That's why medications like metoclopramide or domperidone are used—they prioritize improving gastric motility over just alleviating nausea. Even with these medications, many people may still end up vomiting, but the main goal is to get things moving into the small intestine, the prokinetic effects are highly beneficial.
When we talk about absorption, the small intestine is significantly more effective than the large intestine. The small intestine's epithelial cells have a rapid renewal rate, with a lifespan of just 3 to 5 days. Among these cells, enterocytes are the most abundant and line the villi. They have microvilli that increase the surface area, making them specialized for absorbtion.
In contrast, the large intestine mainly absorbs water although it does absorb electrolytes, but it does so at a
much slower rate. The small intestine is much more efficient, able to absorb substances about 10 times faster, thanks to its specialized cells and structure.
SN is primarily absorbed in the duodenum and jejunum of the small intestine, where it utilizes mechanisms like sodium-glucose co-transporters. After absorption, it travels to the kidneys, first reaching the proximal tubule, then being reabsorbed in the loop of Henle (especially in the ascending limb). It's further reabsorbed in the distal convoluted tubule and collecting duct, where aldosterone helps increase retention. Once absorbed, sodium nitrite enters the portal circulation, is transported to the liver for processing, and then is circulated throughout the body to exert its effects.
Thus and added element is
how much SN given the slower rate of absorption as compared to the small intestine would be necessary for an effective retal application, that would require more research, trial-and-erorr and I just don't think people want to be the guinea pig for trying (and failing and wasting that much SN in trying it out). Stick to the known risk vs the unknown risks I suppose.
As far as concern on sourcing meto, it is pretty easy and no it is not more expensive than the SN itself. Offshore pharmacy won't be crazy expensive although tele health is another possible avenue to explore as well. There are pretty easy ways to get it. Although it is not mandatory and there have been successes of people doing it without any AEs.
See this post for various cases without the use of AEs:
I have combined and added all the brief summary of all the attempts, assumed successful and unsuccessful, of SN suicide. These are all posts that the member has made to document the method, news articles, and scientific articles. If I have missed any I apologise and it would be great if you can...
sanctioned-suicide.net
I don't really see the point in doing 23.5g orally and 1.5g as an enema. At that stage, why not just take the whole 25g orally? You're already dealing with a pretty high dose of SN which is intended to be overkill (pun intended). Once you swallow it, you're going to feel the effects pretty quickly, so trying to do an enema afterward seems a bit pointless and an added layer of difficulty. It won't really speed up the absorption either even if you had low motility that is quelled by the AE (as mentioned above).
Not to mention why add the diarrhea on top of the vomiting? And the pain of salt down (or up) there? Does not sound ideal to me.
There was a member who reportedly did 25g oral and 50g rectally though [
1]. But even the oral amount was at the sufficient amount so I am not too sure if/how much the rectal impacted the success.
Here are a few other conversations on this topic if you are interested in reading more [
1][
2][
3][
4][
5][
6][
7] and getting other perspectives and thoughts on it.
I think the main reason people don't really suggest this method is that there just aren't enough solid examples of it being done aka the reliability factor. It's not so much that people are against the route of administration itself; it's more about adding more variables and dealing with potential unknown side effects. With oral, we know what to expect, but with something like a rectal approach, you might run into some pretty uncomfortable situations—like shitting yourself and not having it actually absorb anyways and just wasting the SN.
Now more about the shitting yourself part: once the salt gets absorbed, your body is just gonna kick into overdrive to clear things out, which is why saline enemas can be so effective at getting things moving. The salt draws water into the intestines and makes everything push out quickly. So there's that extra risk of your body expelling everything before it even has a chance to absorb although I suppose if enough was done to similarly flood the body with SN that even if it is pooped out enough stays, that is in theory I guess possible still. It's probably just easier for people to stick with what they know rather than experiment with something that could be a bit messy & heighten the failure risk.
I am all for innovation though for CTB methods, it is a good thing to discuss and explore but any methods or changes in methods do need R&D.
That's my 2 cents anyways!
With whatever you decide, I wish you nothing but the best of luck and hope you find everything you are looking for and get peace & serenity.
