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doi: 10.1016/j.jaad.2020.06.1009

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This is well known in the medical community

Improper use or overuse can increase the likelihood of side effects, such as: Dehydration and electrolyte imbalance Irritation or inflammation of the rectum and colon Cramping, nausea, or discomfort Increased heart rate due to caffeine absorption In rare cases, using very hot coffee, unclean equipment, or performing enemas too frequently has been linked to more serious complications

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and Al Taha et al., coordinated care involving multiple specialties can significantly improve outcomes for patients with osteoporotic fractures [137,138,139]