Chocolate Enema

Chocolate Enema

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Affiliation

1 Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California.

Gary M Vilke et al.

J Emerg Med .

2015 Jun .

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1 Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California.

Hansen SE, Whitehill JL, Goto CS, Quintero CA, Darling BE, Davis J.
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Johns J, Krogh K, Rodriguez GM, Eng J, Haller E, Heinen M, Laredo R, Longo W, Montero-Colon W, Wilson C, Korsten M.
Johns J, et al.
Top Spinal Cord Inj Rehabil. 2021 Spring;27(2):75-151. doi: 10.46292/sci2702-75. Epub 2021 May 24.
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PMID: 34108835
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No abstract available.

Johns J, Krogh K, Rodriguez GM, Eng J, Haller E, Heinen M, Laredo R, Longo W, Montero-Colon W, Korsten M.
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No abstract available.

Anderson J, Furnival RA, Zhang L, Lunos SA, Sadiq Z, Strutt JR, Kaila R, Hendrickson MA.
Anderson J, et al.
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Argoff CE, Brennan MJ, Camilleri M, Davies A, Fudin J, Galluzzi KE, Gudin J, Lembo A, Stanos SP, Webster LR.
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Background:

Increased scrutiny is occurring from regulatory agencies about the use of nonsterile enema preparations in the emergency department (ED) for constipation. This includes the "off-label" use of milk and molasses (M&M) enemas, as there are no reported data in the medical literature to determine safety and efficacy.

Objectives:

To evaluate the success and complication rates of administering M&M enemas in the ED.

Methods:

This was a structured retrospective study at two EDs over 8 years. Primary success was defined as the patient having a bowel movement. Secondary measures of success included improved pain score by 2 or more points or lowering of a heart rate initially over 100 beats/min by 20 or more beats/min. Complications included: hemodynamic compromise, increased pain, electrolyte disturbances, bacteremia, bowel perforation, rectal pain or bleeding, cardiac dysrhythmias, anaphylaxis, electrolyte disturbances, dizziness or syncope, or hospital admission for issues surrounding enema.

Results:

There were 2013 enemas given, of which 261 were M&M enemas; 214 were given alone. Success rates defined only as bowel evacuation for M&M enemas alone were 87.9% (188/214) and, when used after other treatment failures, were 82.4% (28/34) successful. Five additional patients improved with the secondary measures (90.2% success). There were 8/261 complications (3.1%), of which four had an increased heart rate, two had decreased blood pressure, one had an increased pain score, and one subsequently developed a fever.

Conclusion:

M&M enemas have a low complication rate when used in the ED.

Keywords:

constipation; enema; nausea/vomiting; resource utilization.

Copyright © 2015 Elsevier Inc. All rights reserved.

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* Type your message here:
>Making the M & M even worse punishment
>
>Anyone who has ever been punished with an M&M (Milk
>and Molasses) enema understands how horrible they are
>and how effective as a punishment tool they can be.
>But over the last few days I have improved upon the
>punishment and wanted to pass it along to all
>interested parties.
>
>First, the enema is only part of a good punishment
>system. I think it is important to use a punishment
>system rather than just an enema method. This greatly
>increases the punishment factor and hopefully will
>discourage a repeat offense.
>
>What I do is start by informing the offender that they
>are going to get a punishment enema that they will
>never forget. They are then ushered into the kitchen
>where the punishment solution and items will be
>prepared. I will immediately strip them naked. This
>is often accompanied by pleas and promises that are
>obviously ignored. From this point on they will be
>naked for the entire punishment regime.
>
>They must stand and watch while not moving with hands
>on their heads while I make the punishment ready for
>them. Any movement will result in additional
>punishment from this point on they are to remain
>silent. Should they speak or protest they will be
>rewarded with a soapy washcloth inserted into their
>mouths.
>
>I start by gathering the punishment items. This
>includes a long piece of ginger root that will be used
>as a fig; a jar of blackstrap molasses, and my new
>found key ingredient buttermilk, which make the
>solution much more severe.
>
>I pour about a cup of molasses and a cup of buttermilk
>into a pan and heat it to about 110 degrees. It will
>cool down a bit before it is administered and will
>look like dark chocolate milk.
>
>Then I peal the ginger root and scrape the outside
>with a fork. This releases more “juice” which makes
>the fig more effective.
>
>Now comes the first part of the punishment. The
>offender is placed over my knee and the fig is
>inserted into the anus. It should be moved in an out
>for at least two minutes during which time the burning
>sensation will become extreme. I take a piece of
>adhesive tape and use it to hold the butt cheeks
>together with the fig inserted as I take the offender
>to the bathroom. If they have a soapy washcloth in
>their mouths they may remove it but not rinse.
>
>I use a large bulb syringe to administer the enema. A
>little goes a long way and two bulb fulls will send
>the offender into agony.
>
>Before I administer the enema I will give the toilet
>seat a good coating of icy hot or other such
>substance. When they sit down they will feel a new
>form of punishment that make them think twice about
>offending.
>
>Now I give them a very long and very hard spanking and
>I will be sure us the bristles of the brush side to
>rough their backsides. This makes the icy hot much
>more effective.
>
>Now the fig is removed and the enema quickly
>administered. They will want to clench their butt to
>hold the enema in but that will greatly increase the
>residual burning from the fig. They are instructed to
>hold the enema for 10 minutes, which is impossible.
>The addition of buttermilk to the solution increases
>the long term cramping and the results in a few
>minutes will be explosive.
>
>Now they will likely sit on the toilet after only a
>few minutes. The results will be explosive but a new
>10 minute time period starts. The icy hot will start
>burning their already sore behinds and some additional
>icy hot on a man’s balls or on a woman’s vulva will
>add to the punishment.
>
>While they sit the hairbrush can be used liberally on
>the fronts of their thighs to great effect.
>
>Once the 10 minutes are up they may stand up, but are
>put into a diaper which they will wear for at least 8
>hours. The burning of the icy hot will be quite
>uncomfortable and the cramping of the buttermilk will
>produce additional bowel movements that they try to
>hold, with the burning from the fig still present when
>they clamp their cheeks together or they can just deal
>with a messy diaper.
>
>As I said, I think this will be a great addition to
>the punishment and doubt they will repeat the offense
>any time soon.

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