Risks of enemas. Enemas: Medical Uses, Risks, and Myths Debunked – A Comprehensive Guide

17.02.197424.09.2021 by alexxlab

What are the medical uses of enemas. How do enemas work for constipation relief. Are there risks associated with enema use. Can enemas really detoxify the body. What is the history behind enema practices. How effective are coffee enemas for health benefits.

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The History and Evolution of Enema Practices

Enemas have been a part of human medical practices for millennia, with roots tracing back to ancient civilizations. The earliest documented use of enemas comes from Egypt, mentioned in the Ebers Papyrus, a medical text dating back over 3,500 years. Throughout history, enemas have served various purposes, ranging from medicinal to ritualistic.

In the 18th century, a peculiar practice emerged in Europe, particularly in London. Physicians attempted to resuscitate drowning victims by administering tobacco smoke enemas. This bizarre method, often performed along the River Thames, was based on the belief that the irritation caused by tobacco smoke would induce strong stomach contractions, forcing the lungs to expel water. However, it’s crucial to note that this is not a valid resuscitation technique and should never be attempted.

Historical Uses of Enemas

Providing nourishment to those unable to eat
Ingesting intoxicants
Torture methods
Ritualistic or religious cleansing
Sexual activities
Treating various digestive ailments

Understanding Enemas: Definition and Types

An enema is a procedure involving the injection of liquid or, occasionally, gas into the rectum via the anus. The primary purposes are to administer medication or flush out colon contents. A related procedure, colonic irrigation (often referred to as ‘a colonic’), involves a continuous flow of liquid for an extended period, aiming to clear out the colon completely.

Are there different types of enemas?

Yes, there are several types of enemas, each serving a specific purpose:

Cleansing enemas: Used to relieve constipation and prepare for medical procedures
Retention enemas: Designed to be held in the rectum for a period to allow absorption of medication
Coffee enemas: Claimed to have detoxifying properties (though scientifically unproven)
Barium enemas: Used for diagnostic imaging of the large intestine
Probiotic enemas: Intended to introduce beneficial bacteria into the colon

Medical Applications of Enemas in Modern Healthcare

While the historical uses of enemas were often based on misconceptions, modern medicine has found several legitimate applications for this procedure. Physicians may recommend enemas as part of treatment plans for various gastrointestinal conditions or as preparation for certain medical procedures.

How do enemas assist in medication delivery?

Enemas can be an effective method for delivering medication directly to the source of inflammation in conditions like ulcerative colitis. The gastrointestinal tract can sometimes degrade orally consumed medications during their journey through the stomach and small intestine. By administering medications such as 5-ASAs and corticosteroids via enema, healthcare providers can ensure more targeted and effective treatment of inflammation in the rectum and large intestine.

Can enemas help with severe constipation?

In cases of severe constipation where other treatments have proven ineffective, enemas containing salt solutions can be useful in initiating a bowel movement. However, it’s important to note that this method is not recommended for frequent use due to potential health risks. Enemas for constipation should only be used under a physician’s guidance and when other options, such as dietary changes, fiber supplements, or laxatives, have failed to provide relief.

Diagnostic Uses of Enemas in Medical Procedures

Enemas play a crucial role in certain diagnostic procedures, particularly those involving the large intestine. One such application is the barium enema, which allows physicians to visualize the outline of the colon for diagnostic purposes.

What is a barium enema and how does it work?

A barium enema is a diagnostic test that involves administering a solution containing barium into the rectum. This procedure is followed by a series of X-rays. The barium coats the intestinal walls, allowing the shape and contours of the digestive tract to be clearly visible on X-ray images. This technique can help identify abnormalities such as polyps, tumors, or other structural issues in the large intestine.

While barium enemas were once a common diagnostic tool, they have largely been replaced by more advanced imaging techniques such as CT colonography and traditional colonoscopy. However, they may still be used in specific cases where these other methods are not suitable or available.

The Controversy Surrounding Detox Enemas and Colon Cleansing

In recent years, there has been a surge in popularity of so-called “detox” enemas and colon cleansing procedures, often promoted by celebrities and alternative health practitioners. These practices are based on the belief that the colon accumulates toxins over time, which can be flushed out through enemas. However, this concept is not supported by scientific evidence and has been the subject of much debate in the medical community.

Do enemas really detoxify the body?

Despite claims made by proponents of home enemas, there is no scientific evidence to support the idea that enemas can detoxify the intestinal tract, liver, or gallbladder. The human body has its own highly efficient detoxification systems, primarily the liver and kidneys, which are constantly working to remove harmful substances from our bodies.

The notion that large amounts of waste remain in the colon at any given time is also a myth. In healthy individuals, the colon is quite effective at moving waste through and out of the body. Regular bowel movements, combined with a healthy diet and lifestyle, are usually sufficient to maintain colon health without the need for invasive cleansing procedures.

Are coffee enemas beneficial for health?

Coffee enemas have gained popularity in alternative medicine circles, with proponents claiming various health benefits, including detoxification and cancer treatment. However, these claims are not supported by scientific evidence. In fact, coffee enemas can be potentially dangerous, leading to complications such as rectal burns, electrolyte imbalances, and in rare cases, septicemia.

The American Cancer Society and other reputable medical organizations do not recommend coffee enemas as a treatment for any condition. The risks associated with this practice far outweigh any potential benefits, which remain unproven.

Potential Risks and Complications of Enema Use

While enemas can be useful in certain medical situations, they are not without risks. It’s crucial to understand the potential complications associated with enema use, especially when performed without proper medical supervision.

What are the common risks associated with enema use?

Several risks can arise from improper or excessive use of enemas:

Electrolyte imbalances: Frequent enemas can disrupt the body’s delicate balance of electrolytes, potentially leading to serious health issues.
Dehydration: Excessive use of enemas can lead to fluid loss and dehydration.
Bowel perforation: In rare cases, the insertion of an enema tip can cause tears in the rectum or colon.
Infection: Improper sterilization of equipment or use of contaminated solutions can introduce harmful bacteria into the body.
Rectal irritation or damage: Frequent enemas can cause irritation, inflammation, or damage to the rectal tissues.
Dependence: Regular use of enemas for constipation relief can lead to a reliance on them for bowel movements.

It’s important to note that these risks are significantly heightened when enemas are performed at home without proper medical guidance. Always consult with a healthcare provider before considering the use of enemas for any purpose.

The Role of Enemas in Preparing for Medical Procedures

One of the most common and legitimate uses of enemas in modern medicine is in preparation for certain medical procedures, particularly those involving the lower gastrointestinal tract.

How are enemas used in colonoscopy preparation?

While oral preparations are more commonly used today, enemas can still play a role in preparing the bowel for procedures such as colonoscopies. The goal is to clear the colon of any fecal matter, allowing for clear visualization of the intestinal lining. However, it’s important to note that enemas are typically not the primary method of bowel preparation for most colonoscopies.

Most physicians now prefer oral laxative solutions for colonoscopy prep, as they are generally more effective at cleaning the entire colon. Enemas may be used as a supplementary measure or in cases where oral preparations are not suitable. Always follow your healthcare provider’s specific instructions for procedure preparation.

Debunking Myths and Misconceptions About Enemas

As with many health-related topics, there are numerous myths and misconceptions surrounding enemas. It’s crucial to separate fact from fiction to make informed decisions about health practices.

Common Myths About Enemas

Myth: Enemas can cure diseases. Reality: While enemas can be useful in managing certain conditions, they are not a cure-all and should not be used as a substitute for proper medical treatment.
Myth: Regular enemas are necessary for colon health. Reality: A healthy colon does not require regular cleansing beyond normal bowel movements.
Myth: Enemas can help with weight loss. Reality: Any weight loss from enemas is due to temporary fluid loss and is not a healthy or sustainable method of weight management.
Myth: Enemas can boost the immune system. Reality: There is no scientific evidence to support this claim. A balanced diet and healthy lifestyle are more effective ways to support immune function.
Myth: Herbal enemas are always safe because they’re natural. Reality: Even natural substances can cause harm when used improperly. Herbal enemas can lead to allergic reactions or other complications.

It’s important to approach claims about enemas critically and to consult with healthcare professionals before trying any new health practice, especially one as invasive as an enema.

The Future of Enema Use in Medicine and Alternative Health Practices

As medical science continues to advance, the role of enemas in both conventional medicine and alternative health practices is likely to evolve. While some traditional uses may decline, new applications could emerge based on ongoing research and technological developments.

What does the future hold for enema use in healthcare?

In conventional medicine, the use of enemas is becoming more targeted and specialized. For instance, research is ongoing into the potential of fecal microbiota transplantation (FMT) via enema as a treatment for certain gastrointestinal conditions. This involves transferring fecal matter from a healthy donor to a recipient to restore a healthy gut microbiome.

In the realm of alternative health practices, it’s likely that enemas will continue to be promoted by some as a detoxification method, despite the lack of scientific evidence. However, as public health education improves, there may be a growing awareness of the potential risks associated with unnecessary enema use.

The future may also see the development of more advanced, safer methods for bowel cleansing and medication delivery that could reduce the need for traditional enemas. As always, it will be crucial for individuals to stay informed and consult with healthcare professionals before engaging in any health practice, including the use of enemas.

In conclusion, while enemas have a long history and some legitimate medical uses, it’s important to approach their use with caution and skepticism, especially when it comes to claims about detoxification or alternative health benefits. Always prioritize evidence-based medical advice and consult with healthcare professionals before considering any form of enema use.

Enemas – Gastrointestinal Society

Enemas have been popular for a long, long time. It makes sense that enemas were used historically; when individuals couldn’t take medicine by mouth, and before intravenous medication was common, there was only one route of administration left available! As humans paid more attention to cleaning themselves, it seemed logical to think that the place where waste left the body might require internal cleaning. However, today, there is controversy around enemas. Some celebrities, most of whom are not medical experts, claim that enemas are a cure-all with detoxifying and cleansing superpowers, but physicians are speaking out against the harms of certain popular enemas. In this article, we’ll discuss the truth about enemas, and go over some of the useful applications, as well as the more dangerous ones.

History of Enemas

An enema is a procedure that involves injecting a liquid, or occasionally a gas, into the rectum via the anus to either administer medication or flush out colon contents. Colonic irrigation (often shortened to ‘a colonic’) is a similar procedure that involves administering a continual flow of liquid for minutes to hours to clear out the colon completely rather than the single injection of enema fluid.

Humans have been using enemas for thousands of years. The oldest record of enema use comes from Egypt, mentioned in the Ebers Papyrus, a document written more than 3,500 years ago. Throughout time, people have had many reasons for using enemas, such as for providing nourishment to those unable to eat, ingesting intoxicants, torture, ritualistic or religious cleansing, sexual activity, and attempting to remedy various digestive ailments.

Medical Uses of Enemas

Sometimes an enema is the best tool in a physician’s arsenal to treat or diagnose various gastrointestinal diseases and disorders. In this section, we will outline common and effective uses of the enema.

Delivering Medication

One of the most common medical uses of the enema is to administer medication directly to the source. Individuals with ulcerative colitis experience inflammation only in the rectum and large intestine. The gastrointestinal tract can digest or degrade medications orally consumed during its journey through the stomach and small intestine. For this reason, some medications for ulcerative colitis, such as 5-ASAs and corticosteroids, are available in enema form to deliver the medication directly to the inflamed area for more effective treatment.

Constipation Relief

Enemas can be useful for those with severe constipation. When other treatments, such as dietary intervention, fibre supplements, or laxatives are ineffective, enemas containing salt solutions can help initiate a bowel movement. However, this method isn’t recommended for frequent use, and should only be done in cases where nothing else works, and when your physician gives you the okay, as there are more health risks with enemas than there are with standard constipation treatments.

Bowel Emptying

Your physician might recommend using an enema before a procedure or surgery that requires an empty intestine, such as colonoscopy. However, it is more likely that they will give you an oral preparation that clears out the colon than recommend an enema.

Diagnostic Tests

If your physician wants to see the outline of your large intestine for diagnostic purposes, they might use a barium enema. This involves administration of a solution containing barium, followed by a series of X-rays. The barium coats the intestinal walls and allows the shape of your digestive tract to show up in X-rays.

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A strange type of enema found throughout Europe, especially London, in the 18^th century involved blowing tobacco smoke into the anus of individuals who had drowned. Physicians at the time believed that this procedure would help resuscitate these individuals, and it was a regular occurrence along the River Thames. The theory behind this procedure was that the tobacco smoke would irritate the bowels, which would cause the stomach to contract so strongly that it would force the lungs to cough. As explained by one physician from the time, “for the heat and sharpness of the tobacco smoke irritate so much the bowels, as to cause a violent contraction of the belly, which forces out of the breast the air contained in it.”³

Note: this is not a valid resuscitation method!

Myths about Enemas

Enemas Detoxify

Many proponents of home enemas claim that the main reason to perform enemas is to detoxify the intestinal tract, liver, and/or gallbladder. You might also hear claims that at any given time, a large amount of waste stays in your colon. However, this isn’t true, unless you are very constipated. Even then, whenever you have a bowel movement, it pushes things out roughly in the order it went in. Any waste that you eliminate during an enema is from recent meals and would have been eliminated during normal bowel movements in due time.

Enemas Are Safe

While enemas can be a useful tool in medicine, giving yourself enemas at home can have many complications. An incorrectly administered enema can damage tissue in your rectum/colon, cause bowel perforation and, if the device is not sterile, infections.¹ Long-term, regular use of enemas can cause electrolyte imbalances. Temporary side effects of enemas can include bloating and cramping.

Enemas can also affect the balance of microbiota in your gut. Many proponents of using home enemas to ‘detoxify’ often cite this as a good effect, saying it helps flush out harmful bacteria. However, enemas also negatively affect the good bacteria in the gut (probiotics), which can damage the microbiota balance and cause digestive symptoms.

Coffee Enemas Are Beneficial

Coffee enemas first became popular in the 1920s, when a German scientist, Max Gerson, claimed that coffee enemas were more effective than standard saline enemas, because the coffee would be absorbed rectally, and could help stimulate the liver. Supposedly, this would detoxify the body and could even help cure cancer. However, it is important to note that in the past century, no researchers have published any quality studies showing that coffee enemas can improve health, and the scientific community continues to discredit Gerson’s unfounded ideas.²

Coffee can offer health benefits – such as antioxidants – when you drink it, but there is no advantage to taking coffee rectally. In fact, it comes with the risk of normal enema complications, and the potential for rectal burns if the coffee is too warm. It is also possible to take in too much caffeine, if you are using larger amounts of coffee than you would normally drink. If you want to enjoy coffee, it is best to enjoy drinking it in moderation.

Conclusion

While enemas definitely have their uses, there aren’t many situations where they are necessary. We have safer methods of medication administration, and we know that using enemas regularly doesn’t help detoxify or cleanse your colon. If your physician does recommend you use an enema for any reason, make sure to follow their instructions carefully to avoid unpleasant side effects and injuries.

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Shepherd of the Royal Anus

In Ancient Egypt, a wide range of physicians would attend to their Pharaoh, with each one attending to a different body part. One such position, the Shepherd of the Royal Anus (neru pehut), had the primary duty of providing the Pharaoh with regular enemas, either to administer medicines or to clean out the colon.⁴

First published in the

Inside Tract® newsletter issue 206 – 2018

1. Niv G

et al. Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable. International Journal of General Medicine. 2013:6;323–328.
2. Cassileth B. Gerson regimen. Oncology (Williston Park). 2010;24(2):201.
3. Bruhier, Jacques-Jean, -1756. To the publick. A new method of relieving such persons as are thought to be suffocated, or drowned. [n.p., 1748].
4. Barr J. Vascular medicine and surgery in ancient Egypt. Journal of Vascular Surgery. 2014;60(1):260-3.

Images: © Wayhome Studio | Bigstockphoto.com, Photo: © toxitz | Bigstockphoto.com

Colonic Uses, History, and Complications

A colonic is the infusion of water or other liquids into the rectum by a colon therapist to cleanse and flush out the colon. It is also called colonic hydrotherapy or colon irrigation. Colonics and enemas are similar, but there are some key differences between a colonic and an enema. Learn about who needs one, what to expect, and how to manage potential complications.

Verywell / Brianna Gilmartin

What Is a Typical Colonic Like?

After completing a health history form and consulting with the colon hydrotherapist, the client is asked to change into a gown and lie face up on a treatment table.

The colon therapist inserts a disposable speculum into the anus. The speculum is connected to a long disposable plastic hose connected to the colon hydrotherapy unit.

The client and the colon therapist do not smell the feces as it is filtered through the tube. The therapist usually looks at the feces through the clear hose and may comment on the color.

The client typically feels some discomfort in the abdomen during the therapy. The colon therapist may apply light massage to the client’s abdominal area to facilitate the process.

After the session, the therapist leaves the room, and the client may sit on a toilet to pass any residual water and stool. A typical session lasts 45 minutes to one hour.

Why Do People Get Colonics?

People who get colonics typically say they do it for the following reasons:

To remove accumulated waste from the colon
To help prevent constipation
To improve the overall health

Colonics are always considered a form of alternative medicine. Due to lack of evidence, colonics are not known to improve health and wellness by most conventional medical professionals.

Thus far, scientific support for the potential health benefits of colonics is lacking because there is no hard evidence to back up these claims. However, proponents of colon hydrotherapy claim that accumulated fecal matter in the colon may negatively affect health in some of the following ways:

Preventing water and nutrient absorption
Lead to constipation
Allow harmful colon bacteria and yeast to grow
Cause stagnant toxins to be absorbed into the bloodstream through the colon wall (called autointoxication)

Lack of fiber, excess sugar, and a diet high in red meat are believed to contribute to the problem.

History of Colonics

One of the earliest proponents of colonics and the autointoxication theory was John Harvey Kellogg, MD, founder of the Kellogg cereal company. Many credit Kellogg for the popularity of colonics among conventional physicians from the early 1900s to the 1940s.

Kellogg frequently lectured on colon therapy and recommended colonics for many conditions, such as depression and arthritis. As laxatives grew in popularity, colonics became less popular.

Also, the lack of published evidence on the benefits of colonics contributed to its decline. Today, some alternative practitioners continue to recommend colonics.

Complications

People with certain conditions, such as diverticular disease, ulcerative colitis, Crohn’s disease, severe hemorrhoids, blood vessel disease, congestive heart failure, heart disease, severe anemia, abdominal hernia, gastrointestinal cancer, recent colon surgery, and intestinal tumors are among those who should not have a colonic.

People who are pregnant should not have a colonic as it may stimulate uterine contractions.

Side effects of colonics may include nausea and fatigue after the session, which can last for several hours. Complications may include bowel perforation, excessive fluid absorption, electrolyte imbalance, heart failure, and serious infection.

To Enema or Not to Enema – Digestive Center – EverdayHealth.com

Coffee enemas have been making headlines recently after a Florida couple caught national attention by allegedly using coffee enemas up to four times a day to cleanse their colons. But the debate about whether enemas are helpful has been ongoing since the early 1900s. The concept of colon cleansing for better digestive health or reduction of body toxins might sound appealing, but there’s little medical evidence to suggest that enemas actually help your digestive tract or relieve constipation.

Enemas for Digestive Health?

“Your body is designed to process your waste effectively,” says gastroenterologist David Greenwald, MD, a professor of clinical medicine at the Albert Einstein College of Medicine in the Bronx, N.Y. That doesn’t mean it’s a perfect system or that you’ll always enjoy the results. Everyone has occasional bouts of constipation and diarrhea. But according to Dr. Greenwald, you don’t need to invest in enemas. Treatments such as enemas could be an easy sell because society tends to view defecation as “dirty,” so giving the body a helping hand in the process of cleansing might seem like a good thing. Not so, he says.

Those who promote the use of enemas might be capitalizing on these thoughts by emphasizing that enemas are cleansing or, in some cases, contain natural or herbal ingredients such as chamomile or caffeine, Greenwald says, but he stresses that there’s no medical support for the use of herbs or other materials in an enema.

Enemas are also touted for weight-loss purposes, but Greenwald disputes their usefulness for this purpose as well. “We are not carrying around pounds of unprocessed waste,” he says. There are also some practical reasons to forego an enema:

Cost. “They’re expensive,” Greenwald points out, adding that people can expect to pay $100 or more for a boutique enema. If you’re going to fork out that much, pay for something you’ll be sure to find relaxing, like a massage.
Side effects. Nausea, vomiting, and diarrhea are all possible side effects of an enema, warn the researchers who covered the risks of colon cleansing in a clinical article for The Journal of Family Practice.
Risks. Enema risks include perforation of the rectum, which requires surgery to repair and possible damage to internal organs. Furthermore, the “washing” out of the rectum and intestine can interfere with your body’s normal absorption of nutrients and fluids, leading to chemical imbalances.
Dependency. People can develop a habit of using enemas to create bowel movements, but you can (and should) break this habit. Talk to your doctor about how to do so and what should be a realistic expectation for your bowel movements.

Take a Pass on the Enema Fad

If you’re wondering whether you’ve somehow missed out on the digestive benefits by choosing to drink your morning coffee in a mug instead of inserting it in an enema, fret not. Thai researchers tested the effects of hot coffee drinks and hot coffee enemas with 11 men and found that there was no difference in the measures of antioxidant benefit between the two groups. So if you want the health benefits of coffee, stick with drinking your morning cup of Joe.

Additionally, there’s no reason to think you’ll get a caffeine high from an enema, at least not a greater high than you’d get from drinking it, says Greenwald.

Enema Alternatives

The medical use of enemas to treat constipation is recommended for severe cases only and ideally with the consultation of your doctor. Alternatives to enemas abound. If you’re troubled by constipation or other digestive problems, you should consider changing your diet to include more fiber, drinking more water to move things along, and being physically active.

If bowel movements become painful or are interfering with your quality of life — either because they’re too frequent or not frequent enough — talk to your doctor.

Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable

Int J Gen Med. 2013; 6: 323–328.

Galia Niv

¹Risk Management and Quality Assurance, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel

Tamar Grinberg

²Emergency Department, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel

Ram Dickman

³Department of Gastroenterology, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel

Nir Wasserberg

⁴Department of Surgery B, Rabin Medical Center, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel

Yaron Niv

¹Risk Management and Quality Assurance, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel

³Department of Gastroenterology, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel

¹Risk Management and Quality Assurance, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel

²Emergency Department, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel

³Department of Gastroenterology, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel

⁴Department of Surgery B, Rabin Medical Center, Beilinson Hospital and Tel Aviv University, Tel Aviv, Israel

Correspondence to: Yaron Niv, Rabin Medical Center, 39 Jabotinski Street, Petach Tikva, Israel Tel +972 3 937 7328 Fax +972 3 921 0313 Email li. gro.tilalc@vinyCopyright © 2013 Niv et al, publisher and licensee Dove Medical Press Ltd

This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

This article has been cited by other articles in PMC.

Abstract

Objectives

Constipation is a common complaint, frequently treated with cleansing enema. Enemas can be very effective but may cause serious adverse events, such as perforation or metabolic derangement. Our aim was to evaluate the outcome of the use of cleansing enema for acute constipation and to assess adverse events within 30 days of therapy.

Methods

We performed a two-phase study: an initial retrospective and descriptive study in 2010, followed by a prospective study after intervention, in 2011. According to the results of the first phase we established guidelines for the treatment of constipation in the Emergency Department and then used these in the second phase.

Results

There were 269 and 286 cases of severe constipation in the first and second periods of the study, respectively. In the first study period, only Fleet® Enema was used, and in the second, this was changed to Easy Go enema (free of sodium phosphate). There was a 19.2% decrease in the total use of enema, in the second period of the study (P < 0.0001). Adverse events and especially, the perforation rate and the 30-day mortality in patients with constipation decreased significantly in the second phase: 3 (1.4%) versus 0 (P = 0.0001) and 8 (3.9%) versus 2 (0.7%) (P = 0.0001), for perforation and death in the first and second period of the study, respectively.