Coffee enema myths

This topic came up on another board where of course I am not allowed to most.  So I am going to address some of the myths about coffee enemas here.  Here is one of the quotes by a poster:

"Check into "first pass metabolism". Many drugs cannot be given orally, due to the liver detoxifying them so rapidly from the GI tract. Rectal administration is even 'more direct', as the caffeine from the solution does not (as noted in the link above) combine with hydrocholoric acid in the stomach to create a toxin, and it doesn't inflame the gastric mucosa (which causes an adrenal response)."

The reaction of caffeine with stomach acid (hydrochloric acid, HCl) does not turn the caffeine in to some other toxin.  It simply converts the caffeine in to a salt, caffeine HCl.  Giving caffeine rectally also creates salts as the alkaloid caffeine reacts with the flora acids creating salts such as caffeine propionate and caffeine acetate.

Secondly, the adrenals release anti-inflammatory corticosteroids, and technically epinephrine, that counter inflammation.  This is why crashing the adrenals with caffeine will lead to increased inflammation.  And it does not matter if that caffeine is taken orally or rectally, caffeine still has the same adverse effects.

As for the "first pass" claim actual research shows differently:

Medical Toxicology of Drugs Abuse: Synthesized Chemicals and Psychoactive Plants P. 793

"The absorption of caffeine from the gastrointestinal tract is rapid and complete including including absorption through the intestinal mucosa. There is no significant first-pass effect following the ingestion of caffeine".

In fact, sites promoting coffee enemas claim that the coffee is a dilator for smooth muscle, which would include blood vessels.  Problem is that caffeine use increases blood pressure by the constriction of blood vessels:

http://www.ncbi.nlm.nih.gov/pubmed/339084

Constriction of blood vessels will reduce inflammation.  This is the same principle behind nonsteroidal anti-inflammatory drugs, which work by constricting blood vessels.  The effect is only temporary though.  Once the caffeine wears off the blood vessels will once again dilate increasing the risk of inflammation.  Especially if the adrenals are crashed from the caffeine, which can lead to over dilation of the blood vessels causing them to leak fluids in to the surrounding tissues.

Again, this is a great example of why people should do their own independent research rather than blindly accepting health advice from internet sources.