Rectal douching

Rectal douching is the act of rinsing the rectum with intent to clean it. An instance of this rinsing or a tool used to perform the rinse may be called a rectal douche.

Rectal douching (Rectal irrigation)
Illustration of the large intestine highlighting in red the rectum, the portion cleansed by a rectal douche.
Device to perform a rectal douche: with the tip inserted, the bulb is squeezed to inject liquid.
Pronunciationdouche, /duːʃ/
ICD-9-CM96.39 "Other transanal enema"
MeSHD007507

Uses

Rectal douching is a hygienic practice to clean the rectum to void hardened stools as opposed to a pharmaceutical method to soften the stool.

Rectal douching is distinguished from anal cleansing, which is the routine cleaning of the anus after defecation.

Risks

Evidence is not clear, but it is possible that rectal douching before anal sex can increase the risk of transferring HIV,[1] and other diseases.[2] There is evidence that douching sometimes can disrupt the epithelium, or tissue in the rectum, and if this tissue is damaged, then diseases can spread more easily.[1]

Rectal douching before anal sex increases the risk of transfer of Hepatitis B.[3]

There are reports that activities which can have the side effect of causing unintentional forcing of water into the rectum, such as waterskiing, may cause discomfort but can potentially bring other harms.[4]

Technique

Liquid, typically water, is inserted into the rectum by means of some tool. After some time, the water is expelled in the manner of a routine bowel movement, and, in the process, the rectum eliminates waste and is cleaned.

Most people who use rectal douching do so with plain water.[5] The use of a hose connected to a tap, either in a shower or sink, has been reported as the most popular way to administer a douche.[5] Another popular way is with a handheld bulb and syringe designed for rectal douching.[5]

Less commonly, some people used commercial products sold for performing rectal douching, with single-use bottles of saline being most used.[5] Also commercially available but even less commonly used for rectal douching are mineral oil products intended to assist in an enema.[5]

History

A rectal douche device was patented in 1957 in the United States by Patricia Bragg.[6]

Society and culture

From a public health perspective, understanding rectal douching practices may be important because the practice can be paired with behaviors which are risk factors to acquiring a sexually transmitted infection.[5]

Research

Research into rectal microbicide to prevent the transmission of HIV increased interest into researching safer and more gentle rectal douching techniques.[7] The hope in that research is that a rectal microbicide could be delivered with a rectal douche.[7]

References
  1. Carballo-Diéguez, Alex; Bauermeister, José A.; Ventuneac, Ana; Dolezal, Curtis; Balan, Ivan; Remien, Robert H. (2007). "The Use of Rectal Douches among HIV-uninfected and Infected Men who Have Unprotected Receptive Anal Intercourse: Implications for Rectal Microbicides". AIDS and Behavior. 12 (6): 860–866. doi:10.1007/s10461-007-9301-0. ISSN 1090-7165. PMC 2953367. PMID 17705033.
  2. de Vries, Henry J.C.; van der Bij, Akke K.; Fennema, Johan S.A.; Smit, Colette; de Wolf, Frank; Prins, Maria; Coutinho, Roel A.; MorrÉ, Servaas (2008). "Lymphogranuloma venereum proctitis in men who have sex with men is associated with anal enema use and high-risk behavior". Sexually Transmitted Diseases. 35 (2): 203–208. doi:10.1097/OLQ.0b013e31815abb08. PMID 18091565. S2CID 2065170.
  3. Schreeder, M. T.; Thompson, S. E.; Hadler, S. C.; Berquist, K. R.; Zaidi, A.; Maynard, J. E.; Ostrow, D.; Judson, F. N.; Braff, E. H.; Nylund, T.; Moore, J. N.; Gardner, P.; Doto, I. L.; Reynolds, G. (1982). "Hepatitis B in Homosexual Men: Prevalence of Infection and Factors Related to Transmission". Journal of Infectious Diseases. 146 (1): 7–15. doi:10.1093/infdis/146.1.7. ISSN 0022-1899. PMID 7086206.
  4. Kizer, Kenneth W. (1980). "Medical hazards of the water skiing douche". Annals of Emergency Medicine. 9 (5): 268–269. doi:10.1016/S0196-0644(80)80387-8. ISSN 0196-0644. PMID 7369581.
  5. Javanbakht, Marjan; Stahlman, Shauna; Pickett, Jim; LeBlanc, Marc-André; Gorbach, Pamina M (2014). "Prevalence and types of rectal douches used for anal intercourse: results from an international survey". BMC Infectious Diseases. 14 (1): 95. doi:10.1186/1471-2334-14-95. ISSN 1471-2334. PMC 4015843. PMID 24555695.
  6. A US patent US2811156 A, Patricia Bragg, "Rectal douche", published 29 October 1957
  7. Carballo-Diéguez, Alex; Bauermeister, José; Ventuneac, Ana; Dolezal, Curtis; Mayer, Kenneth (2009). "Why Rectal Douches May Be Acceptable Rectal-Microbicide Delivery Vehicles for Men Who Have Sex With Men". Sexually Transmitted Diseases. 37 (4): 228–233. doi:10.1097/OLQ.0b013e3181bf9b2d. ISSN 0148-5717. PMC 2891180. PMID 19959973.
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