Illustration by Blair Kelly
It’s something you might expect to see on a sci-fi TV episode, but the latest advancements in medical breathing support might surprise you…with help from your butt. Enteral ventilation (a.k.a. “butt breathing”) is one of the newest forms of support a Cincinnati Children’s Hospital researcher is studying, and it’s gaining traction.
The process utilizes oxygenated fluids that are inserted into the body through an enema-style approach. The body absorbs the liquid into the bloodstream through the colon, a potentially helpful option for medical situations, like inflamed or damaged airways, where breathing tube placement isn’t possible.
Those who saw the struggles of intubating patients in the pandemic might have welcomed such a supplementary approach. Children, including preemies who might not do well or could have permanent damage from intubation, might also see it as a welcome alternative, according to lead researcher Takanori Takebe, M.D.
The process had seen positive results in previous studies involving pigs, and initial small studies with humans are equally promising, says Takebe, whose research was inspired by his father’s own lung problems. “We are so excited about intestinal breathing capacities, because we know that the intestinal surface is actually even longer than the lung surface area,” he says. “The GI tract has much more surface and vasculature is quite abundant there.”
Researchers looked to nature as further inspiration for the concept, specifically a fish commonly eaten in Japan called the loach, says Takebe, which can swallow air from the surface and absorb oxygen in its gut to help it survive in difficult conditions.
New research shows that this type of breathing might be able to work for between 30 minutes and two hours, but Takebe says in the future that support might be repeatable a few hours later. In his new study, 27 healthy men in Japan were able to butt breathe for an hour and didn’t have any serious issues, with only minor side effects like bloating and discomfort. Takebe and his team are working on narrowing down how much liquid is needed to improve blood oxygen levels, among other questions.
Should you expect to be offered an enema if you head to the ER with a damaged airway? Not any time soon, says Takebe, since multiple phases of human research remain before the treatment becomes a reality. With more research and funding, he hopes that eventually it will be a popular secondary way to support breathing, with less damage, for those who need it most.
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