By Maureen Shawn Kennedy, AJN editor-in-chief
I recall giving an “M&M” enema when I worked as a nurse’s aide in high school. The small community hospital medication room had a jar of molasses in the cabinet, and I watched the nurse mix ½ a cup of the thick syrup with ½ cup of milk and put it in an enema bag. She then handed it to me and said, “C’mon, it’s easy, I’ll show you how.” And it was, and it worked pretty quickly. Older nurses and physicians swore by it.
By the time I was out of nursing school and working in clinical practice, commercial preparations seemed to be the standard. But as the song goes, “everything that’s old is new again.” This month in AJN, Jackline Wangui-Verry and colleagues’ paper, “Are Milk and Molasses Enemas Safe for Hospitalized Adults? A Retrospective Electronic Health Record Review,” describes their investigation of this long-time and oft-used intervention for constipation.
Examining the safety of a long-established, ‘last resort’ practice.
The authors “wanted to learn whether this approach is actually safe and effective or more of a ‘sacred cow’ . . . .”
This study focused on safety and a follow-up study will include efficacy. They evaluated the hospital records of 196 hospitalized adults who received an M&M enema after laxatives or stool softeners failed to produce a bowel movement. No serious complications—“allergic reactions, bacteremia, bowel perforation, electrolyte abnormalities, abdominal compartment syndrome, cardiac arrhythmia, dehydration, and death; and electrolyte (sodium and potassium) changes”—were reported.
A low-cost intervention.
The authors note the following:
from 1997 to 2010, the total annual costs of caring for patients with a primary discharge diagnosis of constipation rose from $188 million to nearly $852 million. The analysis also found that the frequency of such diagnosis more than doubled in that time, from 6.1 to 12.4 per 10,000 discharges.
M&M enemas can be a low-cost intervention.
The article is free to read on our website, www.ajnonline.com—and watch the video abstract from the lead author.
Really works the Doctor told me the amount of molasses and milk. I used it for a couple years no more pain from laxatives.
In 1985 I was given the M & M for opoid constipation. As I was hospitalized for 2 months, this was expected. I knew of the m n m, but as a horse enema! It worked….great!!
How long will it stay good once mixed the milk and molasses