>{{cite web |url=https://metro.co.uk/2017/08/07/mother-investigated-for-giving-son-bleach-enema-to-cure-his-autism-6834610/ |title=Mother 'investigated for giving son bleach enema to "cure" his autism' |author=Toby Meyjes |date=2017-08-07 |work=[[Metro (British newspaper)]] |publisher=[[DMG Media]] |access-date=2019-03-24 }}</ref> complaints to the FDA reporting life-threatening reactions,<ref>{{cite web |url=https://abc7news.com/news/group-of-socal-parents-secretly-try-to-cure-kids-with-autism-using-bleach/1578833/ |title=Group of SoCal parents secretly try to cure kids with autism using bleach |author=Lisa Bartley |date=2016-10-29 |work=ABC 7 News |publisher=[[American Broadcasting Company]] |access-date=2019-03-24 }}</ref> and even death.<ref>{{cite web |title=The fake cures for autism that can prove deadly |url=https://www.theguardian.com/society/2016/jul/13/fake-cures-autism-prove-deadly |author=Frances Ryan |date=2016-07-13 |work=[[The Guardian]] |access-date=2019-03-24 }}</ref>

Proponents falsely claim that administering enemas to autistic children results in the expulsion of parasitic worms ("[[rope worms]]"), which are fragments of damaged intestinal [[epithelium]] that are misinterpreted as being human pathogens.<ref>{{cite web |title=The truth about chlorine dioxide and other miracle cures for autism |url=https://www.health24.com/Natural/Therapies/the-truth-about-chlorine-dioxide-and-other-miracle-cures-for-autism-20151111 |date=2015-11-11 |work=Health24 |access-date=2019-03-24 }}</ref><ref>{{cite web |url=https://www.autism.com/statement_mms |title=Warning Against Chlorine Dioxide Use |author=Sidney Baker |author2=Ali Carine |author3=Suruchi Chandra |author4=Kelly M. Barnhill |author5=John Green |author6=Maya Shetreat-Klein |author7=Vicki Kobliner |author8=Dana Laake |author9=Elizabeth Mumper |author10=Nancy O'Hara |author11=William Parker |date=2015-07-12 |work=Autism is Treatable |publisher=[[Autism Research Institute]] |access-date=2019-03-24 |archive-date=30 March 2019 |archive-url=https://web.archive.org/web/20190330220822/https://www.autism.com/statement_mms |url-status=dead }}</ref> Oral and rectal use of the solution has also been promoted as a cure for [[HIV]], [[malaria]], [[viral hepatitis]], [[influenza]], [[common cold]]s, [[acne]], [[cancer]], [[Parkinson's disease|Parkinson's]], and much more.

Chlorine dioxide is a potent and toxic bleach<ref>{{cite web |title=PubChem Database. Chlorine dioxide, CID=24870 |url=https://pubchem.ncbi.nlm.nih.gov/compound/chlorine_dioxide#section=Human-Toxicity-Excerpts |work=[[PubChem]] |publisher=[[National Center for Biotechnology Information]] |access-date=2019-03-24 }}</ref> that is relabeled for "medicinal purposes" to a variety of brand names including, but not limited, to MMS, [[Miracle Mineral Supplement]], and CD protocol.<ref>{{cite web|date=12 March 2015|website=vice.com |url=https://www.vice.com/en_us/article/kwxq3w/pararchiveents-are-giving-their-children-bleach-enemas-to-cure-them-of-autism-311|archive-url=https://web.archive.org/web/20190324230611/https://www.vice.com/en_us/article/kwxq3w/pararchiveents-are-giving-their-children-bleach-enemas-to-cure-them-of-autism-311|url-status=dead|archive-date=24 March 2019|title=The Parents Who Give Their Children Bleach Enemas to 'Cure' Them of Autism |access-date=2019-03-24}}</ref> For oral use, the doses recommended on the labeling can cause nausea, vomiting, diarrhea, and potentially life-threatening dehydration.<ref>{{cite web|title=FDA Warns Consumers of Serious Harm from Drinking Miracle Mineral Solution (MMS)|date=3 February 2011|publisher=U.S. Food and Drug Administration |url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm220747.htm|archive-url=https://web.archive.org/web/20110203232945/https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm220747.htm|archive-date=3 February 2011|access-date=2019-03-24|url-status=dead}}</ref>

No clinical trials have been performed to test the health claims made for chlorine dioxide, which originate from former [[Scientology|Scientologist]] Jim Humble<ref name=ne&ya>{{cite web|url=https://uk.news.yahoo.com/parents-making-children-drink-bleach-160057178.html|title=Parents Are Making Their Children Drink Bleach to 'Cure' Them of Autism|date=22 March 2019|work=Newsweek/Yahoo News}}</ref> in his 2006 [[self-publishing|self-published]] book, ''The Miracle Mineral Solution of the 21st Century''<ref>{{cite book |title=The Miracle Mineral Solution of the 21st Century|publisher=Jim Humble|year=2006|author=Jim Humble}} (self published)</ref> and from anecdotal reports. Humble coined the name MMS. Sellers sometimes describe MMS as a [[water purifier]] to circumvent medical regulations.<ref>{{cite news | first = Erik | last = Jensen | title = Deadly chemical being sold as miracle cure | date = 2010-01-09 | url = http://www.smh.com.au/national/deadly-chemical-being-sold-as-miracle-cure-20100108-lyvl.html | work = The Sydney Morning Herald |access-date=2019-03-24}}</ref> The [[International Federation of Red Cross and Red Crescent Societies]] rejected "in the strongest terms" reports by promoters of MMS that they had used the product to fight malaria.<ref>{{cite press release |publisher= [[International Federation of Red Cross and Red Crescent Societies]] |date= 15 May 2013 |title= IFRC strongly dissociates from the claim of a 'miracle' solution to defeat malaria |url= http://www.ifrc.org/en/news-and-media/opinions-and-positions/opinion-pieces/2013/ifrc-strongly-dissociates-from-the-claim-of-a-miracle-solution-to-defeat-malaria/ |access-date= 2019-03-24 |archive-date= 24 February 2021 |archive-url= https://web.archive.org/web/20210224162551/https://www.ifrc.org/en/news-and-media/opinions-and-positions/opinion-pieces/2013/ifrc-strongly-dissociates-from-the-claim-of-a-miracle-solution-to-defeat-malaria/ |url-status= dead }}</ref>

===== Coffee enemas =====
{{Main|Coffee enema}}

Well documented as having no proven benefits and considered by medical authorities as rash and potentially dangerous is an enema of [[coffee]].<ref name=Ernst /><ref name="shils" />

A coffee enema can cause numerous maladies including [[infections]], [[sepsis]] (including [[campylobacter]] sepsis), severe [[Electrolyte disturbance|electrolyte imbalance]], [[colitis]], polymicrobial enteric sepsis, [[proctocolitis]], [[salmonella]], [[brain abscess]], and heart failure,<ref name=colitis /><ref name="acs">{{cite web |publisher = [[American Cancer Society]] |url = http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/ManualHealingandPhysicalTouch/colon-therapy |date = 11 January 2008 |access-date = 13 May 2011 |title = Colon Therapy |archive-date = 24 April 2015 |archive-url = https://web.archive.org/web/20150424180208/http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/ManualHealingandPhysicalTouch/colon-therapy |url-status = dead }}</ref><ref>{{cite journal |vauthors = Margolin KA, Green MR |title = Polymicrobial enteric septicemia from coffee enemas |journal = The Western Journal of Medicine |volume = 140 |issue = 3 |page = 460 |year = 1984 |pmid = 6710988 |pmc = 1021723 }}</ref><ref name=deaths>{{cite journal |vauthors = Eisele JW, Reay DT |title = Deaths related to coffee enemas |journal = JAMA: The Journal of the American Medical Association |volume = 244 |issue = 14 |pages = 1608–1609 |year = 1980 |pmid = 7420666 |doi = 10.1001/jama.1980.03310140066036 }}</ref><ref>{{cite journal |vauthors = Keum B, Jeen YT, Park SC, Seo YS, Kim YS, Chun HJ, Um SH, Kim CD, Ryu HS |title = Proctocolitis Caused by Coffee Enemas |journal = The American Journal of Gastroenterology |volume = 105 |issue = 1 |pages = 229–230 |year = 2010 |pmid = 20054322 |doi = 10.1038/ajg.2009.505 |s2cid = 19156781 }}</ref><ref>{{cite web |publisher = [[Memorial Sloan Kettering Cancer Center]] |url = http://www.mskcc.org/mskcc/html/69283.cfm |title = Livingston-Wheeler Therapy |date = 9 May 2011 |access-date = 13 May 2011 }}</ref><ref>William T. Jarvis, Ph.D., National Council Against Healthcare Fraud, "[http://www.ncahf.org/articles/c-d/caquackery.html Cancer Quackery]". Accessed 11 July 2012.</ref><ref name="pmid6789105">{{cite journal |title = Campylobacter sepsis associated with "nutritional therapy"--California |journal = MMWR Morb. Mortal. Wkly. Rep. |volume = 30 |issue = 24 |pages = 294–5 |year = 1981 |pmid = 6789105 |author1 = Centers for Disease Control (CDC) }}</ref><ref name="pmid20054322">{{cite journal |vauthors = Keum B, Jeen YT, Park SC, Seo YS, Kim YS, Chun HJ, Um SH, Kim CD, Ryu HS |title = Proctocolitis caused by coffee enemas |journal = Am. J. Gastroenterol. |volume = 105 |issue = 1 |pages = 229–30 |year = 2010 |pmid = 20054322 |doi = 10.1038/ajg.2009.505 |s2cid = 19156781 }}</ref>{{Excessive citations inline|date=December 2024}} and deaths related to coffee enemas have been documented.<ref>{{cite journal |vauthors=Eisele JW, Reay DT |title=Deaths related to coffee enemas |journal=JAMA |volume=244 |issue=14 |pages=1608–9|date=October 1980 |pmid=7420666 |doi=10.1001/jama.1980.03310140066036}}</ref>

[[Gerson therapy]] includes administering enemas of coffee,<ref>{{cite web |title=The Gerson Institute&nbsp;— Alternative Cancer Treatment |url=http://www.gerson.org/g_therapy/default.asp |archive-date=1 April 2003 |archive-url=https://web.archive.org/web/20030401121651/http://gerson.org/g_therapy/default.asp}}</ref> as well as of [[castor oil]] and sometimes of [[hydrogen peroxide]] or of [[ozone]].<ref>{{cite journal |vauthors=Weitzman S |title=Alternative Nutritional Cancer Therapies|journal=International Journal of Cancer|volume=78|pages=69–72|year=1998| issue=S11| doi=10.1002/(SICI)1097-0215(1998)78:11+<69::AID-IJC20>3.0.CO;2-7| pmid=9876483|s2cid=20633344 |doi-access=free}}</ref>

Some proponents of alternative medicine have claimed that coffee enemas have an anti-[[cancer]] effect by "detoxifying" metabolic products of tumors<ref name=colitis>{{cite journal |vauthors = Lee CJ, Song SK, Jeon JH, Sung MK, Cheung DY, Kim JI, Kim JK, Lee YS |title = Coffee enema induced acute colitis |journal = The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi |volume = 52 |issue = 4 |pages = 251–254 |year = 2008 |pmid = 19077527 }}</ref> but there is no medical scientific evidence to support this.<ref name="shils">{{cite journal |vauthors = Shils ME, Hermann MG |title = Unproved dietary claims in the treatment of patients with cancer |journal = Bull N Y Acad Med |volume = 58 |issue = 3 |pages = 323–40 |date = April 1982 |pmid = 7052177 |pmc = 1805327 }}</ref><ref name="acs" /><ref>{{cite journal |author = Cassileth B |title = Gerson regimen |journal = Oncology (Williston Park, N.Y.) |volume = 24 |issue = 2 |page = 201 |date = February 2010 |pmid = 20361473 }}</ref>

=== Recreational usage ===

[[File:Inflatable enema nozzle in harness 01.jpg|thumb|right|upright=1|This nozzle (shown here in harness) can be inflated to a diameter wider than a rectum to force holding in an enema that could not otherwise be retained. Used either for pleasure or as part of [[BDSM]] activities.]]

==== Pleasure ====
{{Main|Klismaphilia}}
Enjoyment of enemas is known as [[klismaphilia]], which medically is classified as a [[paraphilia]].<ref>[http://arquivo.pt/wayback/20080224093721/http://www.psychologytoday.com/conditions/paraphilias.html Paraphilias] from [http://www.psychologytoday.com Psychology Today]</ref><ref>{{cite journal|last=Denko|first=JD.|date=April 1973|title=Klismaphilia: enema as a sexual preference. Report of two cases|journal=Am J Psychother|volume=27|pages=232–50 | issue=2|pmid=4704017|doi=10.1176/appi.psychotherapy.1973.27.2.232}}</ref> 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<ref name="Agnew, 1982">Agnew, 1982</ref><ref name="Denko"/> and which can be an auxiliary to, or even a substitute for, genital [[Human sexual activity|sexual activity]].<ref name="Agnew, 1982"/><ref name="Denko">{{cite journal|last=Denko|first=JD.|date=April 1976|title=Amplification of the erotic enema deviance|journal=Am J Psychother|volume=30|pages=236–55 | issue=2|pmid=937588|doi=10.1176/appi.psychotherapy.1976.30.2.236}}</ref>

Klismaphiles may perceive pleasure from a large, water-distended belly, or the feeling of internal pressure. An enema fetish may include sexual attraction to the involved equipment, processes, environments, situations, or scenarios.<ref>Brame et al., ''Different loving – The World of Sexual Dominance and Submission'':517</ref> 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).<ref name="Denko"/>

That some women use enemas while masturbating was documented by [[Alfred Kinsey]] in ''Sexual Behavior in the Human Female'': "There were still other masturbatory techniques which were regularly or occasionally employed by some 11 percent of the females in the sample... Douches, streams of running water, vibrators, urethral insertions, enemas, other anal insertions, sado-masochistic activity, and still other methods were occasionally employed, but none of them in any appreciable number of cases."<ref>{{Citation | last1 = Kinsey | first1 = Alfred Charles | title = Sexual Behavior in the Human Female | publisher = Indiana University Press | place = Bloomington, Indiana, U.S.A. | year = 1953 | isbn = 978-0-253-33411-4 }}</ref>

==== Other sexually related uses ====
Besides klismaphilia, the intrinsic enjoyment of enemas, there are other uses of enemas in sexual play.<ref name=Agnew_page_76|Agnew>, ''Klismaphilia'':76</ref>

===== BDSM =====

[[File:5000 ml Enema Bag with Dildo Nozzle Filled Hanging in Tree.jpg|thumb|right|upright|A filled 5 litre enema bag connected to a bored [[dildo]], ready to inject into a recipient on the ground beneath.]]

Enemas are sometimes used in [[sadomasochism|sadomasochistic]] activities<ref>Brame et al., ''Different loving – The World of Sexual Dominance and Submission'':513,516</ref><ref>Agnew, 2000:74,77,78,79</ref> for [[erotic humiliation]]<ref>Brame et al., ''Different loving – The World of Sexual Dominance and Submission'':515,516,520</ref> or for physical discomfort.<ref>Brame et al., ''Different loving – The World of Sexual Dominance and Submission'':513,517</ref>

===== Rectal douching =====
{{Main|Rectal douching}}
Another sexual use for enemas is to empty the rectum as a prelude to other anal sexual activities such as [[anal sex]],<ref name="Agnew, 2000:76">Agnew, 2000:76</ref> 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.<ref name="Agnew, 2000:76"/>

Rectal douching is a common practice among people who take a receptive role in anal sex<ref name="JavanbakhtStahlman2014">{{cite journal |last1=Javanbakht |first1=Marjan |last2=Stahlman |first2=Shauna |last3=Pickett |first3=Jim |last4=LeBlanc |first4=Marc-André |last5=Gorbach |first5=Pamina M |title=Prevalence and types of rectal douches used for anal intercourse: results from an international survey |journal=BMC Infectious Diseases |date=December 2014 |volume=14 |issue=1 |pages=95 |doi=10.1186/1471-2334-14-95 |pmid=24555695 |pmc=4015843 |doi-access=free }}</ref> although rectal douching before anal sex may increase the risk of transferring [[HIV]],<ref name="Carballo-DiéguezBauermeister2007">{{cite journal|last1=Carballo-Diéguez|first1=Alex|last2=Bauermeister|first2=José A.|last3=Ventuneac|first3=Ana|last4=Dolezal|first4=Curtis|last5=Balan|first5=Ivan|last6=Remien|first6=Robert H.|title=The Use of Rectal Douches among HIV-uninfected and Infected Men who Have Unprotected Receptive Anal Intercourse: Implications for Rectal Microbicides|journal=AIDS and Behavior|volume=12|issue=6|year=2007|pages=860–866|issn=1090-7165|doi=10.1007/s10461-007-9301-0|pmid=17705033|pmc=2953367}}</ref> [[hepatitis B]],<ref name="SchreederThompson1982">{{cite journal|last1=Schreeder|first1=M. T.|last2=Thompson|first2=S. E.|last3=Hadler|first3=S. C.|last4=Berquist|first4=K. R.|last5=Zaidi|first5=A.|last6=Maynard|first6=J. E.|last7=Ostrow|first7=D.|last8=Judson|first8=F. N.|last9=Braff|first9=E. H.|last10=Nylund|first10=T.|last11=Moore|first11=J. N.|last12=Gardner|first12=P.|last13=Doto|first13=I. L.|last14=Reynolds|first14=G.|title=Hepatitis B in Homosexual Men: Prevalence of Infection and Factors Related to Transmission|journal=Journal of Infectious Diseases|volume=146|issue=1|year=1982|pages=7–15|issn=0022-1899|doi=10.1093/infdis/146.1.7|pmid=7086206}}</ref> and other diseases.<ref>{{cite journal |title=Lymphogranuloma venereum proctitis in men who have sex with men is associated with anal enema use and high-risk behavior |last1=de Vries |first1=Henry J.C. |last2=van der Bij |first2=Akke K. |last3=Fennema |first3=Johan S.A.  |last4=Smit |first4=Colette  |last5=de Wolf |first5=Frank |last6=Prins |first6=Maria | last7=Coutinho | first7=Roel A. | last8=MorrÉ | first8=Servaas|journal=Sexually Transmitted Diseases |date=2008 |volume=35 |issue=2 |pages=203–208 |doi=10.1097/OLQ.0b013e31815abb08 |pmid=18091565 |s2cid=2065170 |url=https://dare.uva.nl/personal/pure/en/publications/lymphogranuloma-venereum-proctitis-in-men-who-have-sex-with-men-is-associated-with-anal-enema-use-and-highrisk-behavior(6b9b21d8-9369-4f55-a0e5-c6804db29083).html |doi-access=free }}</ref>

==== Intoxication ====
{{Main|Alcohol enema}}
Noting that deaths have been reported from [[alcohol poisoning]] via enemas,<ref>{{cite web |url = http://darwinawards.com/darwin/darwin2007-13.html |title = The Enema Within |access-date = 11 January 2008 |year = 2008 |publisher = [[Darwin Awards]] }}</ref> 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.

When enema is prescribed for the administration of drugs or alcohol, a cleansing enema may first be used to clean the colon to help increase the rate of absorption.<ref name="pmid6126289">{{cite journal |vauthors = de Boer AG, Moolenaar F, de Leede LG, Breimer DD |title = Rectal drug administration: clinical pharmacokinetic considerations |journal = Clin Pharmacokinet |volume = 7 |issue = 4 |pages = 285–311 |year = 1982 |pmid = 6126289 |doi = 10.2165/00003088-198207040-00002 |s2cid = 41562861 }}</ref>

=== 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 [[entheogen]]s, most notably by the [[Maya civilization|Maya]], thus attaining more intense trance states more quickly. Mayan classic-period sculpture and ceramics depict hallucinogenic enemas used in rituals.<ref name=Hallucinogenic_pre-Columbian/> Some tribes continue the practice today.<ref name="isbn0-06-084550-3">{{cite book|last=Diamond |first=Jared M.|title=The Third Chimpanzee: The Evolution and Future of the Human Animal (P.S.)|url=https://archive.org/details/thirdchimpanzee00jare_0|url-access=registration|publisher=Harper Perennial|location=New York, N.Y.|year=1992|page=432|isbn=978-0-06-084550-6}}; pp. 201</ref>

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.<ref>{{cite web|url=http://chakrapaniayurveda.com/basti/|title=Basti: Medicated Enema Therapy}}</ref>

=== Punitive usage ===

Enemas have also been forcibly applied as a means of punishment.

Political dissenters in post-independence Argentina were given enemas of [[chili pepper]] and [[turpentine]].<ref>{{cite book|author= [[Domingo Faustino Sarmiento]]|title= Facundo: Civilización y barbarie|translator= Kathleen Ross|year= 1845 |publication-date= 2003|page= 210|publisher= University of California Press|isbn=0-520-23980-6}}</ref> Turpentine enemas are very harsh purgatives.<ref>{{cite web|url=https://www.biology-online.org/dictionary/Turpentine_enema|title=Turpentine enema|website=Biology-Online Dictionary|publisher=Biology-Online|access-date=2019-04-20}}</ref>

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]] to ensure "total control" over detainees.<ref>{{cite news|last1=Rushe|first1=Dominic|last2=MacAskill|first2=Ewen|last3=Cobain|first3=Ian|last4=Yuhas|first4=Alan|last5=Laughland|first5=Oliver|title=Rectal rehydration and waterboarding: the CIA torture report's grisliest findings|url=https://www.theguardian.com/us-news/2014/dec/09/cia-torture-report-worst-findings-waterboard-rectal|access-date=13 March 2015|agency=[[The Guardian]]|date=9 December 2014}}</ref> Enemas, officials said, are uncomfortable and degrading.<ref>{{cite web|url=https://www.nytimes.com/2005/01/01/us/fresh-details-emerge-on-harsh-methods-at-guantanamo.html|title=Fresh Details Emerge on Harsh Methods at Guantánamo|author=Neil A. Lewis|date=2005-01-01|department=Archives – 2005|work=[[The New York Times]]|access-date=2019-04-20}}</ref> 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 {{sic}} tube we had" wrote an officer,<ref>{{cite web|url=https://www.theguardian.com/us-news/2014/dec/09/cia-report-rectal-feeding-detainees|title=Controversial 'rectal feeding' technique used to control detainees' behaviour|date=9 December 2014|work=[[The Guardian]]|access-date=2019-04-20}}</ref> and "violent enemas" is how a detainee described what he received.<ref>{{cite web|url=https://www.nytimes.com/2015/06/06/opinion/a-detainee-describes-more-cia-torture.html|title=A Detainee Describes More C.I.A. Torture|author=The Editorial Board |date=2015-06-05|department=Editorial|work=[[The New York Times]]|access-date=2019-04-22}}</ref>

=== In arts and literature ===
==== Written literature ====

In the [[Theatre of Dionysus|Dionysus]]' [[satyr play]] ''Limos'', [[Silenus]] attempts to give an enema to [[Heracles]].<ref>{{cite book|last=Shaw|first=Carl A.|date=2014|title=Satyric Play: The Evolution of Greek Comedy and Satyr Drama|page=15|location=Oxford, England|publisher=Oxford University Press|isbn=978-0-19-995094-2}}</ref>

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!"<ref>{{cite web|url=http://shakespeare.mit.edu/othello/full.html|title=Othello, the Moore of Venice|author=William Shakespeare|date=1603|access-date=2019-03-27}}</ref>

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"<ref>Friedenwald & Morrison, Part I:99</ref>

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".<ref>Magner, ''A History of Medicine'':218</ref>

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?"<ref>{{cite web|url=https://the-mercurian.com/2018/05/10/moliere-at-versailles/|title=?Molière at Versailles|author=Molière|date=2018-05-10|work=Theater in Translation|publisher=The Mercurian|access-date=2020-07-18}}</ref>

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."<ref>{{cite book|last=Orwell |first=George |title=1984|year=1949|location=New York|publisher=[[Harcourt (publisher)|Harcourt, Brace and Company]]|isbn=9780151660353|url=https://archive.org/details/1984orwe00orwe|url-access=registration}}</ref>

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.".<ref>{{cite web|url=https://www.nytimes.com/2014/03/09/books/review/whats-it-like-reading-peyton-place-today.html|title=What's It Like Reading 'Peyton Place' Today?|author=Thomas Mallon |author2=Anna Holmes |date=2014-03-04|department=Book Review|work=The New York Times|access-date=2019-04-18}}</ref> As a teenager, the boy enjoys receiving enemas from his mother.<ref>{{cite web|url=https://exlibrisregina.com/2016/09/20/my-return-to-peyton-place/|title=My Return to Peyton Place|author=R. Saint Claire|date=2016-09-20|work=Ex Libris Regina|publisher=R. Saint Claire|access-date=2019-04-18|archive-url=https://web.archive.org/web/20190219184420/https://exlibrisregina.com/2016/09/20/my-return-to-peyton-place/|archive-date=February 19, 2019|url-status=dead}}</ref>

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."<ref>{{cite web |url=https://www.nytimes.com/2011/10/16/magazine/a-girl-not-named-sybil.html|title=A Girl Not Named Sybil |author=Debbie Nathan|date=2011-10-14|work=[[The New York Times Magazine]]|access-date=2019-04-21}}</ref>

==== Film ====

In ''[[The Right Stuff (film)|The Right Stuff]]'', during flight training astronaut [[Alan Shepard]] retains a barium enema,<ref>{{cite web|url=https://www.nytimes.com/1983/10/21/movies/film-right-stuff-on-astronauts.html|title='Right Stuff,' on astronauts|author=Vincent Canby|date=1983-10-21|department=Film|work=The New York Times|access-date=2019-03-27}}</ref> 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.<ref>{{cite web|url=https://teachwithmovies.org/the-right-stuff/|title=The Right Stuff|publisher=Teach with Movies|access-date=2019-03-27}}</ref><ref>{{cite web|url=https://www.imdb.com/title/tt0086197/characters/nm0001277|title=The Right Stuff|website=[[IMDb]]|access-date=2019-03-27}}</ref>

''[[Water Power (film)|Water Power]]'' is a Pornographic film by Gerard Damiano loosely based on the real-life exploits of [[Michael H. Kenyon]], an American criminal who pleaded guilty to a decade-long series of armed robberies of female victims, some of which involved sexual assaults in which he would give them enemas.<ref>{{cite web|title=Water Power|work=Adult DVD Talk|url=https://www.adultdvdtalk.com/review/waterpower}}</ref>

==== Song ====

The lyrics of [[Frank Zappa]]'s song "The Illinois Enema Bandit" are concerned with [[Michael H. Kenyon]]'s [[sexual assault]]s which included administering involuntary enemas.<ref>{{cite web|url=https://idnc.library.illinois.edu/cgi-bin/illinois?a=d&d=DIL19750609.2.2|title=Enema bandit suspect faces hearing today|author=Mick Ireland|date=1975-06-09|work=Illinois Digital Newspaper Collections|publisher=[[University of Illinois at Urbana–Champaign]]|access-date=2019-03-27}}</ref>

The album [[Enema of the State|''Enema of the State'']]  by [[blink-182]] is titled with the word in it. It features a nurse on the cover. 
==== Monument ====

A {{convert|365|kg|lb|abbr=off|adj=on}} 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, "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, a banner on one of the spa's walls declared "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."<ref>{{cite web|url=https://www.reuters.com/article/us-russia-enema-art/russian-monument-to-enemas-inspired-by-botticelli-idUSL1982017120080619|title=Russian monument to enemas inspired by Botticelli|date=2008-06-19|work=Reuters Life!|publisher=[[Reuters]]|access-date=2019-04-12}}</ref><ref>{{cite web|url=https://www.nbcnews.com/id/wbna25265056|title=Enema monument unveiled Russian resort|date=2008-06-19|website=[[NBC News]]|access-date=2019-04-12}}</ref> It is the only known monument to the enema.<ref>{{cite web|url=https://www.atlasobscura.com/places/monument-to-enemas|title=Monument to Enemas|work=Places|publisher=[[Atlas Obscura]]|access-date=2019-04-12}}</ref>
{{clear}}