Diagnostic techniques involve anorectal manometry, barium enema, and rectal biopsy. Given by enema may cause peri-anal ulcers and fissures. Sorbitol can be used as a laxative when taken orally or as an enema. These include barium swallow, barium meal, barium follow-through, and barium enema. Initial treatment for sigmoid volvulus may occasionally occur via sigmoidoscopy or with a barium enema. This may be a prelude to masturbation or administration of an enema. They do a barium enema and a biopsy to confirm. A barium enema has proven to be a poor diagnostic tool for appendicitis. Occasionally the pipe is inserted rectally to administer an alcohol enema. The Malone antegrade colonic enema (ACE) is also an option. Kramer resolves his constipation by administering himself an enema. It is administered through the use of an enema to cure kidney pain. Mineral oil can be administered either orally or as an enema. The most common old-time remedy involves bed rest subsequent to a guanabana juice enema. A phosphate enema may need to be used to induce straining.