Heart Slowing Question

I seem to recall hearing that a potential side effect of enemas is a slowing if the heart rate. I've used the search function but haven't managed to find anything on here (although I'm sure there is stuff already written).

Some questions:

1. Is this actually a side effect?

2. What causes it?

3. How likely is it to happen?

4. What can I practically do to avoid it?

I'm not a medic so it would be great if someone could explain this in roughly non-medical terms.

Thanks in advance!

Potentially enemas can cause slowing of the heart rate. This is why enemas or rectal exams are contraindicated in coronary patients. The slowing is caused by stimulation of the vagus nerve which is part of the autonomic nervous symptom. This is the parasympathetic portion. Stimulation of this causes slowing of the heart rate, increase in gut movement and other effects. The opposite component of the autonomic system is the sympathetic nervous system which causes increased heart rate and slowing of the gut i.e. the "flight or fight"response. It is highly unlikely that you would have any significant slowing of your heart unless you were in the acute phase of a heart attack.

Liquidsky is a true trained scientist. You can have complete confidence in what he says. We are so fortunate to have a few folks like him on Zity to give us sound medical info.

Sounds like a potential larger problem.

Enemas generally stress the heart, and make it beat faster!

That can be dangerous if it goes too far or lasts too long!!

Yes, I also observe sloving of heartbeat, plus ''paleness" of eyesight after longer enema sessions. Could be rather scary feeling, especially time ago, when I experienced this effect first couple of times.

I think it occurs caused by water getting into bloodstream combined with general tiredness after say 3 or 4 hours of cotinuous enemas. Invariably, after long water play part of injected liquid is left in bowels, then gets into blood, part of it, not all, since I need to pee a lot after last enema.

I agree that it is bit dangerous, but pleasure ,obtained from long sessions is so seductive......

Regarding post 5. See my previous post 2. Slowing is NOT from absorption of water.

Lisak said

Enemas generally stress the heart, and make it beat faster!

That can be dangerous if it goes too far or lasts too long!!

While we're at it, LiasK's post is incorrect

Liquidsky is right. Vagal stimulation will slow the heart.

I cannot find the exact reference tonight, but I do recall researchers reporting changes in EKG patterns when patients were given barium enemas. The paper was cited in some nursing texts that I've read. The exact changes noted in the EKG was not mentioned, or perhaps I've forgotten that detail. Barium enemas are designed to fill the whole colon and to stretch it a bit; perhaps getting some of the barium to reflux through the (ileocecal valve (move backward up into the last part of the small intestine). The patient usually complained of increasing fullness, cramps and sometimes the barium leaked out on the radiology table.

Locally, gastroenterologists would order a Clayton Colon Cleansing Procedure before colonoscopies. It was thought patients would tolerate that rather than Mag Citrate orally followed by enemas until clear.

The Clayton procedure (see the patent application at https://www.google.com/patents/US4403982) involved mixing 2 liters of tap water with 60 ml of Castile soap and 10 milligrams of liquid bisacodyl. The patient was brought into the prep room, positioned on his right side and the enema tube inserted through the anus. A balloon was on the patient’s end of the tubing and sometimes was difficult to slide through the anus, even with copious amounts of lubrication. Once that was placed, air was injected into the balloon with a calibrated syringe and the tubing pulled back toward the enema giver until a snug seal was possible.

Enema solution was then allowed to flow into the patient. If leakage was noted, the flow was stopped and more air was injected into the balloon. When the bag was empty, the patient was rolled from side to side ten times in order to distribute the enema fluid thoroughly in the colon. During that time, the soap and bisacodyl worked their magic and the patient was helped to the bathroom or commode. The nurse would get the patient seated, deflate the balloon, remove the tube and let the patient evacuate his colon.

This procedure was used for a number of years, but was eventually halted because patients (the number is unknown to me) were noted to “code” after Clayton enemas. By then, GoLYTELY and other foul tasting solutions arrived on the scene and to my knowledge, not many doctors use Claytons before colonoscopy.

The question on the board asked if enemas could slow one’s heart rate. There seems to be an association between large volume enemas and cardiac events. Authorities think it is related to stimulation of the Vagus nerve that runs through the GI tract, (see http://www.md-health.com/Enema.html for a more scholarly explanation). That article probably has information in it on frequency of heart issues with enemas and how to avoid it.

Volitional vagal stimulation (bear down) is an effective (and old fashioned) way to slow down the heart in tachycardia (fast heartbeat). Enemas cause the same thing.

By then, GoLYTELY and other foul tasting solutions arrived on the scene and to my knowledge, not many doctors use Claytons before colonoscopy.

I think I remember seeing some of the medical types on here noting that soap enemas were not recommended before colonoscopy because they tended to irritate the bowel and make it look like something bad was happening, which could lead to you being put through the process more often than necessary. The mixture you list (60 mL of castile soap in 2 L of water) is quite strong, about 2 Tbsp/quart, and I'd think there would be some noticeable effect on the colon wall. It seems that it shouldn't be enough to cause chemical colitis in most people, however.

Vagus nerve definitely. They can also cause vomiting.

Vagus nerve definitely. They can also cause vomiting.

Yes, I was getting a bit nauseated during my colonoscopy last week. My heart rate was good so I don't know if it was vagal or pain or other.

Maybe because if all the pushing can cause your heart rate to slow in some cases. Holding your breath and bearing down (Valsalva maneuver).

There are also people who can control their blood pressure and heart rate.

Maybe because if all the pushing can cause your heart rate to slow in some cases. Holding your breath and bearing down (Valsalva maneuver).

There are also people who can control their blood pressure and heart rate.

That's true but ANYBODY can do a valsalva and lower their heart rate (for a while anyway). That's how it works. That's also why elderly people sometimes faint while on the toilet.

A previous post in this thread caught my attention.

As an interesting observation, I wear two heart rate monitors (HRMs). One is a training/GPS watch that I bought more than a year ago and I wear most of the time. It reads my pulse through the skin on my wrist. The other one is a recent addition/replacement of an activity tracker that I struggled to "keep alive." It finally became evident that my old tracker was discharging the battery too fast or the battery had simply run its course and the battery capacity was drastically reduced. So, I sprung for a newer, more advanced activity tracker that has a constant measurement HRM built in.

Like my original GPS watch, when it is tracking a specific activity, it is measuring near constantly and calculating my energy expenditure and other data. Both HRM monitors allow setting custom heart rate zones (which I know from testing) and are able to give me a lot of data about how my training and races look. During periods when no specific activity is being tracked, the HRM is still recording data.

Before I put my confidence in these optical sensors, I cross-checked them with a strap-type HRM. I get good agreement between the strap-type HRM and the two optical sensors. Moreover, the two optical sensors also tend to agree with each other. The difference between them is the constant reading HRM provides an average for the previous 5-minutes and records/reports that value whereas the GPS watch measures my heart rate for one-minute every 10-minutes. Of course, the "gold-standard" multipoint sensor EKG would be seen as more accurate but not practical from the standpoint of continuous monitoring during long distance activity. Both use an HRM algorithm to estimate resting HR as well as measuring minimum HR.

What is interesting is that during long enema sessions my heart rate is elevated enough that one of my sensors tries to classify it against an array of activities. It knows there is not much movement according to the GPS, nor is the accelerometer measuring "steps." So, it tends to see the elevated HR as either a stationary indoor bike or training on an elliptical trainer.

For example, take a recent enema session where I had plenty of time to get well-lubed, to insert various long tubes for very filling enemas, first with 5 liters of a nice lavender Marseilles soapy mixture, and then rinsing with two separate 5-liter saline rinses. According to one of the activity monitors, it classified the activity as 93 "active minutes" on an elliptical trainer and as two hours and eight minutes of elevated fat-burning (or higher) heart rate for a total of 855 calories burned. Now the peak heart rate was only as high at 139 BPM but the average was 103 BPM. So yes, an enema has the tendency to elevate the heart rate from normal. But there are also brief periods when my heart rate drops back to near resting levels during the span of time of an enema. I can't be sure of when that is but I suspect that is when I am being still while the enema is filling me.

For the record, my minimum heart rate over a 30-day average is 46 BPM (usually about the time I wake up), and my average "resting HR" is 56 BPM (a bit more complicated algorithm). My maximum heart rate has been measured over 195 BPM and my VO2max for moderately intense runs of 30-60 minutes comes out about 50. For a 30-minute maximum sustained output run, it comes out close to 60. People with a medical background or serious aerobic training background will know what that means. But I am not worried about the effects of a slightly elevated heart rate over the period of a couple of hours while taking 15-liters of soapy and saline enema solutions. My average HR over the period of running a marathon in 4 hours, 15 minutes to 4 hours, 35 minutes ranges between 145 and 155 BPM, so the HR during enema sessions are much lower.

YMMV.

So the cause as has been mentioned is the vagus nerve from bearing down. The other possibility is the solution you are using might be slowing things down. While it was once thought that vagus nerve stimulation can cause someone to go into cardiac arrest the latest data does not really back that up. That is the reason Atropine is no longer given in asystole cardiac arrest. It can cause pressure to drop temporarily and cause fainting but highly unlikely to cause a heart attack. cardiac arrest and heart attack are two different things.

Just the thought of giving myself an enema or giving one to a lover raise my vital signs.