Nutrient enema

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. In modern medicine, nutrient enemas have been superseded by tube feeding and parenteral nutrition (intravenous feeding).[not verified in body]

## Contents

* 1 History
* 1.1 19th century
* 1.2 20th century
* 1.3 21st century
* 2 Physiology
* 3 See also
* 4 References

## History

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.[2]

### 19th century

Doctor Willard Bliss prescribed this treatment to United States President James A. Garfield after his attempted assassination by Charles J. Guiteau on July 2, 1881.[3] Garfield died after a failed recovery on September 19, 1881.

### 20th century

In 1941, the U.S.' military manual for hospital diets prescribed use of nutrient enemas.[4]

### 21st century

In 2014, when the United States Senate Intelligence Committee published the Committee Study of the CIA's Detention and Interrogation Program, an unclassified summary of its 6,000 page classified report on the CIA's use of "enhanced interrogation techniques", its previously unknown practices of brutally forced nutrient enemas on detainees who attempted hunger strikes[5] and of "rectal rehydration" for punishment and torture became apparent.[6][7]

The South Park episode "Red Hot Catholic Love" features a fictionalized, inaccurate depiction of rectal feeding followed by fecal vomiting.

## Physiology

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.[8]

## See also

* Murphy drip

## References

1. ↑ Mattern, Susan P. (2008), Galen and the Rhetoric of Healing, Maryland, US: Johns Hopkins University Press, pp. 31, 145, 149, ISBN 978-0-8018-8835-9, https://books.google.com/books?id=5IXlOC1_liEC
2. ↑ 2.0 2.1 Mackenzie, J. W. A. (March 1943). "The Nutrient Enema". Arch. Dis. Child. 18 (93): 22–7. doi:10.1136/adc.18.93.22. PMID 21032242.
3. ↑ Bliss, D. W.; Banov, Leon (July 18, 1882). "Feeding Per Rectum: As Illustrated in the Case of the Late President Garfield and Others". The Medical Record (Washington, D.C.). https://www.biblio.com/book/feeding-rectum-illustrated-case-late-president/d/1182401077.
4. ↑ "War Department Technical Manual Hospital Diets". United States Department of War. October 13, 1941. https://collections.nlm.nih.gov/ext/dw/33320860R/PDF/33320860R.pdf.
5. ↑ Yuhas, Alan (December 9, 2014). "Controversial 'Rectal Feeding' Technique Used to Control Detainees' Behaviour". https://www.theguardian.com/us-news/2014/dec/09/cia-report-rectal-feeding-detainees.
6. ↑ Rosenberg, Carol (December 11, 2014). "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.
7. ↑ Mazzetti, Mark (December 9, 2014). "Senate Torture Report Condemns C.I.A. Interrogation Program". The New York Times (Washington, D.C.). https://www.nytimes.com/2014/12/10/world/senate-intelligence-committee-cia-torture-report.html.
8. ↑ "Rectal Alimentation". Nature 118 (2980): 858–859. December 11, 1926. doi:10.1038/118858a0. Bibcode: 1926Natur.118..858..

* v
* t
* e

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)

|
|

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
* Solution
* Hydrogel
* 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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