The History of Coffee Enemas
Linda L. Isaacs, M.D.
Records describing the use of enemas to improve health and relieve constipation date back to ancient Egypt. Coffee enemas specifically have long been in use. In 1866, M.A. Cachot, MD, reported in the Pacific Medical and Surgical Journal that a coffee enema aided in the recovery of a child dying from an accidental poisoning.1 At a medical meeting in 1896, Dr. W.J. Mayo, one of the founders of the Mayo Clinic, recommended coffee enemas to prevent post-operative shock.2Other authors in that era also mentioned this use.3,4
In 1941, a lengthy article by Dr. Carlos Stajano in the Uruguayan Medical, Surgical and Specialization Archives described immediate improvement with coffee enemas in near-terminal patients, including a patient with post-operative shock and another patient with cocaine intoxication.5Dr. Stajano made a passionate argument for their continued use based on his extensive experience with coffee enemas in post-operative management.
Coffee enemas were listed as a stimulant and as a treatment for shock in medical and nursing textbooks in the 1900s.6(p601),7 The Merck Manual of Diagnosis and Therapy, a compendium of orthodox medical treatment, included coffee enemas through the Twelfth Edition, published in 1972.8-10
In 1929, investigators at Lenox Hill Hospital in New York reported that rectal installations of several different liquids caused an increase of bile flow from the liver.11Drinking coffee has been shown to cause gallbladder contraction and elevate levels of cholecystokinin, a hormone that stimulates bile flow.12Coffee enemas may use both of these mechanisms to increase excretion of bile by the liver and gallbladder. An article published in 2014 provides support for this theory; physicians in Korea used coffee enemas as part of the preparation for capsule endoscopy, a procedure in which patients swallow a tiny camera to evaluate the small intestine. Since bile can blur the images in capsule endoscopy, the investigators speculated that the coffee enemas prior to the procedure would stimulate bile flow so that none was present to spoil the view when the camera was swallowed. They found that patients who did coffee enemas had better quality images than those who did not.13
While coffee enemas have not been studied as extensively as other medicinal products of the 1800s such as aspirin, digitalis or nitroglycerin, there is enough in the medical literature, combined with the overwhelmingly positive feedback from patients, to convince me that they are a valuable tool for patients to utilize. As with all interventions, I do not recommend performing coffee enemas without advice from a qualified medical practitioner.
1. Cachot MA. Case of Poisoning by Aconite; Enema of Coffee in the Treatment. Pac Med Surg J 1866;9:239-240. Available at http://google.com/books?id=BkAgAQAAIAAJ
2. Mississippi Valley Medical Association Society Proceedings. West Med Review. 1896;1(7):189-194. Available at http://google.com/books?id=tOVXAAAAMAAJ
3. Allison CC. Operative Technique in Appendicitis, with Cases. West Med Review. 1896;1(6):152-154. Available at http://google.com/books?id=tOVXAAAAMAAJ
4. The Medicinal Employment of Coffee. The Sanitary Record. 1897;20:105S-106S. Available at https://books.google.com/books?id=tS0TAAAAYAAJ
5. Stajano C. The concentrated coffee enema in the therapeutics of shock. Uruguayan Med Surg Special Arch 1941;29(3):1-27.
6. Practitioner AG. The Illustrated Family Doctor: A Handy and Authoritative Guide to Essential Medical Knowledge and the Maintenance of Good Health.London: Waterlow & Sons Limited; 1934.
7. McClain ME. The patient's needs: Enemas. Scientific Principles in Nursing. St. Louis, MO: The C.V. Mosby Company; 1950:168.
8. Bedside procedures. The Merck Manual of Diagnosis and Therapy. 9th ed. Rahway, NJ: Merck & Co, Inc; 1956:1747-1748.
9. Bedside procedures. In: Lyght CE, Gibson A, Keefer CS, Richards DW, Sebrell WH, Daughenbaugh PJ, eds. The Merck Manual of Diagnosis and Therapy. 10th ed. Rahway, NJ: Merck Sharp & Dohme Research Laboratories; 1961:1754-1755.
10. Bedside procedures. In: Lyght CE, Keefer CS, Lukens FDW, Richards DW, Sebrell WH, Trapnell JM, eds. The Merck Manual of Diagnosis and Therapy. 11th ed. Rahway, NJ: Merck Sharp & Dohme Research Laboratories; 1966:1682-1683.
11. Garbat AL, Jacobi HG. Secretion of bile in response to rectal installations. Arch Intern Med. 1929;44:455-462. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/536575
12. Douglas BR, Jansen JB, Tham RT, Lamers CB. Coffee stimulation of cholecystokinin release and gallbladder contraction in humans. Am J Clin Nutr. 1990;52(3):553-556. https://www.ncbi.nlm.nih.gov/pubmed/2393014
13. Kim ES, Chun HJ, Keum B, et al. Coffee enema for preparation for small bowel video capsule endoscopy: a pilot study. Clinical nutrition research. 2014;3(2):134-141. https://synapse.koreamed.org/DOIx.php?id=10.7762/cnr.2014.3.2.134