External Applications in Anthroposophic Nursing

Milk and Honey Enema

Kind of substance

Milk and honey

Guiding principle for the application

Extended bed rest, drug treatments (morphine) and tumor-induced obstructions to intestinal passage can lead to constipation. Intestinal enemas are a tried and tested means of softening the stool.
When milk and honey are used, this lubricates and has a stimulating effect on peristalsis. When a patient’s general condition is weakened and especially during the dying phase, milk and honey enemas can reliably and mildly facilitate elimination, while at the same time providing nutrients through the colon. Of course, milk and honey enemas are also effective for treating habitual constipation and similar cases. They are not recommended for ileus.

Guiding Principle for the substance

Indications

  • Constipation, also due to medication (e.g., morphine)
  • Dying process

Instructions

Particularities
Preferably use in the first half of the day.

Materials

  • 1–2 tablespoons of honey
  • 200–500 ml of warm milk, body temperature
  • Irrigator
  • Intestinal tube
  • Vaseline
  • Bed protection
  • Incontinence pad
  • Night chair or bedpan
  • Hand towel
  • Disposable washcloth or cellulose
  • Disposable gloves


Instructions
  • Inform the patient
  • Prepare the material
  • Mix the milk with the honey, at body temperature
  • The patient lies down on his or her left side
  • Place the bed protection under the genital area
  • Place the incontinence pad under the buttocks
  • Protect the patient’s intimacy: cover the genital area with the hand towel
  • Coat with Vaseline the part of the intestinal tube that will be inserted
  • Attach the intestinal tube to the irrigator hose, remove any air and clamp shut
  • Gently insert the intestinal tube with slight turns (do not use force!)
  • Open the hose and let the liquid run in slowly by gravity
  • Observe the patient’s reaction well, stop at signs of stress
  • The patient should keep the fluid in the intestine for as long as possible: if necessary, ask him to squeeze his buttocks.
  • When a bowel movement seems imminent, help the patient onto the bedpan or toilet chair.
  • Stay with the patient during elimination for safety reasons
  • After elimination, perform intimate care on the patient in bed and, if necessary, place a chamomile oil compress cloth on the patient’s abdomen (to envelop and relax the intestinal tract).


Follow-up
  • Clean the irrigator and hose in accordance with hygiene regulations, dispose of the intestinal tube

Evidence
Well-proven in many patients
Dosage
Maximum of 1 enema daily over 3 days, then 1–2 times weekly as required
Onset of effect
Sometimes immediate, sometimes within 1–3 hours
Length of therapy
Depending on the therapeutic goal, the treatment may be given over several days
Warning
For weakened patients the enema can be very strenuous – observe the patient’s circulation!

Instructions to download

Author

Red., TB, MM