WHEN I first heard the words "coffee" and "enema" used together 20 years ago as a young pharmacist, I burst out laughing.

I then asked, "With cream or sugar?" and laughed again.

Eventually, hilarity turned into shock when I discovered that coffee enemas were a serious part of complementary and alternative medicine.

The National Institute of Health has even given grants to researchers to find out if coffee enemas, along with supplements and diet, can fight pancreatic cancer.

Detoxify

Coffee enemas detoxify the body. They assist the body in conjunction with a detoxification programme. The coffee enema was first used by Dr Max Gerson from the 1940s to 1950s, to treat cancer patients.

Now, after more than 60 years of use in cancer treatment, the coffee enema is finally the subject of serious scientific study through the work of Dr Nicolas Gonzalez, and the United States Cancer Institute.

The therapeutic action of the coffee enema improves the abilities of the liver and gallbladder to remove toxins and cancerous metabolic byproducts by stimulating the flow of bile and increasing enzymatic action of the liver.

Glutathione S-transferases (GST) are a family of enzymes involved in detoxification. Palmitates in coffee increase the production of GST by 700 times. These powerful free-radical-quenching enzymes assist the liver to more effectively detoxify your entire body.

Coffee also contains the alkaloid theophylline, which dilates blood vessels, increasing blood dialysis across the colon wall.

Increased blood supply to the intestinal tract improves muscle tone and digestion, as well as the elimination processes.

Additionally, given that all of our blood passes through the liver every three minutes, the 12 to 15-minute coffee enema increases blood flow through the liver, resulting in a form of dialysis and a uniquely effective detoxification.

Definition

An enema is defined as "a fluid injected into the rectum for the purpose of clearing out the bowel, or of administering drugs or food". Believe it or not, it is one of humanity's oldest invasive medical procedures still in use.

Tribal women in Africa routinely administer it to their children. The earliest medical text in existence, the Egyptian Ebers Papyrus, mentions it. Millennia before, the Pharaoh had a "guardian of the anus", a special doctor whose purpose was to administer the enema. The true Royal Flush.

Enemas sprang up from ancient Greece to India. American Indians independently invented it, using a syringe made of an animal bladder and a hollow leg bone. Pre-Columbian South Americans fashioned latex into rubber enema bags and tubes (the world's first use of rubber).

No one knows when the first daring soul filled an enema bag with coffee. What is known is that the coffee enema was recorded as early as 1917 and was recommended in the prestigious Merck Manual until the mid-1970s.

In the 1920s, German scientists claimed that a caffeine solution could open the bile ducts and stimulate the production of bile in the liver of experimental animals.

Gerson Therapy

Max Gerson used this clinically as part of his detoxification regimen. The effects of caffeine, he postulated, travel upward to the liver. He noted that patients could dispense with pain-killers once on the enemas. Many people have noted a paradoxical calming effect.

But while coffee enemas can relieve constipation, Gerson emphasised: "Patients have to know that the coffee enemas are not given for the function of the intestines but for the stimulation of the liver."

Coffee enemas are still the butt (pardon the pun!) of many jokes. However, in 1981, Dr Lee Wattenberg showed that substances found in coffee promote the activity of a key enzyme system that detoxifies the blood.

Dr Peter Lechner, of Graz, Austria, has reported that "coffee enemas have a definite effect on the colon which can be observed with an endoscope".

Opponents say there is also a potential danger to the rectum, since bowel perforation has been associated with hard insertion devices. At the Gerson-oriented clinics, they use a short nozzle, which is not likely to inflict any harm.

Deaths

Critics always cite the deaths of two Seattle women which was attributed to fluid and electrolyte abnormalities, following enema abuse.

One took 10 to 12 coffee enemas in a single night and continued at a rate of one per hour. The other took four enemas daily.

Drinking orange or pineapple juice just before taking the enemas should help with the electrolytes. Obviously, one can't go overboard with any procedure and not expect consequences.

In a typical coffee enema, the coffee has to be of the regular caffeinated kind and preferably organic.

Very importantly, one should not do more than one quart per day, except under a physician's guidance. If you have trouble retaining an enema, add a tablespoon of blackstrap molasses. One then holds the enema in, while lying on your side for 15 to 20 minutes.

Enemas should be done under the care and supervision of a trained professional. These enemas are also recommended for serious aliments and should not be used routinely.

Datuk Dr Rajen M. is a pharmacist with a doctorate in holistic medicine.