What Is an Enema? – Definition, Types, Uses & Side Effects – Video & Lesson Transcript

Procedure

The nurse explains to Brittany that she will have her undress from the waist down and cover her with a sheet. She will position her lying down on her left hand side. The nurse says she will wash her hands, put on gloves and lubricate the tip of the enema to make the procedure more comfortable. The lubricated tube will be inserted into Brittany’s rectum and the bottle containing the liquid will be squeezed so that all the liquid will be emptied into her colon (large intestine). The enema will then be removed.

Brittany should feel the sensation to have a bowel movement immediately. The nurse explains that it is best if Brittany waits as long as she can without using the bathroom so the liquid has a chance to soften the stool. Brittany agrees to have the procedure performed, but is curious about something: what exactly is the liquid in the enema?

Types of Enemas

There are different types of enemas. Most are made of plain water, but others contain solutions that help draw water out of the bloodstream back into the colon, such as sodium chloride or even baking soda. Others may include a lubricant, such as mineral oil or a cleansing agent, such as soap.

Uses

There are other uses for enemas besides constipation. They can be used to aid in procedures and visual studies, such as colonoscopies and CAT scans. They can be effective in evacuating the bowels prior to surgery or used to put radiographic dye into the intestines, such as barium, to allow for a better visual of the digestive tract.

Some people who can’t take medication due to abnormalities of their digestive tract can have their medication administered by an enema, and instead of being absorbed in the stomach, it’s absorbed through the large intestine into the blood stream. Medical professionals can also use enemas to rehydrate patients who cannot drink or receive intravenous hydration, as the colon will absorb water into the bloodstream. Others use enemas for non-medical reasons for example, to cleanse their colons of stool as part of a fast or diet.

Side Effects

The nurse explains the side effects of using an enema are rectal bleeding, gas, bloating, diarrhea, stomach cramps, and rare allergic reactions, such as hives and difficulty breathing. Brittany was able to use the bathroom, and her pain resolved not after one but two enemas! She felt well enough to be discharged home.

Lesson Summary

An enema is a medical treatment commonly used to treat constipation where liquid is introduced into the colon to soften and liquify stool. There are many uses for it including but not limited to curing constipation and aiding in visual procedures like colonoscopies and CAT scans.

Notes on Enemas

Learning Outcomes

Once you have finished, you should be able to:

• Explain what an enema is
• Summarize the process of administering an enema
• List different types of enemas
• Discuss some of the reasons for receiving an enema
• Identify side effects of enema usage

Soap Suds Enema: Treating Severe Constipation

Many people experience occasional problems moving their bowels. When this happens you may feel bloating, gas, or other symptoms of constipation. Drinking more water and being mindful of what you eat can usually help relieve mild constipation. 

But if the situation continues it can lead to extreme discomfort and fecal impaction. You may need more direct intervention. One method of clearing stool when you cannot do so on your own is an enema. An enema is a mixture of fluid and either an irritant or stimulant. The mixture is introduced into your rectum via a tube to flush out any unpassed stool in your colon. 

One type of enema is a soap suds enema. A detergent is added to water in order to address constipation or fecal impaction. ‌‌There are over-the-counter enemas that you can administer at home. Your doctor may also administer an enema in a medical setting.

Constipation

Most people have bowel movements regularly. This can vary a lot between individuals. Some people go several times a day. Others only need to move their bowels every few days. Bowel movements are supposed to be easy. You should be able to pass feces without straining or discomfort.

Constipation is when you have trouble passing stool. The main symptoms of constipation are:

• Three or fewer bowel movements per week
• Small stools that are hard, dry, and difficult or painful to pass
• Straining to have a bowel movement
• Feeling like you haven’t emptied your rectum after a bowel movement

Constipation is very common. Nearly 80% of Americans will experience constipation at some point in their lives. Many will need help from a doctor to ease their distress.

Fecal Impaction

Long-term constipation can cause your unpassed stool to accumulate in your colon. It can then become a mass that you can’t pass with normal bowel contractions. This is called fecal impaction. Its symptoms include:

• Liquid stool caused by feces that leaks around the impacted mass
• Abdominal pain
• Nausea and vomiting
• Headache
• Feeling like you always need to move your bowels
• Low appetite, weight loss
• Malaise

Without treatment, you may experience dehydration, rapid pulse and breathing, fever, incontinence, agitation, and confusion. You should speak to a doctor if you think you have fecal impaction.

When Is a Soap Suds Enema Appropriate?

Most constipation can be relieved with over-the-counter remedies such as stool softener or gentle laxatives. Drinking plenty of water and eating high fiber foods can also be helpful with occasional constipation. 

You may sometimes need an enema to help restore normal bowel movement. You can ask your doctor if that’s an appropriate remedy for your constipation.

You will need to seek medical attention for fecal impaction to dislodge the mass of feces in your colon. Your doctor will examine your abdomen and do a rectal exam to confirm the impaction. You may also need imaging such as X-rays and blood tests to rule out other problems.‌

Your doctor may need to remove a portion of the impacted stool manually. They may administer a soap suds enema afterward. This enema usually allows you to pass the remaining impacted stool soon after.

Preventing Future Bowel Problems

Constipation is most often related to diet and lifestyle. Adults need 25 to 30 grams of fiber every day to promote proper bowel function. But most Americans only eat half that amount. Fruits and vegetables are good sources of dietary fiber. Adding those to your diet may help with digestion.

Here are some other lifestyle changes that can help prevent constipation.  

Fluids. Drinking plenty of fluids can keep stools soft and easier to pass. Beverages count as fluids. Soups, stews, fruit, and some vegetables are also dietary sources of liquids.

Exercise. Regular physical activity promotes the muscle contractions in the bowel wall that push stool out. Being sedentary can increase your risk of constipation.

Listen to your body. Waiting to defecate when you feel the urge can make it harder to go later. Go to the bathroom as soon as you feel that you need to go whenever possible.

Don’t overuse laxatives. You may become reliant on laxatives if you have gotten in the habit of taking them to help have bowel movements. Talk to your doctor about what to do if you are concerned about laxative overuse.

Constipation is a side effect of certain prescription medications. Ask your doctor for advice if this is a problem for you. They may be able to offer help on managing the issue.

Enemas are an effective method for relieving constipation or fecal impaction. Soap sud enemas are an appropriate treatment when used correctly. Be sure to talk to a doctor before administering one to yourself.

4 Uses of Enema + Side Effects

Historically called clyster, an enema is a procedure that has been utilized for centuries. This procedure has been used for a variety of reasons such as constipation, bowel disorders, and colon cleansing.

Today, an enema is performed in a medical setting or even at home. Keep reading to learn about the different types, uses, and clinically proven benefits of this procedure.

What Is an Enema?

An enema is a procedure in which liquid is injected through the rectum, expelling its contents into the lower bowel.

This procedure has been used for centuries in different forms. Although the apparatus has changed throughout the years, the basic principles of how and why it is used remain the same.

What are Enemas Used For?

Some people may feel uncomfortable by the thought of an enema. However, it may be effective in restoring digestive function and other health problems. Its most common uses and benefits include:

• Bowel stimulant (constipation treatment)
• Colon cleansing (hygiene and colonoscopy preparation)
• X-ray imaging (preparation)
• Medication administration
• Bowel hygiene

However, milder treatments (such as stool softeners, bulk-forming laxatives, drinking solutions, and suppositories) are preferred whenever possible. Because enemas may cause serious side effects such as kidney problems, rectal bleeding, and dehydration if improperly used, it’s important to use them only as directed by a conventional doctor.

You may find information online about certain types of enemas (e.g., coffee enema) having antioxidant effects and treating cancer, but this is not supported by scientific research [1, 2].

The rest of this article will give you a guideline on the different types of enema, as well its associated uses and side effects.

Types of Enema

Cleansing Enema

A cleansing enema is used to cleanse the bowels and digestive organs.

The 3 main types of cleansing enemas include:

• Large volume cleansing enema (500 to 1000 mL): Enema solution (differs depending on the purpose of enema) cleanses the colon and most of the large intestine. This type of enema may cause damage to the external tissue of your bowels [3].
• Small volume cleansing enema (50 to 200 mL): For younger users or elderly patients who may have more sensitive external tissue in their bowels. This rarely causes complications in children [4].
• Packaged pre-disposable enema: These are enemas designed for use at home for users who can do it themselves. These single-use packages come with sodium phosphate solutions. The largest side effects of these are water and electrolyte imbalances, which can be dangerous for the elderly [5].

Retention Enema

A retention enema is when a specific solution is released into the bowel to be absorbed. This is held in for varying periods of time without expulsion of any of the solution. Even though it may be quite uncomfortable, holding it in allows time for the colon to absorb most of the solution (e.g. medication administration).

Coffee Enema

There is some circulation of information that reports that coffee enemas can treat cancer and have antioxidant effects. These both have been disproven in scientific research, so you must be wary when hearing about such uses of coffee enemas [1, 2].

Proponents of coffee enemas also claim that they improve digestion by stimulating the release of bile, although this effect has only been observed in people drinking coffee [6, 7].

In a pilot study of 34 patients (who needed an endoscopy), those treated with a coffee enema had better imaging results [8].

Importantly, coffee enemas may cause serious health complications, especially if used without medical supervision. In addition to those common to other types of enemas (such as digestive issues from bowel stretching, infections from improperly sterilized kits, and electrolyte imbalances), coffee enemas may cause burns (if the coffee is still hot) and irritation (from coffee’s compounds) in the bowels. Two women even died due to severe electrolyte imbalance from frequent coffee enema use [9, 10, 11, 12].

Salt Water Fleet Enema

Fleet enemas are primarily used for the preparation of a colonoscopy and for constipation. The bowel-cleansing solution of sodium phosphate or sodium chloride mixed with water stimulates bowel movements within minutes of the enema. It is more effective in bowel cleansing for colonoscopy preparation than its oral equivalent, with both having similar side effects (dehydration and electrolyte imbalance) [13].

Barium Enema

A barium enema is an X-ray imaging preparation that physicians use to examine and evaluate the lower intestinal tract. The barium solution used helps provide more clear and accurate imaging results. If proper equipment and careful techniques are used by your medical caregiver during this procedure, complications are very rare [14, 15].

Mineral Oil Enema

Mineral oil enemas are used to treat constipation and to clean out the intestines and digestive organs. For older adults, this type of enema is recommended over fleet enemas. Its use with fleet enema has also been reported to help remove large tar burns [16, 17].

Mechanism of Action

The general mechanism of enemas causes increased pressure and potential irritation of the external tissue in your bowels and anus. Although this may cause harmful effects, enemas are proven to be safe if used correctly [18].

Phosphate Enema

Phosphate enemas (one type of fleet enema) cause stimulation of the external tissue in the bowels. This solution is more concentrated than the layer below the external tissue (hypertonic solution), resulting in the movement of water outside the tissue. This causes pressure changes that ultimately help bowel movements [18].

Salt Water, Tap Water, and Soap Suds Enema

These types of enema solutions also increase pressure in the bowels, promoting evacuation. When used in small volumes, these enemas are less irritating than phosphate enemas [18].

Mineral Oil Enema

Commonly composed of glycerin, this enema causes water movements (osmosis) within the bowels that promote defecation [18].

How to Use an Enema

1) Relieving Constipation

The normal amount of time between bowel movements differs from person to person. Many individuals have constipation, which causes increasingly uncomfortable symptoms the longer it remains untreated. Constipation becomes more prevalent as individuals grow older, and negatively impacts the quality of life [16].

Enemas are an effective procedure to treat constipation. Although the most common treatments are laxatives, enemas may be just as useful. A variety of enema treatments are available, and each of them has characteristics that help in specific cases [19].

Once the enema solution is administered through the anus, it is held there to allow time for the solution to get absorbed and mix with the stool. This softens the stool, and voluntary evacuation of the solution after a few minutes normally results in immediate relief [19].

In an observational study on over 500 children with constipation treated with an enema of small volume soap suds, more than 80% showed positive results without any complications. In an additional study on 79 children with constipation, salt water enema treatment resulted in 62% of the children reporting relief [4, 20].

In another study, over 200 people with constipation were treated with only a milk and molasses enema in the emergency department. Bowel evacuation was successful in 88% of these patients, including 82% of those who had failed to respond to other treatments [21].

2) Cleansing the Colon

Colon cleansing has become increasingly important with the expansion of colon screening. The cleaning is required to ensure that certain aspects of colon screening are not missed due to poor visualization [22].

In one clinical trial, 1,200 patients scheduled for barium x-ray imaging were given an enema for colon cleansing. Given a combination of laxatives and water purge, 52% to 80% of their colons were clean. When an additional tap water enema was given an hour before a colon examination, 96% of the colons were clean of fecal matter [23].

In an observational study, a group of 123 patients who also required a barium X-ray were given cleansing enemas to clean their colon. Patients who completed more rounds of enema had significantly less fecal matter present in their bowels [24].

The average person has a variety of bacteria and fecal matter buildup in the colon. Although this may only result in no or slight complications such as bloating, some people believe this can lead to more serious problems such as chronic diseases.

Although there is a widespread practice of colonic cleansing among some natural health practitioners, there is no evidence to support its use to improve and promote health [25].

3) Helping Diagnose Colon Disease

A double-contrast barium enema is a useful technique utilized by health professionals to get x-ray visualizations of the colon and rectum. A high-quality examination can be completed in most patients, which makes it a powerful tool for the recognition and diagnosis of any underlying problems in the colon and rectum [14].

This type of enema is less invasive than a colonoscopy, which would be the alternative visualization technique. If a barium enema is completed after a colonoscopy, it allows for complete colonic evaluation and diagnosis [26].

In one study, 190 patients with a neoplastic disorder referred for a double-contrast barium enema by a physician were given a colonoscopy. The researchers found that enema may give false positives while colonoscopy may have technical difficulties. They concluded that both techniques are beneficial for visualization, with each having its own drawbacks [27].

In an observational study, over 100 people who had just received an incomplete colonoscopy subsequently received a barium enema. The barium enema revealed the entire colon of 94% of the patients. Additionally, this technique allowed the detection of abnormalities not found in the colonoscopy in 14 patients [26].

Barium enema visualization is best used to detect bulges in the wall of the large intestines (diverticular disease). However, there are superior techniques than a barium enema to detect polyps and inflammatory bowel disease. The optimal method to detect complications is to use a combination of visualization techniques (barium enema, sigmoidoscopy, and colonoscopy) [27, 28].

4) Drug Administration

Enemas can be used to administer drugs through the rectum. This method of drug administration may be useful when the right solution is used. They can be designed specifically for full-body administration (systemic) of the drug, or just for the adjacent tissue (local). An additional advantage is being able to maximize local drug concentrations in the colon [29].

Two of the most commonly used types of enemas for drug administration are sucralfate enemas and vancomycin enemas. Sucralfate is frequently used to treat gut diseases, while vancomycin is an antibiotic [30, 31].

In one observational study, 22 people with inflamed colons were given sucralfate enemas twice a day for 3 weeks. Afterward, 19 of the 22 patients demonstrated clinical improvements. In another study, 6 people with rectal ulcers were given sucralfate retention enemas for 6 weeks. Four of the patients had complete relief of symptoms, while the other 2 experienced marked improvements [32, 33].

A retrospective chart review of 47 people with severe colon infections (Clostridium difficile colitis) was treated with a colonic vancomycin enema. Seventy percent responded with full recovery and thus did not require surgery [34].

Side Effects

There are a variety of different side effects associated with different types of enemas. Because some of them can be dangerous, it’s important to use enemas only as directed by a reputable practitioner and immediately report any unwanted effects caused by their use.

The most common side effects include:

• Electrolyte imbalance and dehydration
• Bowel damage
• Arrhythmia (abnormal heart rhythms)
• Sepsis
• Kidney damage
• Increased chance of HIV for MSM

Electrolyte imbalance and dehydration is the most common side effect associated with phosphate enemas. One trial in adults found severe electrolyte shifts in the blood following phosphate enemas. A 90-year old patient given enemas to treat constipation showed severe signs of dehydration [35, 36].

It is critical that a patient using phosphate enemas promptly evacuates, because electrolyte disturbances (hyperphosphatemia) may be life-threatening [18, 37].

Cleansing enemas can perforate and damage the bowels. In a clinical trial on 24 healthy volunteers, those using soap sud and tap water solution enemas damaged the outer skin layers of their bowels. Perforation, electrolyte imbalances (hyperphosphatemia), and sepsis may cause death in up to 4% of the cases (especially in the elderly) [3, 37].

There is a case of a 72-year old patient who got a colonic perforation during a barium enema due to an excess of barium being used. Damage and perforation of the bowels are preventable but not rare [38].

Cases of arrhythmia (abnormal heart rhythms) have resulted from the use of different enemas. Out of 58 patients over 60 years old, 40% developed new arrhythmias during a barium enema. Additionally, non-hazardous heart arrhythmia is possible during small-bowel enemas in elderly patients.

There have been incidents of sepsis (systemic infection) in small infants as a result of contrast enemas. In an observational study of 160 premature babies who received contrast enemas during intensive care, 21 were reported to have clinical sepsis [39].

Kidney failure is prevalent among elderly people who undergo fleet enemas. Eleven elderly patients received fleet enemas for constipation. Kidney failure was found in all the patients after the enema, 5 of whom died as a result [40].

Studies have associated HIV incidence and recent enema use. In one report, over 95% of HIV-positive MSM in their sample used an enema before anal sex and 45.8% used an enema afterward [41].

Interactions

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. Talk to your healthcare provider to find out how enemas might interact with something else you are taking.

Given the effect of fleet enemas on the kidneys, electrolytes, and bowels, there may be some interactions with other drugs you are taking [35, 40, 3].

Most painkillers (i.e., ibuprofen) put a strain on the kidneys as well. If you are taking painkillers in conjunction with performing fleet enemas, it is recommended to consult your doctor to make sure it is safe to do so, as they both can cause kidney damage [42].

Additionally, since enemas stimulate bowel movements, most drugs taken orally may not be digested as effectively as they would normally. A change in the rate of stomach emptying alters the absorption amount of orally ingested drugs. Faster digestion may cause less drug absorption, making the drug less effective [43].

Laxatives should not be taken while performing enemas, as they may result in extreme discomfort and possible damage to the bowels.

Limitations and Caveats

Although a great deal of clinical research has been conducted on the use of different types of enemas, there are still drawbacks. Most of the clinical data and published papers come from before 2000, and updated research has not been conducted with new experimental designs. Additionally, aside from the barium contrast enema, many lingering questions in the medical community remain on whether or not enemas are fully effective and safe.

User Experiences

The opinions expressed in this section are solely those of enema users who may or may not have medical or scientific training. Their reviews do not represent the opinions of SelfHacked. SelfHacked does not endorse any specific product, service, or treatment.

Do not consider user experiences as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare providers because of something you have read on SelfHacked. We understand that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.

One user suffered from eight years of IBS. Already taking co-codamol every day for the last 3 years, the user tried a salt water enema in desperation after watching a YouTube video. The user reported now only occasionally taking co-codamol, and using a fleet enema 2 or 3 times a week, which provided him with immense relief.

Another user used a fleet enema in preparation for a sigmoidoscopy. The user reported it was extremely painful, made them sick to their stomach for hours, and caused them to suffer from chills, shakes, increased heart rate and cramping even after bowel emptying.

An 18-year-old with chronic constipation shared a more mixed review. The user found out about fleet enemas and decided to give it a chance since it was very affordable. Although he found it to be extremely uncomfortable, it worked within minutes and cleaned out his whole colon. The user reported to be very sore and shaky, but finds it much more bearable than the constipation, cramping, and bloating previously experienced.

Enema – an overview | ScienceDirect Topics

Postreduction Care

After successful enema reduction, the infant or child should be observed closely for at least a few hours, depending on the general condition of the patient.

If the intussusception was recognized early and the enema reduction was relatively easy, the child can be discharged home from the emergency department. Prerequisites are that the parents are reliable and the patient is asymptomatic and tolerates fluids for a short period after the reduction.^185,186 Whitehouse and colleagues¹⁸⁷ reviewing 309 patients with intussusception at Children’s Hospital of Wisconsin found that it was safe to discharge 48 (26%) out of 186 patients managed nonoperatively with enema reduction directly from the ED. Recurrence rates did not differ between children observed as inpatients and those discharged home, and there were no missed pathologic lead points.

Most patients, even those with a successful enema reduction, are admitted to a pediatric general surgical unit for observation and further treatment.

If the enema reduction is successful, the child can be started on clear fluids and progressed to a regular diet as tolerated. Intravenous fluids can be decreased and discontinued accordingly. If the patient initially had SBO with vomiting and required insertion of a nasogastric tube, it may take a number of hours for the obstructed small bowel to decompress. It may be preferable to leave the nasogastric tube in place overnight or maintain the child non per os with an intravenous infusion.

The preoperative gram-negative and anaerobic bacterial coverage does not need to be continued unless the patient was febrile before or after reduction and the reduction was difficult.

The presence of fever usually indicates bacteremia, endotoxemia, cytokine (tumor necrosis factor, interleukin) and lysozyme release, and even the production of reactive lymphocytes, in which case antibiotics may be continued for 48 hours.^188–190 In addition, bacterial translocation (the old theory of transmural migration of bacteria) may in part account for the common high fever that accompanies reduction.¹⁹¹ Animal studies have shown that even when viable intussusceptions are reduced operatively under sterile conditions and tissue for culture is taken from the apparently intact serosal surface, pathogenic bacteria are frequently recovered.¹⁷

On the other hand, Somekh and colleagues¹⁸⁸ performed serial blood cultures before attempted air enema reduction, immediately after, and 1 hour later to assess the risk for bacteremia. Their results showed that although fever may develop after air enema reduction attempts, the risk for clinically significant bacteremia and sepsis was extremely low.

At discharge, the parents should be aware of the relatively high recurrence rate after an enema reduction.^108,109 Recurrence rates as high as 20% have been described in the literature with an average of about 10%.

A repeat abdominal US study should be performed if any doubt remains about the success of the enema reduction or the abdominal pain recurs.¹⁹² If the intussusception recurs, the enema process can be repeated. After any successful enema reduction, the ileocecal valve often remains edematous and thickened for a day or more.¹⁰⁸ This appearance can easily be differentiated from a recurrence because it lacks the typical concentric rings. The invaginated mesentery is smaller than the typical target sign of a true intussusception and will disappear with time.¹⁹³ The ileocecal thickening can also be appreciated as a filling defect or narrowing if a contrast enema is performed. Recognition of these signs is important when attempting to confirm complete reduction and also to differentiate postreduction edema from pathologic lead point or recurrent intussusception.

Postreduction US¹⁹² becomes essential in the following difficult situations: to confirm the reduction by air enema when the intussusception disappears but there is minimal or no passage of air into the distal end of the small bowel, to delineate an unreduced ileocolic or ileoileal component of an ileoileocolic intussusception even if there is a large amount of air in the large and small bowel,¹⁹⁴ and to rule out a pathologic lead point. If US shows only enlarged mesenteric lymph nodes, marked bowel wall thickening, and hyperemia (on Doppler evaluation), there may be an ongoing inflammatory process (bacterial enteritis with Yersinia or Clostridium) that originally caused the intussusception.^195,196

Sonography is an important tool to reevaluate a previous partial reduction and to exclude spontaneous reduction before attempting delayed repeat enema reduction.

Different Types of Enema. When it comes to enemas, there are… | by Shop Enema

When it comes to enemas, there are quite a few different types of enemas suitable for treating different types of conditions. Today, we are going to discuss some of the common types of enemas suggested and used by medical practitioners all over the world to cure constipation.

1. Saline enema– Saline enemas are one of the most popular types of enema and can easily be purchased from the pharmacy. It helps in relieving constipation by drawing water from the body and move it into the rectum and lower colon are to trigger a bowel movement. It is also used to clear up the colon before performing a rectal examination. This type of enema usually comes in a small disposable squeeze bottle. It is usually safe to perform this type of enema, but people under the age of 18 or above 65 may experience water and electrolyte disturbance.

Enema Bag Kits

2. Carbon dioxide releasing enema- This type of laxatives such as sodium bicarbonate and potassium bitartrate are unlike the regular enemas. These are different forms of suppositories which trigger bowel movement by forming carbon dioxide in the intestinal tract. The pressure from the gas works up the intestines and creates peristalsis, thus leading to the evacuation of stools.

3. Mineral oil enema- Mineral oil enema work by coating the stools with the oil. This blocks the excess moisture from the stools to get absorbed the intestines and allows a smooth bowel movement. Mineral oil enemas are very helpful to people recovering from a surgery or injury. Also, women recovering from childbirth can also benefit from it. The oil gets attached to the stool and allows it to retain the moisture. This way it becomes easier for the stool to pass through the rectum.

4. Hyperosmotic enema– Hypersomotic enema such as sodium phosphates and glycerin helps in drawing water into the bowel. This adds moisture to the hardened fecal matter making it softer and easy to pass.

Enema – Types, Uses, Procedure And Guidelines

This article explains various types of enema like evacuant enema, retained enema, purgative enema, astringent enema, cold enema etc. Each type of enema is explained in detail. It also describes the uses, procedure and guidelines of enema with solutions or materials used in each type of enema.

Enema is used to clean or introduction of medicines or nutrients. Enema is the introduction of the fluid into colon through rectum for cleaning, feeding or administering medication.

Uses of enema

Enema is used for variety of purposes. It is used in case of constipation, to administer medications, as pre investigative procedure, as pre operative procedure etc. Various are described below.

Enema softens fecal materials in the rectum and makes easy removal of waste product from the rectum

It can be used to treat constipation as it stimulates defecation. Some types of enema increases peristalsis to have easy defecation. Peristalsis is the movement of intestine which propels the food matter towards rectum. During the passage of food material to rectum the digestion and absorption of food materials takes place, the remaining part is formed as stool matter and stored sigmoid colon upto defecation

Enema is used to introduce medications

The fluid which contains medications is introduced into bowel through rectum. Anti-helminthic enema destroys worms in the colon. Worms are parasites which live in intestines for their survival and take away the food material of host human being.

Enema is performed before some investigative procedures

Enema clears the intestines to have a clear visualization of bowel and rectum in colonoscopy. Colonoscopy is an endoscopic visualization of rectum and large intestine. It is also used to have clear view for abdominal x-rays as it cleans the bowel and shade of gas and intestinal contents are eliminated.

Enema is performed before conduction of normal delivery

Enema clears the rectal contents and has a role in prevention of perennial tears during labor or child birth.

Enema is used as a routine pre-operative procedure

Enema clears the colon and prevents the soiling of operation theatre after anesthesia or during the surgery as there will be relaxation of muscles of patient including sphincters.

Enema is used as a diagnostic procedure

Barium enema is used as a diagnostic tool. Barium is a radio-active substance so it is used for X-rays. X-rays after barium enema will give the picture of rectum and colon.

Other uses

Types of enema

Enema is classified into evacuant enema and retained enema.
Evacuant enema is classified into

Retained enema is classified into

Simple evacuant enema

Simple evacuant enema is used to remove fecal materials and gaseous distension. It is also used to clean the bowel and rectum before investigations, surgeries and child birth. Soap water or normal saline are used usually for simple evacuant enema. The amount of the solution used is variable depending on the age of the patient / client and temperature of the solution. For adults 500 – 1000 ml solution is used, for children 250 – 500 ml and for infants

Medicated evacuant enema

Medicated evacuant enema is used to administer medications through the rectum. Ther are different types of medicated evacuant enema. They are

Oil enema

Oil enema is used to soften the fecal matter. Oil enema is used in following conditions

• Severe constipation
• After surgeries to rectum and perineum to prevent injury to sutures

After oil enema simple evacuant enema is performed to remove the softened the stool matter. The solutions used for oil enema are olive oil, castor oil and sweet oil.

Astringent enema

Astringent enema is used to reduce the inflammation, bleeding and mucous discharge in colon. Astringent enema is used in following conditions

The solutions commonly used in astringent enema are 2% silver nitrate solution, tannic acid and alum.

Purgative enema

Purgative enema is used to improve the peristalsis to empty the bowel.
The solutions used commonly in purgative enema are glycerin and castor oil, oxgall, glycerin and water.

Anti-helminthic enema

Anti-helminthic enema is used to kill the intestinal parasitic worms. Soap water enema is performed before anti-helminthic enema is performed. The solutions used in this enema are hypertonic saline solutions.

Carminative enema

Carminative enema is called anti-spasmodic enema. It is used to remove the gaseous accumulation in abdomen. It acts by increasing the peristaltic movement of intestines. Solutions commonly used in this enema are milk and molasses, asafetida in soap water and terpentine.

Cold enema

Cold enema is used to reduce the body temperature during high fever and heat stroke.
Hypothermia and abdominal cramps are common complication of cold enema.

Stimulant enema

Stimulant enema is used in shock, collapse and in some poisoning cases. The solutions used are black coffee / brandy. Black coffee is prepared in 300ml water with tea spoon of coffee powder

Sedative enema

Sedative enema is used to induce sleep or sedation. Paraldehyde, potassium bromide, chloral hydrate are the main drugs used with the solution of sedative enema.

Anesthetic enema

Anesthetic enema produces anesthesia in the patient. The drug avertin is used for anesthetic enema. The dose of avertin is 150 to 300 mg per kg.

Procedure of enema

The articles used for enema are a enema catheter or rectal tube, enema can and the kidney tray. Wash hand thoroughly before starring procedure. Fill the enema can with recommended fluid. Hang the enema can on a stand. Regulate the flow of the solution and introduce rectal tube through the anus. The rectal tube should be lubricated before the insertion of tube into rectum. It allows smooth insertion of tube and prevents damage of mucus membrane. Advice the patient to take breath by mouth as it relaxes the muscles of abdomen. Procedure should be stopped if there is any discomfort reported by the patient. Remove the catheter after administering recommended amount of the fluid.

Guidelines for giving enema

Barium Enema | Cancer.Net

A barium enema is a type of x-ray that allows your doctor to see your colon and rectum. It is also called a colon x-ray or lower GI exam. Barium enemas can help diagnose changes to your large intestine, such as your colon and rectum.

Your doctor might recommend a barium enema to find inflammation, polyps, or cancer in your colon or rectum. The most common reason you may need a barium enema is after rectal surgery. Your doctor will confirm that your body has healed before reversing an ileostomy.

About the colon and rectum

Your colon and rectum are a major part of your digestive system, also called the gastrointestinal tract. These organs help your body process the food it does not use, which becomes waste (feces). The colon is the biggest part of your large intestine. It empties into the rectum, where waste collects as bowel movements. The rectum empties into the anus, where bowel movements leave the body.

The drawing below shows the different parts of the colon and rectum.

How does a barium enema work?

Barium is a contrast medium, which helps radiologists and radiology technicians see details on an x-ray. Barium is not radioactive. It is a white, chalky substance that is mixed with water.

During a barium enema, a radiologist or radiology technician injects the barium liquid into your rectum during an enema. They then take x-rays of your large intestine with the substance inside your body. The barium helps show the shape and features of your large intestine.

Who gives a barium enema?

A radiology technician or a radiologist performs a barium enema. It is done in an x-ray room in either a hospital or a doctor’s office. After the procedure, the radiologist reads the results and diagnoses or confirms any abnormalities.

How should I get ready for a barium enema?

When you schedule the barium enema, you will get detailed instructions on how to prepare, such as what to eat and how to empty your colon. Below, you will find general information about how to get ready for a barium enema. The specific instructions you receive may be different. Always follow the instructions of your health care team before your barium enema.

What to eat. Your colon must be complete empty for the barium enema. Only eat soft foods or clear liquids for 1 to 3 days beforehand. This includes fat-free bouillon or broth, black coffee, and strained fruit juice. You will not be allowed to eat or drink anything after midnight on the day of your procedure.

Empty your colon. You will need to take a laxative or give yourself a regular enema the day or night before your appointment. This removes any remaining waste from your colon. If your doctor prescribes a laxative, it will be either a pill or a powder that you mix with water before drinking. The laxative will make you use the bathroom frequently. Make sure you have easy access to the toilet during this time.

What to wear. Right before your barium enema, you will be asked to remove all clothing, jewelry, and other metal objects that can interfere with the x-ray. You will be given a hospital gown to wear.

Your medications and health history. Ask if you should take your usual medications on the day of the test. This includes prescription drugs, over the counter drugs, and supplements that you take. Let the health care staff know if you have any medical conditions or if you could be pregnant. X-rays can be harmful to a developing baby.

Allergies. Let the health care staff know about any drug allergies or other allergies that you have.

Insurance, cost, and consent. If you are concerned about the cost of your test, contact your insurance company beforehand. Ask how much of the cost you will have to pay.

When you arrive for your test, you will be asked to sign a consent form. This form says you understand the benefits and risks of the procedure and agree to have it. Be sure to ask the health care team about any questions or concerns you have.

What happens during a barium enema?

During the barium enema, the doctor or technician will ask you to lie on your side on an exam table in a private room. They will drape a sheet over your body.

The exam table is attached to an x-ray machine and a video monitor. The x-ray technician will first take several x-rays to make sure your colon is empty.

The doctor or technician will then insert a well-lubricated enema tip attached to a tube into your anus. The barium will flow through the tube into your colon.

During the test, the doctor or technician may ask you to move into different positions. This is so the barium can flow through the entire colon.

Once the radiologist determines there is enough barium in the colon, they may deliver a small amount of air into the colon through the same tube. This step is called a “double contrast barium enema.” It inflates the bowel and produces a better view of the intestinal wall. Several x-rays will be taken during this time. When an x-ray is taken, the barium shows up bright white, clearly outlining the colon and rectum.

A barium enema usually takes 20 to 30 minutes.

Is a barium enema painful?

A barium enema can be uncomfortable for several reasons. You may feel mild stomach pressure and cramping when the barium flows through the colon. Taking slow, deep breaths can help you relax.

You may also feel discomfort from lying still for a long time. Once the barium is inserted into the colon, you may also feel the urge to have a bowel movement. It is important for you to try to hold in the barium until the test is complete.

What happens after a barium enema?

Once the radiologist has taken enough images of the colon, they will remove the enema tip. You will be helped down from the table so you can go to the restroom to push out the barium. You will then return to the exam room for another x-ray to make sure you have emptied your bowel enough.

You can go back to your usual activities immediately after the barium enema. But you should have someone else drive you home from the test.

You may notice gray or white stool for several days after a barium enema. That is the remaining barium leaving your body.

Drink plenty of fluids for the next several days to prevent constipation and help remove the remaining barium. Your health care team may also recommend taking a laxative.

Call your doctor’s office immediately if you have:

• Severe stomach pain

• Fever

• Bloody bowel movements

• Dizziness

• Weakness

Questions to ask your health care team

Before your barium enema, consider asking the following questions:

• Why are you recommending this procedure for me?

• Who will perform the barium enema? Who else will be in the room?

• What will happen during the test?

• How long will it take?

• Will it be painful?

• Are there risks associated with having a barium enema?

• Will I need to avoid any activities afterward?

• How accurate is a barium enema at finding cancer?

• When and how will I learn the results?

• Who will explain the results to me?

• What other tests will I need if the barium enema finds evidence of cancer?

Related Resources

Guide to Colorectal Cancer

Colonoscopy

More Information

RadiologyInfo.org: X-ray (Radiography) – Lower GI Tract

MedlinePlus: Barium enema

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90,000 How to give an enema to a cat or cat with constipation at home?

In this article, we will look at how to give an enema to a cat at home, and most importantly, whether it is worth doing it yourself at all.There are many reasons for a forced enema for a pet, but the absence of a chair does not always indicate constipation. Let’s take a closer look at this.

When should an enema be given?

The main indication for setting an enema is an appointment from the attending physician. If you suspect constipation in your cat, you should first see a specialist for a diagnosis.Usually, not having a bowel movement for several days is not a life-threatening condition, and you still have time to find a doctor to examine the animal. If the diagnosis was confirmed and the doctor prescribed this procedure for constipation, then you can give the cat an enema yourself at home. Usually it is set no more than twice a week, but each case is unique, and the recommendations may differ.

When should you not give an enema?

Under no circumstances should an enema be given before the animal is examined by a doctor.Constipation can often mask other health-threatening conditions. Very often, owners confuse constipation with the lack of urination in an animal due to a blockage of the urethra. Cats, according to the owners, behave typical of constipation: all day without any success they run into the tray, scream, lie on the cold floor. If you give an enema to a cat in this state, his health will not only not improve, but there is also a great risk of bladder rupture, which can lead to the rapid death of the animal.Also, you can not give an enema to a pet with mechanical obstruction of the gastrointestinal tract. In this case, setting an enema will not facilitate bowel movement, and the movement of a foreign body can lead to injuries and ruptures. With constant chronic constipation in a cat, it is possible to develop a condition such as megacolon. This is an excessive expansion of the rectum, in which, like in a pocket, feces begin to accumulate. In this condition, an enema can be performed, but it is possible that this will not bring any success and surgery will be required.

Also contraindications to enema for a cat are: bleeding in the gastrointestinal tract, acute inflammatory diseases, intestinal neoplasms, rectal prolapse, the first days after surgery on the gastrointestinal tract. This procedure should be carried out with caution in pregnant and lactating cats. Animals with diseases of the cardiovascular system are at risk. If you are in doubt about the feasibility of giving an enema to your pet, consult a third-party doctor and get a second opinion.

What types of enemas are

Enemas can be divided into:

1. Therapeutic

   These include cleansing and medicinal enemas. Cleansing enemas are used to treat constipation. They are oily (with an oil solution), hypertonic (with saline) and microclysters (Microlax enema). Medicinal enemas can contain various drugs and can be used for different purposes. For example, herbal decoctions with anti-inflammatory properties can be used in them.Cold enemas are used to lower body temperature and anticonvulsant enemas are used for epileptic seizures.

2. Diagnostic

   Such enemas can be used to inject a contrast agent into the rectum in order to diagnose tumors, ruptures, diverticula. Also, these enemas are used in preparation for an endoscopic examination of the rectum.

How to give an enema to a cat or cat: step by step instructions

Preparation for setting

In order to give an enema to a cat at home, preliminary preparation is required.It is better to put all the necessary items in convenient and accessible places in advance. If you start the procedure with a cat and in the process realize that the item you want is in another room, catching the frightened pet a second time can be overwhelming. It is also better to carry out the preparation process without the presence of a cat in this room, so that it does not feel that something was wrong in advance and does not hide. It is advisable to carry out this procedure with an assistant, it can be extremely difficult for one person to simultaneously hold the cat and do the enema.So, for the procedure you will need:

1. Diapers or newspapers. They are very convenient to cover the floor, so that then you can collect and throw everything away without long washing.

2. Rubber syringe. Its size depends on the size of the pet and the amount of enema prescribed by the doctor.

3. Vaseline. It is useful for lubricating the syringe nose.

4. Warm water. It is necessary to warm up the water to about 30 degrees.In order not to be mistaken, it is better to use a thermometer. A high temperature will cause burns, and a low temperature will cause intestinal cramps.

5. Large capacity. A basin or tray will fit, where the cat will fit after procedure

6. Gloves. Do not neglect your own hygiene, and it is better to carry out all manipulations with gloves.

7. Towel or blanket. You will wrap the cat in it so that it does not injure anyone during the procedure.

Solution preparation

It is necessary to prepare the solution strictly according to the doctor’s prescription. Different medications and volumes of fluid may be required to solve different problems. Here is an example of how to prepare the most commonly prescribed solution in order to correctly deliver an enema to a cat:

1. pour 200 ml of water into a large container;

2. warm it up to a temperature of 30 degrees, check with a thermometer;

3. add 20 ml of vaseline oil;

4. Stir

   well to emulsify, but do not foam.

Technique for setting an enema

When all the equipment and solution are ready, you can start the actual procedure. First, wrap the cat in a towel. Spread out a towel, place or place the cat in the center. Wrap the cat: first with one end of the towel, then with the other on top. If the cat bites, it is better to cover the head with a towel. It is also worth wrapping up the hind legs, as cats are very dexterous in wielding claws on them. Leave only the butt and tail open.Further, in order to correctly give an enema to a cat with constipation, you must follow the points:

1. We draw in the required amount of water into the syringe.

2. We release excess air from it by gentle pressing.

3. Lubricate the tip with Vaseline.

4. Gently, slightly turning a few centimeters or until it stops in the feces, insert the tip into the anus of the animal.

5. Slowly begin to pour the liquid into the intestines. If it is not possible to enter the entire assigned volume, we take a break. Perhaps this is enough for the desired effect. If not, enter the remainder of the volume after a few hours.

6. After the introduction of the required volume, we take out the syringe and cover the anus, lowering the cat’s tail.

7. Do not let go of the cat for 10-15 minutes. At this time, you can knead the feces through the abdominal wall with gentle massaging movements.

8. We put the cat on a basin or tray, wait for the result.

How to give an enema to a kitten

In order to give an enema to a small kitten at home, you should act according to the same points that are described for yours. The fluids will be used much less, therefore it is necessary to clarify this point with the attending physician. For small kittens, Mikrolax is most often used. So setting micro enema for a cat is easier and safer.But the full adult dose of microclysters for the baby will be too much. Therefore, the required dose must be taken with a small insulin syringe. It is very convenient to attach a small-diameter intravenous catheter to the syringe without a needle, so that only a rubber tube remains. It must be lubricated with petroleum jelly or Microlax itself. Then the tube should be carefully inserted into the anus and slowly, without effort, push the plunger of the syringe. If the result is positive, the effect will come in about 10-15 minutes.If there is no effect, the procedure can be repeated, but it is better to consult a doctor to make sure that you did everything correctly.

Causes, symptoms and prevention of constipation

In general, constipation in a cat, regardless of the cause, will manifest itself in a similar way. Owners mostly manage to notice the symptoms of constipation on their own. At first, the cat does not show any signs of anxiety, only less frequent bowel movements can be noticed. Normally, a cat should empty its bowels daily, permissible once every 2 days.Defecation once every 3 days or less should cause the owner’s concern about the health of his pet. At the first sign of constipation, feces may be dry and small in size. Its shape may resemble rabbit feces or a thin ribbon. After a few days of complete absence of stool due to pain in the abdomen, the cat will become restless, and the stomach will become tight to the touch. In about a week, intoxication of the body will begin, the pet will become lethargic, refuse to eat, and vomiting will begin. In the absence of help, the animal will die.

Correct feeding plays an important role in the regular, high-quality stool of the animal. Most often, problems arise when pets are fed unbalanced natural food from the table. A low fiber diet inevitably leads to constipation. Foods such as carrots, pumpkin, and vegetable marrow contain fiber. Too much fiber in your cat’s diet can cause constipation or, conversely, loose stools. Unbalanced natural feeding, especially one containing excess protein, leads to problems such as nutritional hyperparathyroidism in kittens.With this disease, in order to compensate for the lack of blood, calcium begins to leave the bones. Bones become fragile, brittle, transparent, not x-ray. In such kittens, all bones inevitably become bent, including the bones of the pelvis. The pelvis narrows, and feces simply cannot freely pass through it. Therefore, the natural diet should be prepared by a dietitian, or it is better to feed the pet with an industrial ready-made diet.

Feeding with bones often leads to both constipation and intestinal trauma.This condition should be treated only in a hospital clinic.

Low water intake, especially when feeding only dry food, can lead to dehydration and thickening of feces. Dry stools are less likely to pass through the intestines and can cause constipation. The water intake of the cat should be measured, it should be at least 30 ml / kg per day.

If your cat is clean and has thick, long hair, the cause of constipation may be the accumulation of hairballs in the intestines. This condition may also be accompanied by vomiting.For prevention, it is recommended to regularly give your pet a special paste, pads or food to remove wool from the body.

A more rare reason for the absence of stool is the development of a large number of helminths in the intestines of the cat. Cats that do not undergo regular treatments are at risk for this problem. Helminths, in the course of their activity, begin to curl up into a ball and can clog the intestines in its thin part. Most likely, this problem will require a prompt solution.And drugs for helminths, most likely, will not solve the problem. A bulky “ball” of parasites simply cannot physically leave the intestines. But the death of helminths will cause intoxication with decay products, which will only worsen the animal’s well-being.

Various systemic diseases can also lead to constipation. Chronic kidney disease causes dehydration, which can lead to dry feces. Tumor formations can interfere with the passage of feces mechanically.The tumor can be intraluminal and localized inside the intestine, closing the passage like a plug. Also, the tumor can be located outside the intestine and squeeze its lumen with its volume. In addition to the absence of stool, vomiting, soreness in the abdomen, decreased appetite and body weight can be noted. Injuries in the pelvic area can lead to fractures and abnormal fusion of bones, due to which feces will no longer flow freely into the pelvic opening. Nervous system damage from injuries to the back can lead to poor conduction and contribute to a lack of intestinal motility, which can lead to constipation.Sore joints in an older cat may prevent it from adopting a comfortable position for defecation, and the cat will have to endure for a long time.

Therefore, any case of missing stool should be reviewed by a physician to rule out other problems. The best prevention of constipation is quality balanced feeding and regular check-ups.

Frequently Asked Questions

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11 October 2021

Updated: 12 October 2021

Cleansing enema – a technique for cleansing the body with an enema at home

Setting a cleansing enema

“A cleansing enema is a cure for all diseases,” traditional healers assure us.Have you recently had a party with a feast? Do you constantly feel heaviness in your stomach? Or are you tired of fighting acne? These and many other symptoms indicate one thing: it’s time to take care of your health. But how can you help yourself? Go on a diet, play sports, or maybe … just do an enema? The latter option has become insanely popular among Russians in recent decades. It’s much easier to cleanse your intestines in 10 minutes than dieting. But can a home cleansing enema really make us feel better and our waistline narrower? Let’s figure it out.

What is an enema?

The expression “to make an enema” means to introduce liquid into the intestines. The liquid must be at a certain temperature, and it is injected using a special “device” that is sold at the pharmacy. Usually just water is injected, but patients often create special formulations – be it various herbs or medications. Enema comes in different sizes. You can buy a syringe for both an adult and a newborn. Setting up a cleansing enema is not a complicated procedure.

Doctors recommend that adults, for the effectiveness of the procedure, replace the usual syringe with an Esmarch mug, which differs in its device and its volume. This is a reservoir for fluid, which has a nipple at the very bottom. A tube is attached to it, and it is already crowned with a tip. The mug is also equipped with a tap – it can be easily replaced with a clothespin.

When might an enema be needed?

Unfortunately, this is not always a voluntary procedure. Sometimes, for example, during constipation – it is necessary.Young patients do not welcome her, since the enema seems to be something unaesthetic, associated with a long stay in the toilet. Undoubtedly, there are other ways to induce stool, but this one is perhaps the fastest, easiest, safest, and practically has no contraindications.

The cleansing enema has other indications, quite strict and well-known to many. For example, in Russia women must be given enemas before childbirth, at the beginning of labor. This is necessary purely for hygienic reasons, since during contractions and attempts, feces can be spontaneously released.Enemas are also done for women who have already given birth in the event that they have perineal tears and (or) they underwent an episiotomy (perineal incision).

There are diseases in which independent stool is difficult, and then, again, a cleansing enema becomes salvation, the technique of which is very simple.

This procedure is also indicated for intoxication, poisoning. If you have to investigate the digestive system, urinary system or the pelvic system, as well as examination of the colon, then an enema is inevitable.

Sometimes a cleansing enema is used for weight loss, getting rid of acne and other “prophylactic” purposes. But these procedures do not have a demonstrative effect.

Putting an enema correctly

How to enter it correctly? An enema (syringe) is an elastic product in the form of a ball with a hole, as well as with a hose (tube) attached to it. It is very easy to draw water. To do this, squeeze the ball on both sides by immersing the tube in water. The liquid must have a certain temperature – depending on the severity of the disease, from 12 to 42 degrees.There are different types of enemas – not only cleansing. A certain mixture is suitable for different procedures. Water is used as a safe but reliable remedy.

How to make a cleansing enema yourself at home? There are several ways. Let’s consider the most famous ones. The first is “lying”. They lie on their left side, on an oilcloth. This is necessary for those who cannot hold water. About a liter of liquid is poured into an enema. In the position of the buttocks apart, water flows through the tube into the intestine. It is often recommended to lubricate the tip with petroleum jelly – then it will enter the anus more easily.The tube is inserted carefully. If she meets the wall of the intestine on the way, you need to pull out the tip and start it again, at an incline to the navel, and then turn it to the tailbone. When fluid enters the intestines, the abdomen feels full. There is a natural urge to defecate.

The second method is in the pose on all fours. In this case, you will have to enter the tip with one hand.

It is better to hold water for about 10 minutes. Both methods are simple enough, but the procedure should not be overused.Often they try to include it in various spontaneous cleansing systems. This procedure should be carried out on the recommendation of a doctor, after an appropriate examination. The doctor examines the condition of the organs and concludes that an enema is necessary. With frequent use of the device for its intended purpose, the chair is released independently and involuntarily.

90,000 different enemas are needed, all kinds of enemas are important.

In connection with the sudden illness of Byr, a discussion arose about the prompt treatment of spring flu with a universal favorite folk remedy – a three-bucket enema…

How many, however, wonderful things can be found by typing in Yandex innocuous query “enemas”.
In addition to additional knowledge, how to put them, and that they are oil, upper, lower, hypertonic, siphon, medicinal, nutritious (wow!), Cleansing, etc., dug:

An American killed her husband with a wine enema
http: / /www.utro.ru/articles/2005/02/03/403895.shtml
terrible murder

also

“A film for lovers of enemas – when a fountain comes out of the priests, plus an excellent selection of clips of pissing girls.”
yeah. The operator hid under the rim of the toilet.” For fans “… ahem!

” IN THE OFFICE OF THE GYNECOLOGIST. VIDEO CLIPS “
” They measure the temperature with a thermometer in the bottom, insert candles, make enemas, make them urinate on the ship. “
set aside to fill the deck!

is also horror. Outdid the American
http://udaff.com/creo/62744.html

” stuff like that. “
I can’t imagine…

“The main guide for a nurse / Artificial nutrition Eating with an enema”
like a papilla, or what?

“It is better to take water for the enema boiled and cooled to 25-30 ° C. If the dog is indoor decorative, small in stature, then they use it for the enema …”
Remember the subject from the udaffcom. be careful with the dogs …

“Naturally, I could not miss such an opportunity. J And immediately began to push Artemka his favorite enema, persuading and convincing him that he was…
an enema, because it is given only to children, that he does not like an enema, etc. I tried to convince him that he needed to give an enema, that it was necessary and … “
This is called an” erotic story “

” Could you ever suggest that the most ordinary enema is actually a very mysterious, mystical thing , cult and even … “
and even out of it you can make a doll for voodoo rituals …

” The idea of ​​using an enema instead of doping, and at the same time having fun, did not leave Yulia since she and her friend spied, like an uncle… “
Zzhent’s dreams are bizarre.

” I myself have a lot of experience with enemas “(yeah.