Isotonic?

I have had several enema experiences. I'd say small to medium volume over short periods (1-3 disposable 500 ml bags holding for just a few minutes each, plain tap water).

Since I'm not using pressure beyond the bag hanging at eye level, I'm not worried about pressure. I can handle the "is it too much" question confidently myself regarding pressure and fullness.

But I do worry about electrolyte imbalance. I just don't know what times/volumes put you near the problematic level.

First: How many quarts over what period of time is generally safe?

Second: If I use an isotonic solution, am I safe from electrolyte imbalance problems within the range of volume/time we discuss here, say

First let me say that each person's body will react differently .

What is the recipe for an isotonic solution?

1tbsp. of salt per quart of water.

I have frequently read about that same recipe for an isotonic solution (1 tsp of salt per quart of water) and it makes sense to me. However, I tend to have more cramps when using such a solution compared to normal tap water. So yes everyone's body reacts differently and it seems we have to experiment to find the best solution for each of us.

I'm currently under Visiting Nurse care, having recently undergone abdominal surgery. The nurses do three, 2 qt s/s enemas followed by a fourth of plain tap water. They have commented that more than that will upset balance. The encourage me to take asidolphilis (sp?) available in pill form from various health-food stores.

Please note carefully that the isotonic "recipe" is one TABLEspoon of salt to one quart water, not one teaspoon. This thread has two, both using standard US abbreviations, Tbsp. and tsp., and those who want to get it right need to know the correct ratio.

Merlot, public service announcer

Hi Everyone,

PLEASE READ THIS FOR SAFETY'S SAKE

I just did some sums. I ordinarily take about 5 litres of salt solution as an enema. Into the 5 litres goes 6 desertspoons of sea salt. This is a fairly strong purgative enema and will, if retained too long, produce dehydration. This indicates that it is hypertonic, i.e. more salty than the body's fluids.

So I did some sums for my US friends here (and that's most of you!). A US gallon of water weighs 8 pounds, or 3.633 Kg (1 Kg = 2.202 pounds). Taking the density of water at 1 Kg/litre, that means that one US gallon = 3.633 litres. So 1 US quart = 3.633/4 = 0.908 litres.

To my 5 litres I add 6 desertspoons of salt = 3 Tablespoons. Here I should add that previous posters have not told us if they are talking level tablespoons or heaped ones; and that makes a huge difference! For clarification, my desertspoonsful of salt are heaped.

So, using my school math, I am adding to each US quart an amount of 3 x 0.908/5 tablespoonsful of salt.

This comes to 0.545 tablespoons, or slightly more than half of what is proposed by our earlier posters.

My salt enema is slightly more salty than regular sea water. I also use sea water enemas often, so this remark is not guesswork. Sea water is seriously dehydrating when used as an enema!

I confess, folks, that I don't know the precise relationship between a heaped and a level spoonful. But let me guess: it might be about 2:1. If indeed this is so, and earlier posters WERE talking about level spoonsful, then my spoonful is about equal to two level spoonsful. So my regular enema is about one tablespoonful per quart, equal to the supposed 'isotonic' enema. I can say with the certainty of experience that anyone taking such an enema and holding it for fifteen minutes (difficult) will be extremely thirsty afterwards!

On the other hand, if the earlier posts referred to heaped spoonsful, an enema as proposed might be almost twice as strong as mine, and the thought makes me tremble! To the man or woman who takes that, I bow in admiration. Jy is werklik kragdadig!

Johnny

According to The Merck Manual and Taber's Cyclopedic Medical Dictionary, a saline solution is ONE TEASPOON NaCL/qt. H2O., not one tablespoon. This solution is abbreviated N.S. Sol.)

(meaning normal saline solution). This solution equals the salinity of the blood stream and does not cause the osmotic pressure to transfer fluid from blood to bowel, or from bowel into blood.

Using a Tablespoon/qt. concentration creates a HYPERTONIC solution, which will work just like epsom salts and draw water from the body into the bowel. Use of these hypertonic solutions repeatedly can cause dehydration of the body. Use of repeated tap water solutions can cause the condition known as, "Water Intoxication" and in a person with impaired renal function, this can be deadly.

I didn't write the formulas, I'm just reporting what the medical manuals have to say on this.

Thank you jimmyt44 for a credible scholarly source! Naturally, I stand by my own observations, since they are the result of numerous enemas both of sea water and my defined salt solution. Both are seriously hypertonic, and produce thirst immediately. But I am aware that anything reported from outside the USA is likely to be disbelieved within its borders, so Merck must triumph!

Mr. Webmaster, can you put this one into a place of prominence for the safety of our newbies?

Johnny

This has been gone over MANY times.

I don't really care what Tabers says, because everybody measures a teaspoon differently and very few actually use a measuring teaspoon. People generally measure this very INaccurately.

The correct amount of table salt is 9 grams per liter or quart. WEIGH IT!!!

That makes a 0.9% solution, which is physiologically isotonic to blood. If you must use spoons, use one measuring teaspoon and one measuring HALF teaspoon to get the right concentration.

As a means of reference, a penny weights 2.5 grams, a nickel weighs 5.0 grams, a dime weighs 2.27 grams and a quarter weighs in at 5.67 grams.

So, 4 dimes per quart makes a physiologic solution. All you guys with balances for measuring your pot should be able to handle this.

Finally, DOES THIS ALL MATTER AND IS A PHYSIOLOGIC/ISOTONIC SOLUTION NECESSARY??

NO, NOT ONE BIT as long as you aren't presently under your physician's care for kidney failure. Plain water is perfectly fine.

You can have repetitive enemas for hours without any adverse affects. If you are at all concerned, swallow a gatorade when you are done.

I’m sorry to be such a hard-ass on this, but this question has come up and been specifically answered many times, usually inaccurately.

Once again, SwitchableSusie is right on the money, on all counts. If you are in reasonable health, and do not suffer with kidney problems, enjoy your enemas without all this worry over electrolyte imbalances.

If you were to lay on a bed and not move a muscle all day long, your body would require approximately 1500cc's of water to function. Every time you exhale, you're getting rid of water. Don't believe me? Breathe on a mirror. You would have to drink approximate 1 & 1/2 quarts of water each day just to stay at a zero net gain/loss, even if you were completely bed-ridden. How many of you really drink that much water each day? With every cup of coffee, tea, soda pop, beer, wine and other forms of alcohol you drink, you piss out more water than the volume of fluid you just consummed.

Alcohol & caffine turn off ADH (Anti-Diuretic Hormone). This makes you piss more. This is also the reason you feel hungover after a night of drinking. You are so dehydrated that you do not have enough water in your tissues for your cells to run the Krebs Cycle. Sweetened drinks such as Cokes or iced tea (also known as "sweet tea" here in the South) set up what is known as a "hyperosmolar diuresis." In other words, the increase in blood sugar draws fluid from the tissues into the bloodstream where the kidneys regulate the excess by making you piss.

The fact is, from that first cup of coffee in the morning to that glass of water you drink before getting in bed, you are altering your fluid & electrolyte balance all day long. If you are active during the summer months, you are altering your fluids & electrolytes with every drop of sweat. If you use a dry heat source such as electric heat in your home during the winter, you are altering your fluid & electrolyte balances. This is why your skin is so dry and itchy during the winter months. The human body is constantly adjusting itself by either making you pee more often or signaling that you are thirsty.

Now if you really want to worry about something, check the bacterial count of the tap water you are putting in your enema bags....😃

Regards,

The Cave Man

Hey, you. It's been a while. Winter is almost here, so I suppose it's my time to crawl into my cave. I tend to drink at least seven 20 oz. bottles of water daily, along with two or three 12 oz. sodas or teas. Sometimes I drink so much that my mouth dries out and I have to drink something other than water to feel comfortable again. Then again, I'm just weird.

While some of you may not think the matter of an isotonic solution isn't that important, I believe that it is. I'm taking a diuretic to control Meniere's disease and have ended up in the emergency room with weakness, dizziness and heart palpitations due to low potassium. It wasn't the diuretic alone that caused the drop in my potassium level, but a marathon enema session using plain water. You can bet that I won't be doing that again.

I think it's misleading and irresponsible to suggest that it isn't anything to worry about. Many people are on diuretics for one reason or another and especially older folks for edema, heart disease, etc. And enema enthusiasts tend to be in the older crowd as enemas were practiced more frequently in their generations than in recent generations.

It may be annoying to read the same questions again and again, but we're all here to share and to help each other. Who better to ask questions than one's peers?

[quote author=egirlky link=topic=14050.msg156734#msg156734 date=1229581755]

. . . . I tend to drink at least seven 20 oz. bottles of water daily, along with two or three 12 oz. sodas or teas. Sometimes I drink so much that my mouth dries out and I have to drink something other than water to feel comfortable again. Then again, I'm just weird. . . . . I'm taking a diuretic to control Meniere's disease and have ended up in the emergency room with weakness, dizziness and heart palpitations due to low potassium. . . . .

[/quote]

Diane, you are drinking way too much water, soda and tea. You don't NEED to drink that much, it has become a habit. If you drank less, you would be able to cut back on your diuretic and your fluid/electrolyte balance could normalize. You may also be having a problem with medications you are taking. "Dry mouth" is the MOST COMMON side effect of drugs on the market. I would look into that as a factor, too.

Egirlky,

Due to your health problems which require you to be on a diuretic, and with your concern over only putting isotonic solutions in your body, I would ask if you make a point of adding sodium chloride to those seven 20 ounce bottles of water (nearly a gallon and a half) you drink each day? And, of those teas and sodas you consume, are you making sure they are both non-caffeinated and non-sweetened? If not, then you are not being consistent.

The fact is this, regardless of which end of your alimentary tract you choose to add water to, your body will absorb it. The difference is that water ingested by mouth is rarely purged immediately, where water ingested per rectum is usually evacuated within a matter of minutes. So, which route of administration could be more detrimental to those with kidney problems? By mouth, obviously.

With regard to my being “misleading & irresponsible,” I will remind you that I began my post with the caveat “if you are in reasonable health and do not have kidney problems....” I stand by that statement. What I find irresponsible are posts containing statements such as “I read somewhere on the Internet” or “sounds right to me” with no scientific data whatsoever to back up a particular claim.

I will say this again; if your doctor has prescribed diuretics, then obviously he or she does not think your kidneys are functioning properly. In that case, restrict your water intake according to your doctor’s advice. On the other hand, if you are in a reasonable state of health, with no kidney problems, then the only difference between ingesting water by mouth versus ingesting water per rectum is that your body will absorb all of the water taken by mouth, and only a small amount of the water taken per rectum unless you do not expel it. So which should you be more concerned with?

Regarding your claim of experiencing dry-mouth due to drinking too much, well, you leave out a lot of important information. Which diuretic are you taking? What is the dosage? What is your urine output each day? Are the teas & sodas you drink caffeinated and or sweetened? If so, then you’re contributing to the problem. Are you eating canned soups which are loaded with sodium? Do you tomatoes? Those are loaded with sodium as well.

In conclusion, if you or anyone else are going to be consistent regarding your concern over fluid & electrolytes, then be sure to add the proper amount of salt to any and all water you put into your body, regardless of the route of administration. If you are not experiencing problems with your kidneys, and not on any medications which alter your NaCl & k+ levels, then your body will regulate itself on its own. It is designed to do that and does it very well.

The point of my previous post was to show how folks are worrying about how enemas may be altering their fluid & electrolytes, while at the same time paying no attention whatsoever to everything else they do which changes their fluid & electrolytes on a minute by minute basis.

The Cave Man

P.S. I am not being argumentative simply for the sake of argument. These are the sorts of posts I enjoy most. I consider this to be a “thinking post,” unlike those wanting to know if your mother gave you an enema.

[quote author=Eleutheros link=topic=14050.msg140340#msg140340 date=1226090640]

Hi Everyone,

PLEASE READ THIS FOR SAFETY'S SAKE

. . . . So I did some sums for my US friends here (and that's most of you!). A US gallon of water weighs 8 pounds, or 3.633 Kg (1 Kg = 2.202 pounds). Taking the density of water at 1 Kg/litre, that means that one US gallon = 3.633 litres. So 1 US quart = 3.633/4 = 0.908 litres .. . . .

Johnny

[/quote]

The math here is a little convoluted and the conversion factors are not correct.

Look up on any conversion chart. One US quart is 946 ml and one gallon in 3.79 liters. (I think 3 significant figure accuracy is enough more than enough for this.)