Short description: Enema administered with the intent of providing nutrition when normal eating is not possible
A nutrient enema, also known as feeding per rectum, rectal alimentation, or rectal feeding, is an enema administered to provide nutrition in cases where normal eating is not possible. This treatment is ancient, dating back at least to the second century AD when documented by Galen,[1] and commonly used in the Middle Ages,[2] remaining a common technique in 19th century.[3] In 1941, the U.S.' military manual for hospital diets prescribed use of nutrient enemas.[4] In modern medicine, nutrient enemas have been superseded by tube feeding and parenteral nutrition (intravenous feeding).[citation needed]
A variety of different mixes have been used for nutrient enemas throughout history. A paper published in Nature in 1926 stated that because the rectum and lower digestive tract lack digestive enzymes, it is likely that only the end-products of normal digestion such as sugars, amino acids, salt and alcohol, will be absorbed.[5]
This treatment was given to U.S. President James A. Garfield after his shooting in 1881.[6]
When the United States Senate Intelligence Committee published an unclassified summary of its 6,000 page classified report on the CIA's use of torture, its previously unknown practices of brutally forced nutrient enemas on detainees who attempted hunger strikes[7] and of "rectal rehydration" for punishment and torture became apparent.[8][9]
See also
References
- ↑ Mattern, Susan P. (2008), Galen and the Rhetoric of Healing, Johns Hopkins University Press, Maryland, USA: Johns Hopkins University Press, pp. 31, 145, 149, ISBN 978-0-8018-8835-9, https://books.google.com/books?id=5IXlOC1_liEC
- ↑ J. W. A. Mackenzie (March 1943). "The nutrient enema". Arch. Dis. Child. 18 (93): 22–7. doi:10.1136/adc.18.93.22. PMID 21032242.
- ↑ Mackenzie JW (March 1943). "The nutrient enema". Arch. Dis. Child. 18 (93): 22–7. doi:10.1136/adc.18.93.22. PMID 21032242.
- ↑ "War Department Technical Manual Hospital Diets". Technical Manuals. United States Department of War. October 13, 1941. https://collections.nlm.nih.gov/ext/dw/33320860R/PDF/33320860R.pdf.
- ↑ "Rectal Alimentation". Nature 118 (2980): 858–859. 1926. doi:10.1038/118858a0. Bibcode: 1926Natur.118..858..
- ↑ Bliss, D. W. "Feeding Per Rectum: As Illustrated in the Case of the Late President Garfield and Others". Washington: N.p., n.d. Rpt. from the Medical Record, July 15, 1882.
- ↑ "Controversial 'rectal feeding' technique used to control detainees' behaviour". CIA torture report. The Guardian. https://www.theguardian.com/us-news/2014/dec/09/cia-report-rectal-feeding-detainees.
- ↑
Carol Rosenberg (2014-12-11). "Senate report confirms CIA had 'black site' at Guantanamo, hid it from Congress". Miami Herald. http://www.miamiherald.com/news/nation-world/world/americas/guantanamo/article4434603.html.
- ↑
"Senate Torture Report Condemns C.I.A. Interrogation Program". New York Times. 2014-12-10. https://www.nytimes.com/2014/12/10/world/senate-intelligence-committee-cia-torture-report.html.
Routes of administration, dosage forms |
|---|
| Oral | Digestive tract (enteral) | | Solids |
- Pill
- Tablet
- Capsule
- Pastille
- Time release technology
- Osmotic delivery system (OROS)
| |
|---|
| Liquids |
- Decoction
- Elixir
- Electuary
- Emulsion
- Extended-release syrup
- Effervescent powder or tablet
- Herbal tea
- Hydrogel
- Molecular encapsulation
- Powder
- Softgel
- Solution
- Suspension
- Syrup
- Syrup Concentrate for dilution and/or addition of carbonated water
- Tincture
|
|---|
|
|---|
Buccal (sublabial), sublingual | | Solids |
- Orally disintegrating tablet (ODT)
- Film
- Lollipop
- Sublingual drops
- Lozenges
- Effervescent buccal tablet
- Chewing gum
|
|---|
| Liquids |
- Mouthwash
- Toothpaste
- Ointment
- Oral spray
|
|---|
|
|---|
Respiratory tract | | Solids |
- Smoking device
- Dry-powder inhaler (DPI)
| 00 |
|---|
| Liquids |
- Anaesthetic vaporizer
- Vaporizer
- Nebulizer
- Metered-dose inhaler (MDI)
|
|---|
| Gas |
- Oxygen mask and Nasal cannula
- Oxygen concentrator
- Anaesthetic machine
- Relative analgesia machine
|
|---|
|
|---|
|
|---|
Ophthalmic, otologic, nasal]] |
- Nasal spray
- Ear drops
- Eye drops
- Ointment
- Hydrogel
- Nanosphere suspension
- Insufflation
- Mucoadhesive microdisc (microsphere tablet)
|
|---|
| Urogenital |
Ointment
Pessary (vaginal suppository)
Vaginal ring
Vaginal douche
Intrauterine device (IUD)
Extra-amniotic infusion
Intravesical infusion
|
|---|
| Rectal (enteral) |
- Ointment
- Suppository
- Enema
- Murphy drip
- Nutrient enema
|
|---|
| Dermal |
Ointment
Topical cream
Topical gel
Liniment
Paste
Film
DMSO drug solution
Electrophoretic dermal delivery system
Hydrogel
Liposomes
Transfersome vesicles
Cream
Lotion
Lip balm
Medicated shampoo
Dermal patch
Transdermal patch
Contact (rubbed into break in the skin)
Transdermal spray
Jet injector |
|---|
Injection, infusion<br />(into tissue/blood) | | Skin |
Intradermal
Subcutaneous
Transdermal implant
| |
|---|
| Organs |
- Intracavernous
- Intravitreal
- Intra-articular injection
- Transscleral
|
|---|
| Central nervous system |
- Intracerebral
- Intrathecal
- Epidural
|
|---|
Circulatory, musculoskeletal |
- Intravenous
- Intracardiac
- Intramuscular
- Intraosseous
- Intraperitoneal
- Nanocell injection
- Patient-controlled analgesia pump
- PIC line
|
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|
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