What are the different types of enemas used for constipation relief. How do cleansing and retention enemas work. What are the potential benefits and side effects of using enemas for bowel cleansing.

Understanding Enemas: A Comprehensive Guide

Enemas have been utilized for centuries as a method to alleviate constipation and cleanse the colon. These rectal injections of fluid are designed to stimulate bowel movements and empty the lower intestine. While they can be administered by healthcare professionals, many individuals opt for self-administration at home.

The primary purposes of enemas include:

• Relieving chronic constipation
• Preparing the bowel for medical tests or surgeries
• Cleansing the colon

The Science Behind Constipation and Enema Use

Constipation occurs when the natural movement of stool through the intestines slows down, resulting in hard, dry, and difficult-to-pass stools. This condition can be chronic for some individuals, necessitating interventions like enemas or rectal laxatives.

Are enemas always necessary for constipation relief? Not necessarily. While they can be effective for severe cases, lifestyle changes such as increasing fiber intake, staying hydrated, and regular exercise can often alleviate mild to moderate constipation without the need for invasive procedures.

The Constipation-Depression Link

Some enema advocates claim that waste buildup in the colon can lead to various ailments, including depression, fatigue, headaches, allergies, and irritability. While it’s true that many people with chronic constipation experience psychological symptoms, scientific evidence directly linking waste buildup to these effects is limited.

Cleansing Enemas: Flushing the Colon

Cleansing enemas are typically water-based solutions designed to be held in the rectum for a short period. Their primary function is to flush the colon, promoting the evacuation of loose matter and impacted stool. Here are some common types of cleansing enemas:

1. Water or Saline: These are the gentlest options, using plain water or a salt solution that mimics the body’s sodium concentration. They work by expanding the colon and mechanically promoting defecation.
2. Epsom Salt: Similar to saline enemas but with added magnesium, which may help relax bowel muscles and provide more effective constipation relief.
3. Sodium Phosphate: An over-the-counter option that works by irritating the rectum, causing it to expand and release waste.
4. Lemon Juice: A mixture of warm, filtered water and lemon juice is believed to balance the body’s pH while cleansing the colon.
5. Apple Cider Vinegar: Proponents claim that combining apple cider vinegar with warm water can quickly clear the bowel and potentially offer antiviral benefits to the digestive system.
6. Soap Suds: Adding a mild soap like castile to water creates a solution that mildly irritates the bowel, encouraging rapid stool excretion.

Retention Enemas: Extended Bowel Treatment

Unlike cleansing enemas, retention enemas are designed to be held in the bowel for an extended period, typically a minimum of 15 minutes. These enemas may be water- or oil-based and work by softening the stool, making it easier for the body to expel. Some popular retention enemas include:

• Coffee: A mixture of brewed, caffeinated coffee and water, thought to promote bile removal from the colon. This type was popularized by physician Max Gerson as part of cancer treatment protocols.
• Mineral Oil: Primarily works by lubricating waste inside the colon, sealing it with water, and promoting its removal.
• Probiotic: Combining probiotics with water may cleanse the bowel while helping to colonize beneficial gut bacteria. Studies have shown that Lactobacillus reuteri enemas can reduce inflammation in children with ulcerative colitis.
• Herbal: Some individuals use herbs like garlic, catnip tea, or red raspberry leaf mixed with water to create enemas with purported nutritional, anti-inflammatory, and infection-fighting benefits.

Potential Benefits of Enema Use

When used appropriately, enemas can offer several potential benefits:

1. Quick Constipation Relief: Enemas can provide rapid relief from severe constipation when other methods have failed.
2. Bowel Preparation: They are effective in preparing the bowel for medical procedures such as colonoscopies or surgeries.
3. Detoxification: Some believe that enemas can help remove toxins from the body, although scientific evidence for this claim is limited.
4. Improved Digestive Health: By clearing out impacted stool, enemas may contribute to better overall digestive function.
5. Hemorrhoid Relief: In some cases, enemas can help alleviate symptoms associated with hemorrhoids by softening stool and reducing straining during bowel movements.

Can enemas improve overall health beyond constipation relief? While some proponents claim wide-ranging health benefits, more research is needed to substantiate many of these claims. It’s important to approach such assertions with a critical eye and consult healthcare professionals for evidence-based advice.

Potential Risks and Side Effects of Enemas

Despite their potential benefits, enemas are not without risks. It’s crucial to be aware of possible side effects and complications:

• Electrolyte Imbalance: Frequent or improper use of enemas can disturb the body’s electrolyte balance, potentially leading to serious health issues.
• Dehydration: Overuse of enemas can cause excessive fluid loss, resulting in dehydration.
• Bowel Perforation: In rare cases, improper administration of an enema can lead to bowel perforation, a serious medical emergency.
• Infection: If equipment is not properly sterilized, there’s a risk of introducing harmful bacteria into the rectum and colon.
• Dependency: Regular use of enemas can lead to dependency, making it difficult for the bowel to function normally without them.
• Gut Microbiome Disruption: Frequent enemas may disrupt the balance of beneficial bacteria in the gut, potentially affecting digestive health and immune function.

How often can one safely use enemas? The frequency of enema use should be limited and based on medical advice. Generally, they should not be used more than once a week unless specifically prescribed by a healthcare provider for a particular condition.

Safe Administration of Enemas

If you’re considering using an enema, it’s essential to follow proper administration techniques to minimize risks:

1. Consult a Healthcare Professional: Before starting any enema regimen, consult with a doctor or healthcare provider, especially if you have underlying health conditions.
2. Choose the Right Equipment: Use sterile, properly sized equipment designed specifically for enema administration.
3. Prepare the Solution Carefully: If mixing your own solution, follow instructions precisely and use clean, warm (not hot) water.
4. Position Yourself Correctly: The most common position is lying on your left side with knees drawn up to your chest.
5. Insert the Nozzle Gently: Lubricate the nozzle and insert it slowly and carefully into the rectum.
6. Administer the Solution Slowly: Allow the fluid to flow in gradually to prevent discomfort and cramping.
7. Hold the Solution: For cleansing enemas, try to hold the solution for a few minutes before releasing. For retention enemas, follow the specific instructions for holding time.
8. Clean and Sterilize Equipment: After use, thoroughly clean and sterilize all equipment to prevent infection.

What precautions should be taken when self-administering enemas? Always use clean equipment, maintain proper hygiene, and stop immediately if you experience pain or unusual discomfort. If you’re unsure about the procedure, consider having your first enema administered by a healthcare professional.

Alternatives to Enemas for Constipation Relief

While enemas can be effective for severe constipation, there are several less invasive alternatives that can help maintain regular bowel movements:

• Dietary Changes: Increasing fiber intake through fruits, vegetables, and whole grains can significantly improve bowel regularity.
• Hydration: Drinking adequate water throughout the day helps soften stool and promote easier passage.
• Exercise: Regular physical activity can stimulate bowel movements and improve overall digestive health.
• Probiotics: Consuming probiotic-rich foods or supplements may help balance gut bacteria and improve digestion.
• Over-the-Counter Laxatives: Various oral laxatives are available for occasional use, but should not be relied upon long-term.
• Stool Softeners: These products work by drawing water into the stool, making it easier to pass.
• Natural Remedies: Some people find relief with natural remedies like psyllium husk, flaxseed, or aloe vera juice.

Are natural alternatives as effective as enemas for constipation relief? For many people, natural methods can be just as effective and are generally safer for long-term use. However, severe or chronic constipation may require more intensive interventions, including enemas, under medical supervision.

When to Seek Medical Advice

While occasional constipation is common, certain symptoms warrant medical attention:

• Persistent constipation lasting more than three weeks
• Severe abdominal pain
• Blood in the stool
• Unexplained weight loss
• Alternating constipation and diarrhea
• Chronic reliance on laxatives or enemas

These symptoms could indicate underlying health conditions that require professional diagnosis and treatment.

The Role of Enemas in Medical Procedures

Beyond constipation relief, enemas play a crucial role in various medical procedures:

1. Colonoscopy Preparation: Enemas are often used in conjunction with oral laxatives to thoroughly cleanse the colon before a colonoscopy.
2. Barium Enemas: This diagnostic procedure uses a special enema containing barium to highlight the colon on X-rays.
3. Pre-Surgical Preparation: Some surgeries, particularly those involving the lower digestive tract, require a clean bowel to reduce infection risk.
4. Treatment of Certain Conditions: Enemas may be used therapeutically for conditions like ulcerative colitis or to administer certain medications directly to the colon.

How do medical-grade enemas differ from home-use products? Medical-grade enemas are typically more potent and are administered under controlled conditions. They may contain different solutions tailored to specific medical needs and are often part of a more comprehensive bowel preparation regimen.

The Future of Bowel Cleansing Techniques

As medical science advances, new methods for bowel cleansing and constipation relief are being developed:

• Oral Cleansing Solutions: Improved formulations of oral laxatives that are more effective and better tolerated.
• Targeted Probiotic Therapies: Specific probiotic strains designed to address particular digestive issues.
• Microbiome Modulation: Techniques to optimize gut bacteria composition for improved digestive health.
• Non-Invasive Stimulation: Methods like transcutaneous electrical nerve stimulation (TENS) to promote bowel movement without internal intervention.

Will these new technologies replace traditional enemas? While enemas will likely continue to have a place in medical treatment, these emerging technologies may offer less invasive alternatives for many patients in the future.

Cultural and Historical Perspectives on Enemas

The use of enemas has a rich history spanning various cultures and time periods:

• Ancient Egypt: Enemas were used for ritual purification and medical treatment, as depicted in the Ebers Papyrus from 1550 BCE.
• Native American Practices: Some Native American tribes used enemas made from local plants for cleansing and healing rituals.
• European Royalty: In the 17th and 18th centuries, enemas became fashionable among European aristocracy as a health and beauty treatment.
• Modern Alternative Medicine: Today, enemas are part of various alternative health practices, including some controversial cancer treatment protocols.

How have cultural attitudes towards enemas evolved over time? While once considered a standard medical practice, enemas are now viewed more critically in mainstream medicine. However, they remain popular in some alternative health circles and continue to be used in specific medical contexts.

Ethical Considerations in Enema Use

The use of enemas, particularly in non-medical contexts, raises several ethical considerations:

1. Informed Consent: Ensuring that individuals fully understand the risks and benefits before undergoing enema procedures.
2. Marketing Claims: Addressing potentially misleading claims about the benefits of enemas in alternative health markets.
3. Cultural Sensitivity: Recognizing and respecting cultural differences in attitudes towards bowel health and cleansing practices.
4. Research Ethics: Ensuring that studies on enema efficacy and safety are conducted ethically and with proper oversight.

How can consumers make informed decisions about enema use? It’s crucial to seek information from reputable medical sources, critically evaluate claims made by product manufacturers, and consult healthcare professionals before incorporating enemas into a health regimen.

Enemas in Popular Culture and Media

Enemas have made their way into various forms of media and popular culture:

• Literature: References to enemas can be found in works ranging from ancient texts to modern novels.
• Film and Television: Enemas have been featured in comedic scenes, medical dramas, and documentaries.
• Social Media: Online communities and influencers often discuss and promote various enema practices, sometimes controversially.
• Advertising: Historical advertisements for enema products provide insight into changing societal attitudes towards digestive health.

How does media representation impact public perception of enemas? Media portrayals can significantly influence public understanding and attitudes towards enemas, sometimes leading to misconceptions or unrealistic expectations about their benefits and risks.

The Economics of Enema Products

The enema product market is a significant segment of the broader digestive health industry:

• Market Size: The global enema bags market was valued at over $150 million in 2020 and is projected to grow.
• Product Diversity: The market includes disposable kits, reusable equipment, and various solutions and additives.
• Healthcare Costs: Enemas used in medical settings contribute to the overall cost of procedures like colonoscopies.
• Alternative Health Sector: Specialty enema products and services form a niche market within the alternative health industry.

What factors drive growth in the enema product market? Aging populations, increasing prevalence of digestive disorders, and growing interest in alternative health practices all contribute to market expansion. However, the market is also influenced by changing medical practices and regulations.

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Enemas are used to relieve constipation and cleanse the colon. Water- or saline-based enemas tend to carry the least risk. However, enemas can have side effects, such as disturbing your gut bacteria and affecting your body’s electrolyte balance.

Enemas are rectal injections of fluid intended to cleanse or stimulate the emptying of your bowel.

They have been used for hundreds of years to treat chronic constipation and prepare people for certain medical tests and surgeries (1).

Enemas can be administered by a medical professional or self-administered at home.

This article reviews different types of enemas, as well as their potential benefits and health concerns.

Constipation is a condition in which the natural movement of your stool slows down, making them hard, dry, and difficult to excrete. For many people, this can be a chronic problem that requires an intervention like an enema — or a laxative inserted rectally.

Enemas may also be prescribed to flush out your colon before certain diagnostic tests or surgeries. Your bowel needs to be empty before these procedures to reduce infection risk and prevent stool from getting in the way.

According to some enema advocates, when waste builds up in your colon over time, it leads to ailments like depression, fatigue, headaches, allergies, and irritability, and using enemas can provide relief.

While it’s true that many people with chronic constipation experience depression and other psychological symptoms, evidence is lacking to suggest that waste buildup directly leads to the other aforementioned effects (2, 3).

There are two main types of enemas — cleansing and retention.

Cleansing enemas

Cleansing enemas are water-based and meant to be held in the rectum for a short time to flush your colon. Once injected, they’re retained for a few minutes until your body rids itself of the fluid, along with loose matter and impacted stool in your bowel.

Some of the most common cleansing enemas include (3, 4):

• Water or saline. The least irritating of all options, water or saline — salt water that mimics your body’s sodium concentration — are used primarily for their ability to expand the colon and mechanically promote defecation.
• Epsom salt. This is similar to a water or saline enema, but magnesium-rich Epsom salt is said to be more effective at relaxing bowel muscles and relieving constipation.
• Sodium phosphate. This is a common over-the-counter enema that works by irritating your rectum, causing it to expand and release waste.
• Lemon juice. Lemon juice mixed with warm, filtered water is said to balance the pH of your body while cleansing your colon.
• Apple cider vinegar. Advocates say that mixing apple cider vinegar with warm, filtered water can quickly clear the bowel and may have other antiviral healing effects on your digestive system.
• Soap suds. Adding castile soap, or another mild soap with minimal additives, to water mildly irritates the bowel, which encourages the rapid excretion of stool.

Retention enemas

Retention enemas are designed to be held in your bowel for an extended period — usually a minimum of 15 minutes — before being released. Retention enemas may be water- or oil-based, which softens the stool and makes it easier for your body to expel.

Some of the most common retention enemas include (5, 6, 7):

• Coffee. Coffee enemas are a mixture of brewed, caffeinated coffee and water thought to promote bile removal from the colon. They were popularized by Max Gerson, a physician who used them to help treat people with cancer.
• Mineral oil. This type of enema works primarily by lubricating waste inside of your colon, sealing it with water, and promoting its removal.
• Probiotic. Mixing probiotics with water may cleanse your bowel while helping colonize your good gut bacteria. Lactobacillus reuteri enemas have been shown to reduce inflammation in children with ulcerative colitis.
• Herbal. Some people use herbs like garlic, catnip tea, or red raspberry leaf mixed with water to make herbal enemas with purported nutritional, infection-fighting, and anti-inflammatory benefits.

Summary

Enemas are rectal injections of fluid that are intended to cleanse your bowel or treat chronic constipation. The two main types — cleansing and retention enemas — come in a variety of solutions and can be injected at home.

Enemas can treat constipation and clear out your bowel. However, many people choose to use enemas for other purported health benefits (8, 9).

Some advocates claim that enemas can support weight loss, remove toxins and heavy metals from your body, and improve your skin, immunity, blood pressure, and energy levels.

Still, evidence is limited to suggest that enemas are effective for these purposes or that they benefit everyone who uses them. Most evidence in support of their effectiveness is anecdotal, despite their widespread use in modern medicine (10).

Enemas appear to be most effective when used to relieve chronic constipation in a medical setting, though they come with many risks, especially when self-administered at home (11, 12).

Summary

Enemas can be effective in cleansing the bowel and treating chronic constipation, but most evidence in their favor is anecdotal rather than science based.

Though enemas can clean out your bowel, you should consider their risks and take certain precautions before using one.

May interrupt your body’s natural balances

Enemas may disturb your gut bacteria and throw off your body’s electrolyte balance.

Research shows that enemas used in preparation for medical procedures significantly disrupt gut bacteria, though the effect appears to be temporary. However, enemas that are split and administered in two doses seem to have fewer effects on the microbiome (13, 14).

Electrolyte disturbances have been observed with various types of enemas, such as large-volume soap suds enemas and those containing minerals.

For instance, there have been reports of Epsom salt enemas causing death from magnesium overdose. In another case, an older man died from severe electrolyte disruption caused by taking two sodium phosphate enemas (3, 15, 16).

Other reports note that the overuse of enemas to flush out the colon may lead to severe dehydration, which can be fatal (17).

Enema solutions can harm your bowel

Lemon juice, apple cider vinegar, and coffee enemas are highly acidic, and scientific evidence to suggest their effectiveness or safety is lacking.

What’s more, the evidence shows that their acidity and makeup can harm your bowel and lead to rectal burns, inflammation, infections, and even death (1).

Similarly, there are reports of children being given acidic hydrogen peroxide enemas, which resulted in an inflamed colon, bloody diarrhea, vomiting, and long-term complications (18).

Furthermore, in some people, herbal enemas have caused internal bleeding that required a blood transfusion and removal of the colon (1).

Dirty or improperly used tools can cause infection and damage

If you self-administer an enema at home, it’s critical to make sure that the tools you use are sterile, meaning they’re free of harmful germs. The use of dirty tools increases your risk of contracting a potentially dangerous infection.

Improper tool use may also cause physical damage to your rectum, anus, or colon. Studies indicate that perforation of the bowel is not a rare complication of frequent enema use that could put your internal organs at risk of infection (3, 12, 19).

Sterile enema injection kits, which usually include a bucket, tubing, solution, and sometimes a bulb, can be found online or at many local drug stores. They come with directions for cleaning and safe use.

Summary

Though enemas can be safe and effective, they come with many risks, especially when administered at home. Improperly used enemas can cause potentially life-threatening physical and chemical damage to your rectum or colon.

If you’re mainly considering an enema to stimulate and clean out your digestive system, there may be other, less invasive options.

Some potential alternatives to enemas, which can promote waste excretion and bowel regularity, include (20, 21, 22, 23):

• drinking caffeinated coffee, which is known to stimulate defecation
• staying well hydrated with water
• getting regular exercise like walking, running, biking, or aerobics
• trying an over-the-counter oral laxative like magnesium
• increasing your fiber intake by eating whole plant foods like fruits, vegetables, whole grains, nuts, and seeds.

If you have severe constipation or other medical issues, speak to your medical provider to determine whether an enema would be a safe and appropriate treatment.

Summary

Less risky alternatives to enemas that can help stimulate bowel movements include staying hydrated, getting regular exercise, and following a healthy, high-fiber diet.

Enemas are used to relieve constipation and cleanse the colon. Water- or oil-based solutions are injected into the bowel through your rectum to expel impacted waste.

Mild enemas like water or saline carry the least risk, but you should consult your healthcare provider before using one at home. Furthermore, ensuring the proper use of sterile injection tools is very important for safety.

Many people swear by enemas to promote regularity and prevent constipation, but evidence of their effectiveness is limited.

Other, less risky alternatives may be a better option in most cases.

Enema Constipation | Everyday Health

Some common steps in administering an enema include:

• Drink one or two glasses of water prior to the enema, as it can cause you to become dehydrated.
• Lie on your stomach with your knees pulled under you.
• Lubricate the enema tube and gently insert it into your rectum.
• If you’re using a disposable enema, gently squeeze the contents into your rectum. If you’re using an enema bag with a homemade solution, hold the bag up and allow gravity to deliver the contents.
• Once the bag is empty, remove the tube from your rectum.
• Wait in that position until you feel the need to move your bowels. You should feel a powerful urge within 2 to 10 minutes. Try to hold the enema in for at least 5 minutes to achieve maximum benefit.

Health Concerns Regarding Enemas

Because enemas can cause dehydration, overuse of enemas can create serious health problems. Use of enemas for constipation on a regular basis can lead to an electrolyte imbalance in the body called hyponatremia, in which the blood becomes diluted and its salt content becomes lower than normal. Hyponatremia can cause muscle spasms and swelling of the brain that leads to mental impairment. This is a particular concern when using enemas with plain tap water.

On the other extreme, overuse of phosphate enemas for constipation can lead to a condition called hyperphosphatemia, in which the blood levels of phosphate salts become elevated.

Be sure to consult with your doctor before using an enema, and exhaust all other possibilities first.

Learn more in the Everyday Health Digestive Health Center.

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what to choose for the treatment of chronic constipation

Chronic constipation is most often observed in the elderly: more than 36% of patients over 60 years of age suffer from defecation disorders, while before the age of 60 the problem is 3 times less common. Also at risk are people with limited mobility, bedridden patients, patients after operations on the abdominal organs.

Constipation significantly impairs the quality of life, disrupts the digestive process, and can lead to dangerous coloproctological diseases. Therefore, patients with chronic constipation must be prescribed treatment: diet therapy, exercise therapy, drug therapy (laxatives), enema, if indicated.

Laxatives for constipation – types and features of use

Medication for constipation is challenging because most people self-medicate and take over-the-counter laxatives for a long time. Unsystematic therapy exacerbates existing disorders, therefore, by the time of examination by a doctor, a person usually has many days of constipation, and the defecation process is accompanied by strong straining, the need for manual assistance for emptying.

General principles for the use of laxatives:

● the choice of the drug is carried out taking into account the cause of constipation: irrational nutrition, physical inactivity, intestinal atony after surgery, chronic gastrointestinal diseases, etc. ;

● with long-term constipation and the presence of concomitant diseases, a combination of laxatives with a different mechanism of action is recommended;

● The dosage and frequency of use of laxatives are periodically changed in order to achieve a good therapeutic result without harm to health and adverse reactions;

● with difficult and painful bowel movements, oral laxatives are combined with local remedies in the form of rectal suppositories;

● for neurological and psycho-emotional causes of constipation, drugs are prescribed that affect the peripheral and central nervous system.

In medical practice, different types of laxatives are used. They differ in mechanism and strength of action, adverse reactions, indications. Next, we will talk in detail about each group of drugs, mentioning their advantages, disadvantages and nuances of use.

Please note that the information is provided for informational purposes only! For the selection of laxatives, we recommend that you consult an ID-Clinic therapist, which is available online, at a clinic appointment, at home for patients with limited mobility.

Stool bulking agents

Medicines contain bran, cellulose, flax seeds and other components that increase the amount of feces and normalize its consistency. Increased stool volume stimulates mechanoreceptors, enhances intestinal motility and promotes the process of defecation.

The drugs act gently and physiologically, so they are prescribed for long-term use, including in elderly and debilitated patients. The exception is patients in the postoperative period and those with adhesive disease, in whom such laxatives can provoke an increase in pain.

The advantages of drugs from this group:

● have good drug compatibility, which is important for people who constantly take drugs to correct chronic diseases;

● safe medicines with a minimum number of adverse reactions and complications;

● do not “turn off” the motor function of the intestine and are not addictive;

● can be used for a long time without the risk of complications;

● bind cholesterol and increase its excretion with feces, thereby helping to correct dyslipidemia and atherosclerosis.

Osmotic laxatives

Another commonly used group of laxatives. They increase the osmotic pressure in the intestinal lumen and retain water, thereby softening the stool. Like the previous group of drugs, osmotic preparations increase the volume of feces, contribute to its promotion and painless removal during defecation. Medicines can be used long-term to normalize the functioning of digestion and regular stools in patients with chronic constipation.

Benefits of osmotic laxatives include:

● do not irritate the intestinal mucosa;

● are not addictive;

● are not absorbed into the blood, do not wash out salts and vitamins from the intestines;

● have an additional prebiotic effect – stimulate the growth of beneficial intestinal microflora;

● show an auxiliary therapeutic effect in cardiovascular diseases, renal and hepatic insufficiency, diabetes mellitus.

Drugs that cause chemical irritation of intestinal receptors

Drugs from this group have a dual effect. First, they increase intestinal motility, helping to move the stool and causing the urge to defecate. Secondly, drugs stimulate the secretion of fluid and electrolytes into the intestinal lumen, which allows you to increase the volume of feces and make them more liquid. Medicines have a quick laxative effect, so patients often purchase them for self-medication.

However, this category of drugs has a number of significant disadvantages:

● provoke secretory type of diarrhea, causing disturbances in water and electrolyte balance in the body;

● quickly addictive, require a constant increase in doses, which is fraught with dangerous side reactions;

● with prolonged uncontrolled use cause degenerative changes in the nervous structures of the intestine;

● can provoke a specific drug complication – laxative disease.

Given the potential risks and complications, stimulant laxatives are usually given in short courses of up to 2 weeks. They help to cope with long-term constipation, after which patients are transferred to milder and gentler drug options for continuous use.

Softeners

This category includes various types of oils that are taken orally, administered in the form of rectal suppositories. They soften the feces, coat the mucous membrane of the rectum and facilitate the process of defecation.

Such drugs do not have a pronounced laxative effect, so they are used to a limited extent. Most often, oil products are used in the postoperative period and in bedridden patients to reduce straining during bowel movements.

Enemas for constipation – when and why they are prescribed

For many people, enema becomes the main self-help remedy for constipation, but in fact, this procedure is not a treatment and does not help solve the problem of the gastrointestinal tract. Abuse of artificial bowel cleansing is fraught with a violation of the microflora, progressive atony of the colon and aggravation of constipation. Therefore, enemas are prescribed only as a one-time procedure to remove the accumulation of stool and improve the patient’s condition.

The main indication for enema is the lack of effect from drug treatment of constipation. However, do not prescribe an enema yourself. This is a medical procedure that should be carried out on the recommendation of a doctor no more than 1 time per week. For cleansing, ordinary water or water-oil solutions are used, which cover the walls of the intestine, facilitate the removal of dry, lumpy feces.

In addition to conventional enemas, microclysters are also used. They contain a combination of laxatives that are injected in small amounts into the rectum. On sale there are options for single use – a portioned tube with a special tip for rectal use. Microenemas show a strong and fast effect, but like regular enemas, they are not suitable for frequent use.

If the prescribed treatment regimen does not help, and there is a frequent need for enemas to empty the intestines, you should visit the doctor again. A change in pharmacotherapy, the use of stronger laxatives or drug combinations may be required.

With the progression of constipation, the absence of the effect of conservative tactics and complicated forms of colostasis, surgical intervention is indicated. In this case, the ID-Clinic doctor gives a referral for hospitalization so that the hospital surgeon selects the tactics of the operation and performs the necessary treatment.

Contrast enema | Memorial Sloan Kettering Cancer Center

This information will help you prepare for your contrast enema at Memorial Sloan Kettering (MSK).

A contrast enema is an x-ray examination of the colon. It is done with a contrast medium such as barium or iodine solution, also called iohexol (Omnipaque ^® ), air, or a combination of the two. The contrast agent makes it easier to examine the colon during x-ray examination.

Most people need to have a colon cleanse (prepare the bowel) before a contrast enema. Please check with your healthcare provider prior to your procedure to determine what preparation you need.

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Before your procedure

If you are hospitalized before your contrast enema, your ward nurse will give you everything you need to prepare your bowels. If you are coming to the hospital from home for the contrast enema, check with your doctor about preparations. Most people need to purchase everything listed below a few days before the procedure.

• Polyethylene glycol (MiraLAX®). You will need 1 vial (238 g).
• Gatorade® (light in color, not red or purple). You will need 2 bottles (32 oz. (950 ml) each).
• Bisacodyl (Dulcolax®), 5 mg tablets. You will need 4 tablets.

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The day before your procedure

Follow the No Treatment Diet

Follow the No Treatment Diet the day before your procedure. Drink plenty of other fluids besides water, coffee, and tea. You need to get calories from these liquids so that you don’t get weak.

Bowel Preparation Instructions

At 3:00 pm , take 2 bisacodyl (Dulcolax) tablets.

At 17:00:

• Divide MiraLAX into two halves. Pour half MiraLAX into each bottle of Gatorade (32 oz. (950 ml) each).
• Shake until completely mixed.
• Drink a glass (8 ounces (240 ml)) every 30 minutes until you have finished both bottles.

At 7:00 pm , take the remaining 2 bisacodyl (Dulcolax) tablets.

Instructions for eating and drinking before the procedure

• Do not eat after midnight the night before your procedure. This also applies to lozenges and chewing gum.
• Between midnight and two hours before your scheduled arrival time at the hospital, you can drink no more than 12 ounces (350 ml) of water (see picture).
• Refrain from eating and drinking two hours before your scheduled arrival time at the hospital. This also applies to water.

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Day of procedure

Things to remember

• Take only the medicines your doctor has told you to take on the morning of your procedure. Wash them down with a few small sips of water.

What to bring

• List of medications you are taking.
• Medications for breathing problems (such as an inhaler), if needed.
• Medicines for chest pain, if you use them.
• If you have a stoma, bring an extra bag and supplies with you.

Where to Park

The MSK Garage is located on East 66 ^th Street between York Avenue and First Avenue. For parking pricing, call 212-639-2338.

To enter the garage turn onto East 66 ^th Street off York Avenue. The garage is located about a quarter of a block from York Avenue, on the right (north) side of the street. A pedestrian tunnel leads from the garage to the hospital.

There are other garages located on East 69 ^th Street between First Avenue and Second Avenue, East 67 ^th Street between York Avenue and First Avenue, and on East 65 ^th Street between First Avenue and Second Avenue .

Where to go

You need to come to the MSK main building. Enter through the entrance at 425 East 67 ^th Street, between First Avenue and York Avenue, and take elevator A to the 2nd floor ^.

What to expect on the day of your procedure

When you arrive at the hospital, doctors, nurses, and other medical staff will ask you several times to spell and spell your name and date of birth. This is necessary for your safety. People with the same or similar names can have the procedure on the same day.

After you change into a hospital gown, the technologist and radiologist will talk about the procedure and answer your questions. You will be helped to lie flat on your back on the X-ray table.

You will have an x-ray of your abdomen to make sure there is no stool (feces) in your colon. The radiologist will insert a small tube into the rectum so that the contrast agent can flow into the large intestine. At this point, you may feel spasms. The radiologist will monitor the passage of the contrast agent through the colon on a monitor screen while the machine takes x-rays.

During the procedure, the top of the table may be tilted up or down and you may be assisted in different positions. This will help the contrast agent cover the entire surface of the colon.

The technologist will remove the tube from your rectum and take you to the bathroom where you can release the contrast material and air. After that, one or more x-rays will be taken. After the radiologist has reviewed all x-rays, you can leave.

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After your procedure

You can return to your normal diet and lifestyle unless your doctor or nurse tells you otherwise.

If you have been given a barium enema, your stools will be white for the next few days until all of the barium has been eliminated. Barium can cause constipation, so it’s important to drink plenty of fluids to help move it out of the intestines.