Do you know anyone who is using a PIE machine?

People who have suffered a spinal cord injury have difficulty having a bowel movement because they can't get good control over their muscles. A machine is available to help these people. It is called a PIE machine (Pulsed IrrigationEvacuation). It is a computer-controlled machine which imitates the functions of colonic irrigation. The machine costs more than $7,000 and is available only with a doctor's prescription.

The machine uses a disposable nozzle and hoses. I would like to purchase a sample of the nozzle, but I can't get it without a doctor's prescription.

Do you know anyone who is using this machine who would be willing to sell me one nozzle?

The website for the manufacturer is: piemed.com

The website contains very little information.

What a rip off theres not 200 dollars worth of parts in that contraption…… a solenoid pump makes a pulse you can control as does several other types depends on how big of pulse the rest is run of the mill simple circuts

@jeffreyboston

The P*I*E machine is interesting in theory, but in practice it is very little different than either a closed system colonivc on something like a Dotolo or Specialty Health machine or the Coloclean disposable system for use in bed at home.

Let me elaborate: Briefly, the P*I*E machine has a cart with a bag for clean, warm water, a pump system, and a bag for waste water and poo. The speculum is very like the one-piece disposable speculums used with either of the colonic machines listed, except it has an inflatable retention aid balloon, like the Coloclean. The one-piece speculums do not have an obturators so the water and poo hoses can be connected before the speculum is inserted.

In operation, the P*I*E machine pumps water into the user in little bursts, of about 5-10 ml each, a couple of times per second. In my opinion, the tidal volume of these little pulses are just about worthless. It's not at all like a Higgenson in that the pulses can hardly be felt. The machine's operating mode is controlled by a patient button, and it cycles through fill, pulse hold, and release. During the fill water goes in at a constant rate while being pulsed; during pulse hold the water pulses but no more water is given, and during release the water and poo flows out into the waste bag. IMO the controller, at least the one I used ca 10 years ago, is pretty stupid. For example, if you stop the inflow, you cannot restart it.

Don't get me wrong The P*I*E will make you poo sooner or later. If you are severely constipated it may take a couple of hours but eventually it will soften and break up hardened poo. Being on the machine is not unpleasant and pooing is not painful.

If you want something like this, consider the Cololean, available on-line for about $75. About the only differences are:

The water and poo bags of the P*I*E are many times larger than those of the Coloclean, which are roughly 2500ml. This is a mixed blessing. The Coloclean ones need filling/emptying several times during a session but the P*I*E are much heavier to handle and empty.

The other difference is the pulsing, but IMO the P*I*E's pulsing doesn't do much. The outflow hose of the Coloclean can be ‘crimped’ and this causes a powerful surge of water into the recipient's colon, and this is helpful to ‘power through’ a clog or cramp.

It should be noted that it is pretty hard to use any of these machines without a therapist or helper. This applies to both the closed colonic machines, and especially the P*I*E, or Coloclean. The difficulty is refilling the water bag and emptying the poo bag when you're lying in bed with the speculum in you

Thank you, Sean, for the additional information. I am trying to obtain the instruction manual for the PIE machine, but the manufacturer will not send it to me directly. If you are still registered as a user of the PIE machine, I would appreciate it if you could contact the manufacturer and request a .pdf electronic version of the instruction manual. I would be grateful if you could forward it to me.

According to information which I received by phone from the manufacturer, water is pumped in for 3 seconds and then allowed to drain out for 6 seconds. There are several different modes available on the PIE machine. The pulsing is only one of the available modes.

A big disadvantage of the PIE machine is that it does require 2 people, one person to receive the enema and a second person to operate the controls and observe if poop is entering the drain bag. A bowel movement is supposed to occur within 45 minutes.

I am trying to build a version of the PIE machine which can be purchased by anyone over the counter.

I was also interested in the pulsed pump concept, so I found a used SciLog peristaltic pump on eBay for about $250 that came with the perfect pump head for enema use — a Cole-Parmer Masterflex L/S that would go up to 2.9 liters per minute. I was able to rig up a handheld switch by hacking up a printer cable so I can stop and start it remotely. It works great and works fine with my normal thick-wall silicone tubing. It will easily pump out of a larger reservoir or bag, and with some thought can be easily set up to change fluids (soap suds in a 5L bag, saline rinse in a larger container or camp shower, coffee in a different bag, etc).

The pulsation due to the action of the peristaltic pump feel quite nice and enable a larger volume of water to be taken easily. It’s not quite as intense as something like a Pado pulsating massager held in direct contact with the nozzle, but it’s definitely noticeable and pleasant. The only bad thing about this pump is the high potential pressure it’s capable of creating; I’ve left the outflow side clamped on accident before and ran the pump, resulting in the tubing blowing off and spraying water everywhere. As such, I wouldn’t recommend using this setup with any type of retention nozzle that couldn’t be rapidly removed. In practice, this hasn’t been an issue, but it is something to watch out for. The other inconvenience is the power requirement and obviously the machine itself is not waterproof, so while the pump head is only mechanical and can tolerate some light splashing just fine, it can’t go in the tub or shower and must be tethered to an outlet.

The whole setup is a bit cumbersome and a lot of gear to haul out and set up, but worth it if you’re looking for the pulsation. It can also be calibrated down to the ml, so if you’re really interested in a running counter of how much fluid has been dispensed, it can do that with a high degree of accuracy. It also has a mode to dispense in metered doses, so e.g. pressing the remote button or hitting “run” on the face of the device would dispense a configurable volume, e.g. 250ml.

Anyway, if one is so inclined, ebay has lots of used peristaltic pumps that can be had for a fraction of their new prices. Just pay attention to pump rates and tubing sizes. From what I can gather, the exact model I have is typically used for transferring fluids for research and medical purposes, so some creative keyword searches might show you listings where someone doesn’t quite understand or care exactly what they’re selling.

@jeffreyboston

I bought my unit second hand many years ago, so have never been a registered user. At the time, I don't think there was even such a thing. The instructions were Xeroxed and not in electronic form and I can't access them. They were just user instructions.

It sounds like the machine programming may have changed since my unit. And, yes, it is very awkward to use solo. It can be done, but is not easy, and works if you get full results with one bag of water.

If the patient is very constipated, they are unlikely to have a ‘bowel movement’. It's a lot more like passing a few bits with every fill/drain cycle. In fact, the machine cannot deal with a ‘bowel movement’ as a big lump of poo will clog the speculum. This is the same thing that happens on a closed colon hydrotherapy system with a constipated person, and why I prefer a therapist that starts sessions with an enema, which gets the big, hard lumps of poo out on the toilet.

As to building an OTC system, you are dreaming. Such a system would have to be FDA approved and that costs millions. In talking with Roy Abel, the P*I*E inventor, many years ago, getting the machine software approved was a nightmare. The FDA regulates colon hydrotherapy machines, and even disposable enema bags, too.

I've tried many machines/systems of this kind out of curiosity over many years to evaluate their ease of use and poo power. Pretty much any of them are difficult to use solo and, honestly, there isn't really much difference among them. All will clog on a big lump of poo. With any the key is a gentle fill, followed by a long retention time to soften poo, release and repeat.

IMO, the reason the P*I*E is sold is that some insurance companies will pay for it and it is less messy for the nursing staff than repeated enemas and a bedpan.

I'd suggest you buy a Coloclean, either on eBay or direct, and play with that before trying to re-invent something. It is just as effective in making someone poo completely as any of the machines The Coloclean can be washed and disinfected with bleach after use and is good for perhaps 10+ sessions. It is easy and clean to use as all the waste water and poo go into a closed bag. The only stinky part is emptying the bag into the toilet. (BTW, the disposables for a single P*I*E session cost about the same as a whole Coloclean)

You can find those nozzle on line. They do make ones that works with enema bags or city water and the end just put it in the toilet.