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Subject: Isotonic solution--what IS it?


Author:
Rick
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Date Posted: 10:17:25 03/15/10 Mon

I'd venture an educated guess that those of us who have administered many enemas have encountered a patient or two who got nauseated during the procedure, or who actually vomited.

Since this isn't exactly the result that we're after, we'd of course like it not to happen at all. In researching why some people do get sick or nauseated during an enema, I've learned that some experts think this is a result of an electrolyte imbalance brought on by the instillation of a lot of water, which of course is what an enema is all about in the first place.

Under the category "enemas," Wikipedia tells us that electrolte depletion can be avoided by use of an isotonic solution, stating: "...an isotonic solution has the same salt concentration as the normal cells of the body and the blood...an isotonic saline solution is least irritating to the rectum and colon, having a neutral concentration gradient. This neither draws electrolytes from the body as can happen with plain water- nor draws water into the colon, as will occur with phosphates."

But then try to find out what an isotonic solution IS. Try Googling "isotonic solution" and you get all kinds of technically worded scientific talk, but no clue of what it actually is or how to make it.

My question to Arthur Hamilton, Dr. Marouf or any other scientific/medical person/layman-in-the-know out there is this: would an "isotonic solution" in an enema keep the recipient from becoming nauseated; and if so, how would you make one? And while we're on the subject, since the whole point of Gatorade is to provide replenished electrolytes, would a Gatorade enema be at all beneficial?

It really can be a bit of a downer when the guy you're giving an enema to suddenly turns green and starts to barf.

--Rick

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[> Subject: Re: Isotonic solution--what IS it?


Author:
dranon
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Date Posted: 10:38:21 03/15/10 Mon

Isonotonic means that the solutions contains ions in the same concentration as the surrounding tissue/fluids. The main ions in the body are Sodium, Potassium, Chloride and Bicarbonate. So a mixture of sodium chloride (salt), Potassium Chloride, and sodium Bicarbonate (baking soda) in the right amouts will cover it.

Normal saline as it is called is isotonic for Sodium and Chloride, and is about 1 tsp of salt per liter of water.

Products such as Golytely and Colyte for Bowel cleansing are essentially isotonic for sodium,Potassium,bicarbonate, chloride and sulfate (Nulytely and Trilyte are not isotonic).

If you look up the ingedient list and amounts on a Golytely label (or in the PDR), if you leave off the PEG 3350, you will have an isotonic solution.

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[> Subject: Re: Isotonic solution--what IS it?


Author:
Liz (Slightly off subject)
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Date Posted: 03:03:02 03/17/10 Wed

When I was a little kid and my mother was giving me an enema, I often became nauseated and did nearly vomit. At one doctor visit when I was about 14, in which my mother accompanied me, I asked the physician why I got so nauseated during an enema. The doctor explained in a rather scientific manner that nausea sometimes is the result of too much solution being given too fast. A year or two later I went to a library and learned that the nausea could be the result of so much fluid being introduced as to push the cecum, a valve between the small and large intestine.

My best to all,

Liz

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[> [> Subject: Re: Isotonic solution--what IS it?


Author:
Rick
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Date Posted: 09:08:25 03/18/10 Thu

Hi, Liz,

Thank you for your explanation. The nausea question has bothered me for some time, since on more than one occasion, the person to whom I was giving enemas complained of nausea, and on one occasion actually vomited.

From what I'd gleaned on posting boards such as this one, the culprit appeared to be electrolyte imbalance. Your "too fast" explanation actually makes more sense, though, when you think about the mechanics of an enema. Even to veteran enema recipients, the process can be grueling, especially when more than one is involved.

I guess the rule, especially when dealing with novices, should be "take it slow." Thanks for pointing this out.

--Rick

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