Buddy Games is the latest comedy to use gross-out humour to amuse

There's Something About Mary was probably the movie that really put the gross-out comedy into the respectable (if that's the word) movie mainstream: not not only was it full of cringe-inducing moments but it was also funny and sweet and - most importantly - a hit.

A lot of its successors, however, have tried to raise the gross-out stakes without providing the context to make an audience care. The Jackass phenomenon transferred this to "reality" TV and film but had nothing much to offer besides its array of stunts and ickiness. If you wanted to see how long it took for a laxative to take effect and the results, well, this was the place.

Moral hygiene and "educational" films, that toured from town and to town in rented theatres and were not subject to the Hollywood production code, were precursors to the gross-out film. In the guise of informing people about the harmful effects of illicit sex and other alleged evils, the films - including the highly successful, long-touring Mom and Dad - might show footage of childbirth (included for sensationalism rather than education) and the physical manifestations of sexually transmitted diseases. Australian filmmakers also got into the act: Remorse, a Story of the Red Plague (1917) told the story of a squatter's son who contracted venereal disease in the Big City, lost his love, became an outcast and committed suicide.

Maniac (1934) straddled exploitation and horror. Ostensibly a film about mental illness, punctuated by "informative" text, it's more about cheap thrills. Maniac tells the story of a man who helps a mad scientist revive a corpse before killing and impersonating the cut-rate Frankenstein. Among its bizarre highlights are catfights - both feline and human - and a (faked) scene in which a character removes a cat's eye and eats it (saying that "it's not unlike an oyster or a grape!"). It's a cheap, sleazy, movie, but it's certainly different.

Freaks (1932) was a mainstream Metro-Goldwyn-Mayer horror movie that, even in its heavily cut release version made an impact with its real-life "freaks" including a limbless man and a microcephalic man) and nightmarish finale (it was banned in Britain for decades). Whether it was on the side of the "outcasts" or merely exploiting them is debatable, though the story (beautiful trapeze artist schemes to marry and kill a sideshow dwarf for his money) suggests the former. It's bizarre and unforgettable.

Horror, of course, kept on with the gross-out moments of violence, blood, and more, becoming more explicit as the years went on and censorship loosened. Indie filmmaker Herschell Gordon Lewis's films such as Blood Feast in the early 1960s were early examples of bloody excess. George Romero's Night of the Living Dead with its cannibal zombies started a trend many would follow and escalate. Mockumentaries like Mondo Cane and Cannibal Holocaust purported to show real horrors, adding that extra frisson. In the 1970s, The Incredible Melting Man used heavy, gooey makeup to deliver on its titular promise and writer-director-star Herb Robins and his collaborators in the horror comedy The Worm Eaters put real creepy-crawlies in their mouths for the sake of art, or at least money. And there have been many other gross-out horrors: gorehounds and the strong-stomached will no doubt have their favourites - the exploding head in Scanners, the vomit in The Exorcist, the effects of the flesh-eating illness in Cabin Fever,

In the 1970s, comedies started to get in on the action. John Waters' low-budget Pink Flamingos (1972) was an early example - it climaxed with the character played by Divine (really) eating dog excrement . Mel Brooks's mainstream hit Blazing Saddles gifted us with a scene of cowboys feasting on baked beans and heartily farting - this notorious example of bad taste would come to seem quaint. In one scene of National Lampoon's Animal House, John Belushi stuffed his mouth with mashed potatoes, puffed out his cheeks and then pushed them, spewing out the contents in imitation of a "zit". A stream of comedies aimed at young adults focusing on matters sexual were often gross in talk, less so in action, but in the 1990s the aforementioned Mary (and other Farrelly brothers films), American Pie, and Freddy Got Fingered, The 40 Year Old Virgin were among the films trying to out-gross each other (in more than one sense). The better movies like Mary and Pie had coherent storylines and reasonably interesting and sympathetic characters along with the intended-to-be-shocking showpieces like Steve Carell actually having his chest waxed in Virgin or Jason Biggs getting up close and personal with a pastry in Pie. Tom Green's Freddy film, which seemed more shock for shock's sake, was generally reviled.

These gross-out films were male-dominated but Bridesmaids (2011) showed women could be just as disgusting as men - again, in a film that told a story with engaging characters.

Given comedies have by now subjected the human body and its byproducts to just about every conceivable indignity and abuse, we can only wonder what else the depraved minds of filmmakers can conjure up next. We might be at the stage where there's nowhere further to go and the only gross-outs are rehashes with, inevitably, diminishing returns. Here's a thought: how about focusing more intently on characters, stories and laughs? The most successful comedies, gross-out and otherwise, generally do just that.