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== Contemporary approach ==
<p style="text-align:justify;">The oral route is considered as the most convenient route for drug administration. However, oral medications are not possible in some clinical and pharmaceutical perspective in several circumstances. Rectal route may be used as a clinical alternative in these circumstances which yields both systemic and local actions. The hepatic first-pass metabolism effect can be reduced by rectal administration by partially bypassing the liver following systemic absorption. Rectal formulations are mainly used in the systemic conditions such as pain, fever, nausea, vomiting, migraines, allergies, and sedation.<ref name="ref7">Susan Hua. Physiological and Pharmaceutical Considerations for Rectal Drug Formulations. Front Pharmacol. 2019; 10: 1196. doi: 10.3389/fphar.2019.01196. PMCID: PMC6805701, PMID: 31680970.</ref>
<br/>Boofing or rectal administration medication and other fluids are administered through rectum. There they are absorbed by capillaries of rectum and thus enter the circulatory system and distribute them to whole body.<ref name="ref8">www.en.wikipedia.org.Rectal administration. [Internet].2023 [cited 2023 July 31]. Available from https://en.wikipedia.org/wiki/Rectal_administration#:~:text=Rectal%20administration%2C%20colloquially%20known%20as,body's%20organs%20and%20bodily%20systems.</ref> One of the studies also showed that basti medicine reaches up to ileo-caecal junction.<ref name="ref9">Juneja Yashwant M, Thakar A. B. Standardization of procedure of administration of Basti w.s.r to Kshinashukra (oligozoospermia), MD Dissertation, IPGT& RA. Jamnagar: Gujarat Ayurved University; 2010</ref>
<br/>As compared with oral administration, rectal administration is faster in action and higher in bioavailability. Vomiting can be prevented by rectal administration thus it prevents the loss of drug. The two third of rectum’s venous drainage is in the middle and inferior rectal vein which drains directly to systemic circulation and only one third of it goes to the hepatic portal system. Thus, two third of rectal administered drug bypasses the metabolic phase. It can be administered at home which doesn’t require inpatient setup as in intravenous administration. Many of the oral drugs can be modified for rectal administration by crushing and suspending them in water.
<br/>There are many digestive tract problems where the rectal route can be selected for drug administration such as bowel obstruction, dysphagia etc. In palliative care and long-term care, it is the cheap and safe alternative to intravenous or subcutaneous delivery of medications.<ref name="ref10">www.en.wikipedia.org.Rectal administration.[Internet] 2023 [cited 2023 July 31].Available from https://en.wikipedia.org/wiki/Rectal_administration#:~:text=Rectal%20administration%2C%20colloquially%20known%20as,body's%20organs%20and%20bodily%20systems.</ref></p>
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