Milk and Molasses Enema - page 3
The other night at work I had an order to give a patient a milk and molasses enema. Having never done this before and only heard in nursing school that they used to be given I asked the other nurses... Read More
Sep 11, '05Quote from suebird3talk about "old school" THAT brings back memories for me!Not exactly something I would consider while doing the enema. I am sure it beats the "3 H" enema, anyday.
Triple H Enema: High Hot and Helluvalot
Sep 12, '05Quote from nrskarenrnwouldn't a coffee enema work just as well but less messy?milk and molasses works as mild stimulant to stimulate bowel peristalsis, evacuate stool and is easy on the bowel lining.
see prior post on subject:
for those patients whose hard stool is just beyond the reach of your glove,and you don't have a sse bag or rectal tube available. attach a 18 fr or larger foley to end of a fleets enema bottle, lubricate well with water soluble gel, insert tube with rotating motion up past stool as high as it will reach. administer enema up high, try to keep the patient side-lying for 15 min, expect great results.
brown cow = m+m = milk and molasses enema
warm 8oz milk in pan on stove or microwave 1 min. mix in 8 oz molasses. allow mixture to cool to room temp (test on inside of forearm).
once cooled, add to enema bag and your ready to go.
swear too that brear rabbit superior to grandma's molasses as has higher darkstrap molasses content. :chuckle
see diane k. newman, rnc, msn, crnp, faan incontinence nurse practitioners article for good info: http://www.seekwellness.com/incontinence/bowel.htm
Sep 12, '05Quote from VeryPlainJaneMakes you wonder doesn't it, have given it also and it does work! Appears also to be less uncomfortable then the typical SSE. Wonder if a coffee enema would keep the patient from sleeping!!:chuckleWouldn't a Coffee Enema work just as well but less messy?
Sep 12, '05I wonder if the M&M emena is making a come-back I've only been a nurse for a year and have given 2, also know of a few others that have been given?? But if this is the case they better start stocking us with molasses it's tough to find at 2am when dietary is closed
Sep 12, '05Quote from Ifs_WinteryI
I've given lactulose enemas to many hepatic encephalopathy patients and let me tell you WHOA! First, I learned to pad the whole bed from head to toe and then I learned to pad all around the bed on the floor also!
Try giving warm olive oil as an enema !!!!
Feb 6, '09This brings back memories: God, I hated those things! I used to work with a doctor who would order them late at night. The kitchen was closed, so I'd have to round up someone with a key to get the milk (obviously, we should have stored the milk on the unit, but by night shift it was usually gone). Then you had to heat the milk and molasses - this was in the days before microwaves were readily available, so we had to do it on the stove. Unless you watched it like a hawk, it would either boil over and make an unholy mess, or take f-o-r-e-v-e-r to get warm. I usually turned the stove on and off several times, since fifteen uninterrupted minutes for watching a pan was a rarity. Then you had to wait for it to cool down...
Frankly it wasn't worth the effort. I never noticed that it was anymore effective than the pre-packaged enemas. I suspected that doctor just wanted to know how much extra crap a nurse would put up with before she handed in her resignation.
Feb 6, '09Quote from General E. Speaking, RNtalk about "old school" THAT brings back memories for me!
Triple H Enema: High Hot and Helluvalot
LOL...I haven't heard that in a while either. M and M enemas...they do work...Yep...pad around the bed too!
Feb 7, '09I think the molasses kinda acts like lactulose in the bowel and pulls fluid into the bowel to soften the stool. I can't find my old fundamentals book to check this out
Feb 7, '09Interesting, I've never heard of this. You really do learn something new every day. I don't even know where I'd get molasses unless the pharmacy keeps some in stock for just such an order? Sounds like it would have to be a day shift kind of thing.
Nov 19, '09This seems like a somewhat dated discussion, but I thought I would throw my 2-cents worth in anyway. I will preface this by saying I have never given or received one of these enemas, but I have heard they are very effective. My understanding is the mechanism as to why they are so effective evolves around the osmotic pressure effect of the solution combined with the solution itself, which is very high in sugar. The bacteria in the bowel feed rapidly on the sugars thus creating a lot of gas and bowel extension creating a somewhat explosive result.
Nov 19, '09Thanks to the microwave the thing is a lot easier to make nowadays. I had to do this without supplies other than a retention bag, a patient fridge, and an old OB nurse to tell me the process. So basically I got like six little cartons of milk (maybe it was 3, I'm not sure)- any kind of milk since we only had 2 of whole milk, and every single packet of pancake syrup I could find that did NOT say "sugar free" on it. Put pancake syrup in a disposable, clean, suction container. We have the kind that don't have a liner, resembles a flowerpot in shape, and it's the right size to fit in a small microwave, plus it doesn't melt in the microwave. Respiratory isn't happy that I used them, but they really didn't want them back either. Put container with syrup only in it, in the microwave for one minute. Then put milk in, stir, put in microwave for another minute. (About the amount of milk: basically you would like approximately one liter of liquid.) Stir until you have brownish gooey milk and you think it's melted, may have to microwave it a little more. Stir, let cool until it's tepid. Hang enema set on IV pole and clamp off. Put mixture in bag, carefully- you may have to have someone hold the bag open so it doesn't make a mess.
Unhook your patient from telemetry and any other "wires" if you are able. Otherwise it's easy to choke the patient in the following process. Lube the end of the enema set (it's rather large), keep it clamped, lie patient on left side, insert enema. Instruct patient to do deep, slow breathing while you slowly, over about 5 minutes, let 250cc or so of the enema flow into patient. Keep it there for another minute. Instruct patient to roll over to their tummy. Repeat the breathing and the 250 cc flow thing, slowly. A minute or so after they have done this and are as relaxed as is possible, have the patient roll to the right side. This is why the tele wires, IV lines, etc. would be a problem (and I haven't even thought to try it on a vent patient). Repeat the whole thing on the right side. Slowly let the rest of the enema flow in and do nothing (else) to make the patient anxious. Remove the enema when it's all been in for a minute and make sure that the patient has a bedside commode immediately next to the bed, like at a right angle. If you have to hook any wires, IV lines, etc. back up, go ahead and do that. Put towels on the floor, anti-slip socks on patient's feet, and have baby wipes nearby. Stay close and open a window if you can, because the unholy smell will knock you down if you don't.
I have given this with success to elderly constipated ladies who sing halelujah at the end of the poop fest, and one old fella with colon cancer whose impactions were in the small bowel near the appendix. It works. The turning over slowly, helps slosh the mixture up in the large intestine and can reach the lowest parts of the small bowel if done right. The cramping from the large bowel does help encourage the small bowel to move along as well. It's safe for CHF and dialysis patients, and I've not seen it adversely affect either blood sugar or fluid balance.
Nov 20, '09Indy, I think your success with this procedure evolved around "and an old OB nurse to tell me the process."
I'll tell you right now, the old OB nurses are great at bowel work! If I may editorialize, I would say, "Beyond compare!" In my opinion you can learn more from an OB RN in two weeks than you will learn from a med/surg RN in a year.
But hey, that is just my opinion.
Oct 15, '10You're right. The old OB nurses are it on a stick. They can do more, with less, and more creatively than you'd think. You can't faze them and they will teach you stuff, you just have to show up with your ears on!