Alcohol Enema (Alcohol-Induced Colitis)

Patient selection: enema solution containing ethanol

Reasons for an ethanol-containing enema include:

(1) social challenge

(2) sexual fetish

(3) bowel cleansing

(4) self-management of a bowel disorder

The colonic mucosa can be damaged by an ethanol concentration>= 10% (20 proof). An enema using beer is unlikely to cause a colitis, but administration of wine or undiluted liquor (35-50%) can cause a diffuse colitis that may mimic ischemic colitis on colonoscopy.

Alcohol-induced colitis may present with anal pain, tenesmus and colonic bleeding within 24 hours of the enema event.

Another problem can occur from the amount of alcohol absorbed. Fatal alcohol intoxication can occur if too much alcohol is administered. A fatal scenario could occur if a bottle of undiluted liquor is used as the enema fluid.

In addition, the person may be using other substances which may contribute to a fatal outcome.