What are the different types of enemas. How to perform an enema at home safely. What are the potential side effects of enema use. When should you consider using an enema for constipation relief.

Understanding Enemas: Purpose and Function

Enemas are a medical procedure involving the injection of fluids into the rectum to cleanse or stimulate bowel emptying. This centuries-old technique has proven effective in treating various digestive issues, most notably constipation. But what exactly is an enema, and how does it work?

An enema introduces liquid into the lower intestine through the rectum. This fluid serves multiple purposes:

• Softening hardened stool
• Stimulating bowel contractions
• Flushing out impacted fecal matter
• Delivering medications directly to the colon

While healthcare professionals often administer enemas in clinical settings, many individuals opt for self-administration at home to manage chronic constipation or prepare for medical procedures.

Types of Enemas: Choosing the Right Solution

Enemas come in various forms, each designed to address specific digestive concerns. Understanding the different types can help you or your healthcare provider select the most appropriate option for your needs.

Cleansing Enemas

Cleansing enemas are water-based solutions intended to flush out the colon thoroughly. They are further divided into two categories:

1. Large volume enema: Using 500-1,000 ml of fluid, this type effectively treats constipation by cleansing a significant portion of the colon. Patients are often instructed to retain the fluid for an extended period to ensure complete stool release.
2. Small volume enema: Utilizing less than 500 ml of fluid, this option targets the lower part of the colon. It’s suitable for individuals who don’t experience constipation in the upper colon regions.

Oil-Retention Enema

For those dealing with hardened stool, oil-retention enemas offer a solution. These enemas typically contain 90-120 ml of an oil-based solution, which patients are advised to retain for at least an hour to effectively soften the stool.

Return-Flow Enema

Also known as a Harris flush, this type of enema addresses constipation caused by intestinal gas. The procedure involves injecting large volumes of fluid in 100-200 ml increments, then drawing it out along with the trapped gas. This process is repeated several times until all the gas is expelled.

Cooling Enema

In cases of extremely high body temperature, a cooling enema may be employed to lower the patient’s core temperature. While not a common procedure, it can be an effective method in specific medical situations.

Rectal Instillation of Medication

Some enemas serve as a delivery method for medications directly into the colon. This approach can help relieve intestinal mucosa, balance electrolytes, and combat infections. Typically, a cleansing enema precedes this type of treatment.

Enema Solutions: Ingredients and Their Effects

The effectiveness of an enema largely depends on the solution used. Here are some commonly employed enema solutions and their specific functions:

• Normal saline solution: A mixture of salt and water that draws the body’s water into the bowels, softening feces.
• Glycerin: Stimulates the colon lining to induce bowel movements.
• Castile soap: A mild soap made from various oils, added to saline solution to stimulate bowel movements.
• Coffee: A mixture of brewed coffee and water, believed to aid in removing bile from the colon.
• Phosphate solution: Attracts water into the bowel to soften hardened feces. However, it should be used cautiously due to potential health risks associated with excessive phosphate intake.

Step-by-Step Guide to Self-Administering an Enema

While professional administration is often preferred, many individuals choose to self-administer enemas at home. Follow these steps for a safe and effective procedure:

1. Thoroughly wash your hands before beginning.
2. Gather all necessary supplies: enema solution, enema bag, silicone catheter with balloon, syringes, towels, and lubricant.
3. Prepare the enema bag by attaching the tube and filling it with the prescribed amount of solution.
4. Assume the proper position: kneeling with your chest on a pillow and buttocks elevated.
5. Lubricate the catheter and gently insert it into the rectum, about 4-5 inches deep.
6. Inflate the catheter balloon and position it properly to prevent leakage.
7. Connect the catheter to the enema bag and begin the fluid flow.

Always consult with a healthcare professional before attempting to self-administer an enema, especially if you have any underlying health conditions or concerns.

Potential Benefits of Enema Use

When used appropriately, enemas can offer several potential benefits for digestive health and overall well-being:

• Relief from chronic constipation
• Improved bowel regularity
• Preparation for medical procedures or surgeries
• Management of fecal incontinence
• Delivery of medications directly to the colon
• Potential detoxification effects (though scientific evidence is limited)

Do enemas help with weight loss? While some proponents claim that enemas can aid in weight loss by removing toxins and excess waste, there is limited scientific evidence to support this claim. Any weight loss experienced after an enema is likely due to temporary water loss rather than fat reduction.

Potential Risks and Side Effects of Enemas

While generally considered safe when used as directed, enemas can pose certain risks and side effects. It’s crucial to be aware of these potential complications:

• Dehydration or electrolyte imbalances
• Rectal irritation or damage
• Infection if proper hygiene is not maintained
• Dependency if used too frequently
• Perforation of the rectum or colon (rare but serious)

Can enemas cause long-term damage to the colon? When used excessively or improperly, enemas may potentially damage the natural balance of gut bacteria or weaken the colon’s muscular function over time. However, occasional use under medical supervision is generally considered safe for most people.

When to Seek Medical Advice

While enemas can be an effective home remedy for occasional constipation, there are situations where professional medical advice should be sought:

• Persistent or severe constipation
• Blood in the stool
• Unexplained weight loss
• Chronic abdominal pain
• Symptoms of dehydration following enema use
• Fever or signs of infection

Is it safe to use enemas during pregnancy? Pregnant women should always consult with their healthcare provider before using any type of enema, as certain solutions may pose risks to the developing fetus.

Alternatives to Enemas for Digestive Health

While enemas can be effective for occasional use, there are several alternative methods to promote digestive health and regularity:

• Increasing dietary fiber intake
• Staying properly hydrated
• Regular exercise
• Probiotics and fermented foods
• Over-the-counter laxatives (under medical supervision)
• Herbal teas known to promote digestion

How can you improve bowel regularity naturally? Establishing a consistent bathroom routine, managing stress levels, and avoiding prolonged sitting can all contribute to improved bowel regularity without the need for enemas or other interventions.

Enemas in Medical Procedures: Preparation and Recovery

Enemas play a crucial role in preparing patients for various medical procedures, particularly those involving the lower digestive tract. Understanding their use in this context can help patients better prepare for upcoming treatments or surgeries.

Pre-Procedure Enemas

Many diagnostic and surgical procedures require a clean, empty colon for optimal results and safety. Enemas are commonly used for:

• Colonoscopies
• Sigmoidoscopies
• Colorectal surgeries
• Certain X-ray examinations

How long before a procedure should an enema be administered? The timing can vary depending on the specific procedure and the patient’s individual circumstances. Generally, enemas are given a few hours before the scheduled procedure, but always follow your healthcare provider’s instructions precisely.

Post-Procedure Recovery

In some cases, enemas may be recommended during the recovery period after certain surgeries or treatments. They can help:

• Relieve post-operative constipation
• Prevent complications from bowel obstructions
• Administer medications directly to the affected area

What should you expect after a medical procedure involving enemas? It’s normal to experience some cramping, bloating, or general discomfort immediately following the procedure. These symptoms typically subside within a few hours to a day.

The Role of Enemas in Alternative Medicine

Beyond conventional medical use, enemas have gained popularity in various alternative and complementary medicine practices. While scientific evidence for many of these applications is limited, proponents claim numerous benefits:

Detoxification

Some alternative health practitioners advocate for regular enema use as part of detoxification routines. They argue that enemas can help remove toxins accumulated in the colon, potentially improving overall health.

Coffee Enemas

Popularized by certain alternative cancer therapies, coffee enemas are believed by some to stimulate liver function and enhance detoxification. However, it’s important to note that mainstream medical organizations do not endorse these practices due to lack of scientific evidence and potential risks.

Ayurvedic and Traditional Chinese Medicine

Both Ayurveda and Traditional Chinese Medicine incorporate various forms of enemas or similar practices in their treatment protocols. These are often used in conjunction with herbal remedies and dietary changes.

Are alternative medicine enema practices safe? While many people report positive experiences with alternative enema practices, it’s crucial to approach them with caution. Always consult with a qualified healthcare provider before incorporating any new health practice, especially those involving internal treatments like enemas.

Enema Myths and Misconceptions

As with many health practices, enemas are subject to various myths and misconceptions. Let’s address some common misunderstandings:

Myth: Enemas are necessary for regular colon cleansing

Fact: The colon is designed to eliminate waste naturally. For most healthy individuals, regular enema use is unnecessary and may disrupt the colon’s natural function.

Myth: Enemas can cure serious diseases

Fact: While enemas can provide symptomatic relief for certain conditions, they are not a cure for serious diseases. Always seek proper medical diagnosis and treatment for persistent health issues.

Myth: All types of enemas are equally safe and effective

Fact: Different enema solutions and methods carry varying levels of risk and efficacy. What works for one person may not be suitable or safe for another.

Myth: More frequent enema use leads to better health

Fact: Excessive use of enemas can lead to dependence, electrolyte imbalances, and potential damage to the colon. Moderation and medical guidance are key.

How can you distinguish between valid enema practices and potentially harmful ones? Always rely on information from reputable medical sources and consult with healthcare professionals before incorporating enemas into your health routine.

The Future of Enema Use in Medicine

As medical knowledge and technology continue to advance, the role of enemas in healthcare is evolving. Here are some potential developments and areas of research:

Targeted Drug Delivery

Researchers are exploring the use of specialized enemas to deliver medications directly to specific areas of the colon. This targeted approach could enhance treatment efficacy for conditions like inflammatory bowel disease while minimizing systemic side effects.

Microbiome Modulation

With growing understanding of the gut microbiome’s importance, scientists are investigating how enemas might be used to introduce beneficial bacteria or prebiotics directly into the colon.

Advanced Diagnostic Tools

Future enema solutions may incorporate diagnostic capabilities, allowing for real-time analysis of colon health during administration.

Personalized Enema Protocols

As precision medicine advances, we may see more tailored enema treatments based on an individual’s specific gut microbiome, genetic profile, and health conditions.

What role will enemas play in future medical treatments? While it’s difficult to predict with certainty, it’s likely that enemas will continue to be refined and integrated into various medical protocols, potentially offering more targeted and effective treatments for a range of digestive and systemic health issues.

Enema Safety: Best Practices and Precautions

Whether administered at home or in a medical setting, proper safety measures are crucial when using enemas. Here are some essential best practices and precautions to keep in mind:

Hygiene and Sterilization

• Always use sterile equipment and solutions
• Thoroughly clean and disinfect reusable enema kits after each use
• Wash hands thoroughly before and after the procedure

Proper Technique

• Follow instructions carefully, especially regarding solution preparation and administration
• Use gentle insertion techniques to avoid injury
• Maintain a comfortable position to minimize discomfort

Temperature Considerations

• Ensure the enema solution is at or near body temperature to prevent shock or discomfort
• Avoid extremely hot or cold solutions, which can damage the delicate rectal tissues

Frequency and Duration

• Limit enema use to avoid dependency or electrolyte imbalances
• Follow recommended retention times for different enema types

Medical Considerations

• Consult a healthcare provider before using enemas if you have any underlying health conditions
• Be aware of potential interactions with medications or other treatments
• Avoid enemas if you have active hemorrhoids, rectal bleeding, or recent colorectal surgery

How can you ensure the safest possible enema experience? Always prioritize proper technique, hygiene, and moderation. When in doubt, seek guidance from a qualified healthcare professional who can provide personalized advice based on your individual health needs and circumstances.

By following these guidelines and maintaining open communication with your healthcare provider, you can maximize the potential benefits of enemas while minimizing risks and ensuring a safe, effective experience.

Types, Procedure, Side Effects, and More

Written by Jeffrey Weishaupt

Medically Reviewed by Jabeen Begum, MD on November 24, 2021

• Types of Enemas
• What Are the Different Enema Solutions?
• How to Use an Enema

Enemas are injections of fluids used to cleanse or stimulate the emptying of your bowel. This procedure has been used for years to treat constipation and similar issues. 

Constipation is a severe condition that slows down the movement of your stool. It also makes the stool hard and difficult to excrete. It can become a chronic problem for many people and requires treatment, such as enema.

Enemas can also treat fecal incontinence, a condition in which the stool leaks from the rectum unexpectedly. 

They are also used to clean the bowel before any test or surgery. 

A professional usually does the enema procedure, but you can also self-administer enemas at home.

Some types of enema include:

Cleansing enema. This procedure is water-based. It includes holding the injection in the rectum for a short time to flush the colon thoroughly. Your body then releases the stool within a few minutes.

Cleansing enema is further divided into two types:

• Large volume enema. It is an effective treatment for constipation as it cleanses a large part of the colon. The fluid amount used in this type is 500-1,000 ml. The doctors may ask you to hold the fluid in your anal opening for a long time to release the stool completely.
• Small volume enema. It is used to clean the lower part of the colon. The fluid amount used is less than 500 ml. It is recommended to people who are not constipated from the upper part of the colon.

Oil-retention enema. This enema type is for people whose stool has hardened. The oil-retention enema softens the stool. The enemas used in this process usually contain 90-120 ml solution. The doctor may ask you to retain the solution for at least an hour to get effective results.  

Return-flow enema. Also known as Harris flush, a return-flow enema is done on people with trouble pooping due to intestinal gas. In this method, a large fluid volume is used, which is injected in 100-200 ml increments. The fluid is then drawn out along with the flatus (intestinal gas). This process is repeated three to five times until the gas is entirely out. 

Cooling enema. If your temperature is extremely high, the doctor may use a cooling enema to lower your body temperature. It is not a common procedure.

Rectal instillation of medication. Enemas can also be used to insert medications into your colon. Enema relieves the intestinal mucosa, and the medicines balance the electrolytes and fight infections. This procedure is done after cleansing enemas. 

Some commonly-used enema solutions include:

• Normal saline solution. It is a combination of salt and water. The salt of the mixture sends the body’s water into the bowels to make the feces soft.
• Glycerin. It stimulates the lining of the colon to cause bowel movements.
• Castile soap. It is a mild soap made of many oils, like olive oil. This mild soap is added to saline solution, which is then inserted through an enema. This solution stimulates the bowel to create movements. 
• Coffee. It is a mixture of brewed coffee and water, used to remove bile from the colon. 
• Phosphate solution. A phosphate solution enema attracts water into the bowel to soften the hardened feces. Remember that too much phosphate in your body may cause health risks. So never go for more than one enema a day. Phosphate enema is also not recommended for people with kidney problems.

You can self-administer an enema or give it to your child at home. The steps include:

1. Always wash your hands before starting the procedure.
2. Collect all the necessary supplies. These include any type of solution, enema bag, silicone catheter with a balloon, two slip-tip syringes, a catheter-tip syringe, towels, and lubricant. Your doctor will tell you how much solution to use.
3. Put air in one slip-tip syringe and connect it to the balloon on the catheter. Push the plunger to inflate the balloon and then pull it back to empty the balloon.
4. Put the tube on the enema bag.
5. Pour the prescribed amount of solution into the bag.
6. Open the clamp and let a few drops of fluid out. Now, re-clamp the tube and squeeze the drip chamber until the fluid fills the tube halfway.
7. Now, lie on your knees with your hand on a pillow and keep your buttocks up. If you are administering an enema to your child, ask them to lie down in the same position. 
8. Use the lubricant on the balloon end of the catheter.
9. Put the balloon end of the catheter into the rectum for 4–5 inches. 
10. Next, fill in 20–30 ml of air in the syringe and connect it to the catheter port. Blow up the balloon by pushing the plunger.
11. Pull the catheter slowly until you feel resistance. Keep pulling the catheter with gentle hands to prevent the leakage of the enema.
12. Connect the catheter to the enema bag.
13. Now, open the tube clamp and allow the enema to flow in for 5–10 minutes. You can close the clamp a little to slow down the enema flow.
14. Hold the fluid in for 5–10 minutes. Don’t detach the fluid tube from the catheter. 
15. Now, rush to the bathroom and put yourself or your child on the toilet. Allow the air to come out of the balloon. Connect the other slip-tip syringe to the catheter port and pull the plunger back. Allow the catheter to come out. 
16. Wait for 45 minutes to push out the stool.
17. When done, clean the bag with water and the catheter via the catheter-tip syringe filled with soapy water.

There are no enema side effects. But, you may experience enema leaks during the procedure. Some people also complain about cramping and discomfort. 

If you are unsure about doing the procedure yourself, ask your doctor for help.

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Enema Administration: Purpose, Procedure, and Risks

An enema is a technique used to stimulate stool evacuation, usually to relieve constipation. How it’s done depends on the type of enema and whether you can do it at home or at the hospital.

The enema process helps push waste out of the rectum when you cannot do so alone. Enemas are available for purchase at pharmacies for home use, but you should ask a doctor or nurse for specific instructions to avoid injury.

Other types of enemas are administered to clean out the colon and better detect colon cancer and polyps. If you have concerns or worsening symptoms after an enema, ask a doctor right away.

Constipation is a common gastrointestinal condition. It occurs when the colon is unable to remove waste through the rectum. People with this condition have three or fewer bowel movements over a seven-day period. Mild constipation often occurs when you don’t eat enough fiber or drink enough water on a regular basis. Daily exercise also helps to prevent constipation.

An enema administration is most commonly used to clean the lower bowel. However, this is normally the last resort for constipation treatment. If diet and exercise are not enough to keep you regular, your doctor might recommend a laxative before trying an enema. In some cases, laxatives are used the night before an enema administration to encourage waste flow.

Enemas may also be used before medical examinations of the colon. Your doctor may order an enema prior to an X-ray of the colon to detect polyps so that they can get a clearer picture. This procedure may also be done prior to a colonoscopy.

Learn more: Colonoscopy »

There are several common types of enemas.

The purpose of a cleansing enema is to gently flush out the colon. It may be recommended prior to a colonoscopy or other medical examination. Constipation, fatigue, headaches, and backaches may be relieved by a cleansing enema. During a cleansing enema, a water-based solution with a small concentration of stool softener, baking soda, or apple cider vinegar is used to stimulate the movement of the large intestine. A cleansing enema should stimulate the bowels to quickly expel both the solution and any impacted fecal matter.

A retention enema also stimulates the bowels, but the solution that is used is intended to be “held” in the body for 15 minutes or more.

You may be asked to fast or follow special dietary instructions in the days prior to having an enema. Instructions may vary, depending on your doctor and your personal health needs.

If you plan to administer an enema at home, make sure that all of the equipment you are using has been sterilized and that you have a lubricant on hand. Pay careful attention to the way that you prepare the enema solution. You may have to mix it yourself with medicinal components.

To lessen the pressure felt in your colon, empty your bladder before you begin the enema. You may also want to place a towel or cloth down in the area between your bathtub and your toilet, in case fluid leaks out of your bowels when you get up to empty your colon. It’s important to measure and mark your enema tube the first time you use it so that you do not insert the tube more than 4 inches into your rectum.

At a medical office

If you are unfamiliar with enemas, you should consider having a medical professional administer one for you. They can also offer instructions for home kits that are available over the counter at pharmacies. Check with your doctor before use.

Some types of enemas are exclusively administered at medical offices. A barium enema, for example, uses a liquid compound that highlights certain areas of the gastrointestinal tract. This increases the amount of the tract that your doctor can see during an exam. Barium enemas are not used to treat constipation.

Read more: Barium enema »

At home

Enemas can be administered in the comfort of your own home. This way can be less expensive, but you should ask your doctor for detailed instructions beforehand. Due to the delicate nature of the procedure, a loved one should help.

Enemas utilize a solution of salt water that is placed into a bag on one side of the tube. The other portion is lubed and placed directly into the rectum. In order for the solution to reach the colon properly, hug your knees to your chest while lying on your stomach or on your side. Here are the standard instructions:

1. Fill the enema bag with your desired solution, using warm water. Make sure the clamp is shut. Hold the bag with the hose end down and open the clamp for a moment or so to get rid of any air bubbles, which you do not want to introduce into the colon.
2. Hang the bag alongside the bathtub so that you can access it while lying on your left side.
3. Lubricate the end of the tube to make insertion more comfortable before inserting the tube, no more than 4 inches into your rectum. Bear down and push the anus out as you insert the tube to make it more comfortable. Lie on your left side and pull your knees to your chest.
4. Wait for the fluid to enter your rectum, breathing deeply and watching the bag until it is empty.
5. Remove the nozzle from your rectum slowly.
6. You will probably feel the urge to use the bathroom (“evacuate”) immediately. If you are doing a cleansing enema, carefully stand up and move to the toilet. If you goal is retention, follow the instructions of your desired enema.

Once all of the solution is emptied into the colon, a bowel movement is expected within the hour. If you fail to expel any waste, call your doctor. You may be ordered to perform the procedure at a later time. Successful administrations result in the expulsion of waste from the rectum.

There are plenty of holistic and nontraditional advocates for enemas as a beneficial method for internal cleansing. For Western medicine at large, the verdict is still out on whether regularly administered home enemas have proven benefits. Not much conclusive research has been done into their long-term health benefits. The occasional use of enemas for “colon irrigation” and relief of constipation will most likely not harm you, as long as your equipment is sterile and you follow directions carefully. But keep in mind that administering enemas has risks.

When conducted properly following a doctor’s instructions, enema administrations are generally considered safe. A barium enema can cause waste to take on a white color for a few days afterward. This is the normal effect of barium and should clear up on its own. If you can’t produce waste, talk to your doctor about ways to loosen your stool.

Forcing an enema into the rectum can cause irritation and damage to surrounding tissue. Never force the tube into the rectum. If problems persist, try administration at a later time or call your doctor. Blood that is present in the stool after the enema may mean there is rectal damage or an underlying medical problem. Consult with a physician immediately regarding any rectal bleeding.

Your risks for enema-related complications are greater if you administer the tubes multiple times a day. The best course of action is to use the enema once a day, and around the same time every day, as directed by a doctor. This not only reduces side effects, but will also help to train your body to release waste regularly. If constipation continues for more than a few days, call your physician.

In extremely rare cases, the incorrect administration of an enema can cause an embolism (or blockage) to form. Pulmonary embolisms, which occur in the lungs, can be fatal. In other rare cases, an incorrectly administered barium enema can result in perforation of the rectum.

Older adults should avoid the over-the-counter “Fleet” enema, which contains sodium phosphate. A small study in JAMA Internal Medicine linked it to serious complications such as kidney failure.

Some people find that they have several additional bowel movements in the hours after an enema. For this reason, many plan to stay home for the rest of the day after an enema is administered. But for the most part, you may carry on with your regular routine after the enema process is complete.

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Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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Enema for constipation – how to do, contraindications, types

Enema with constipation of the intestine
Enema with constipation – how to do, contraindications, types | Phytomucil Norm
Enema for adult constipation is an effective treatment that can be done at home. The article is about how to properly put an enema for constipation of the intestine and their types (for example, cleansing). Phytomucil Norm
Phytomucil Norm

Constipation is often accompanied by painful sensations and is fraught with intoxication. It is necessary to fight constipation, so doctors often offer an integrated approach to treatment: dieting, increasing physical activity, taking laxatives or other medications. With prolonged constipation, it is important to empty the intestines as soon as possible. An enema will help to do this.

An enema is a medical procedure that involves injecting water or liquid solutions into the rectum through the anus. It can be performed both by the patient himself, and by a medical worker or relative – no special knowledge is required during the procedure. However, it should be understood that such manipulation has certain indications and contraindications, the technique of execution and the features of the conduct.

Enema for constipation

Enema is one of the most affordable methods used both in the hospital and at home. It allows you to get a quick effect and empty the intestines within 5-15 minutes after the introduction of the solution. Understanding how to make an enema for constipation allows you to instantly relieve the symptoms of stool retention: cleanse the large intestine, stimulate intestinal motility, remove gases.

This approach has disadvantages, especially if we are not talking about once occurring, but about chronic constipation. An enema is not a treatment for constipation and the digestive system disorders that cause it. Many people who have tried all the ways to get rid of constipation note the following disadvantages of an enema:

• discomfort – when washing the intestines, discomfort is inevitable;

• the impossibility of using the enema repeatedly – it is strongly not recommended to use the enema regularly, as this can lead to complications;

• the presence of contraindications in the form of hemorrhoids, anal fissure and other anorectal diseases – frequent companions of constipation;

• the risk of developing addiction – enema can cause the development of lazy bowel syndrome and provoke dependence on manipulations.

According to the gastroenterologist, KMN Shulpekova O. Yu., “in some cases, the formation of dependence on enemas is a big problem” (Shulpekova Yu. O., 2006, p. 90). This happens due to not agreed with the doctor or too frequent use.

The constant use of an enema does not solve the underlying problem. The person fights against the symptom, but does not direct their attention to the source of the problem – the disease of the gastrointestinal tract, the specifics of the diet or the level of physical activity. Therefore, you should not be zealous with enemas, it can only help in special cases when you need to urgently empty your intestines.

Readings

A pear enema is indicated for acute constipation – in cases where stool retention is rare and not chronic. In addition, the procedure is carried out with caution if the patient has a so-called fecal blockage.

A fecal blockage is a condition in which an accumulation of feces forms in a certain area of ​​​​the rectum. The lump is gradually compacted, while gaps remain between it and the walls of the intestine, through which liquid feces pass and are brought out. The person thinks they are developing diarrhea and may start taking antidiarrheal medication, which exacerbates the problem.

With partial obstruction of the rectum, symptoms of intoxication quickly increase. Treatment of fecal obstruction is carried out without laxatives. However, the enema is also used with caution: the procedure will help in cases where the enema tip freely penetrates above the stone and there is no risk of injuring the walls of the rectum.

In addition to constipation, there are other indications for bowel cleansing with enemas:

• intoxication, poisoning;

• planned operations;

• forthcoming birth;

• upcoming proctological examination;

• preparation for X-ray examination of the digestive, urinary system, pelvic organs;

• preparation for endoscopic interventions;

• preparation for the formulation of a medicinal enema.

Sometimes an enema is prescribed in the postoperative period, when your own stool is not observed after a certain time after surgery. Usually on the second or third day.

But for whatever indication an enema is planned, it is important to remember that this procedure must be carried out only with a doctor’s prescription. After all, there are a number of serious contraindications that you may not recognize in yourself.

Enema contraindications

Enemas for constipation are categorically contraindicated in cases of suspected complete intestinal obstruction. Doctor Subbotin A. M. emphasizes that “due to its low efficiency, the use of enemas is currently used mainly only in patients with signs of partial intestinal obstruction” (Subbotin A. M., 2010, p. 1754).

But it is important to distinguish between partial and complete obstruction: in the first case, loose stools pass. Partial blockage ends with a resolution in the form of liquid feces with a putrid odor.

Complete intestinal obstruction is characterized by acute pain, pallor of the skin, sweating, tachycardia, often accompanied by nausea and vomiting. A characteristic feature is asymmetric bloating. In some cases, long-term constipation can only be distinguished from intestinal obstruction using ultrasound or x-rays. Therefore, if you suspect such a condition, it is better to consult a doctor.

There are other contraindications to enema:

• bleeding from any part of the gastrointestinal tract, bleeding from the rectum;

• inflammation of the large intestine;

• rehabilitation period after interventions in the rectal area, perianal area, for example, after removal of hemorrhoids;

• hemorrhoids, anal fissure, proctitis, proctosigmoiditis;

• intestinal tumors.

Enema stimulates intestinal peristalsis and uterine tone, so if possible it is better to refuse the procedure during menstruation, so as not to increase bleeding. During pregnancy, an enema is done only under the supervision of a doctor and in case of urgent need.

How to make an enema

How to make an enema for an adult with constipation? If you have been prescribed an enema by a doctor, it is important to know how to do it correctly. First of all, you should prepare. You will need an Esmarch mug or a rubber pear with a tip, an oilcloth or an absorbent sterile diaper, liquid paraffin or baby cream, an antiseptic (for example, a solution based on chlorhexidine).

It is better to carry out the procedure in the bathroom, if it is suitable for this. At the same time, it is important that the surface on which the person lies is flat and firm. It is necessary to cover the surface with oilcloth and prepare a solution for enema. About which solution is best suited in a particular case, we will describe later in the article.

The tip of a syringe or Esmarch’s mug should be wiped with an antiseptic, applied to the tip with petroleum jelly or baby cream, in extreme cases – vegetable oil. A person should take a comfortable position – lie on either side or stand in a knee-elbow position, relax.

The enema is injected into the anus to a depth of 5-10 centimeters. The urge to go to the toilet can begin immediately after the start of the introduction of the solution, and it is important to restrain them for a certain time. The temperature of the solution can be from 10-21 to 39 ° C, depending on the indications.

Please note that the steps involved in administering an enema may vary depending on the type of enema.

The steps for self-administering an enema are as follows:

• collect Esmarch’s mug according to the instructions;

• fill it with a solution;

• bleed some fluid to bleed air;

• treat the tip with vaseline oil or baby cream;

• lie on your left side, pull your knees to your chest;

• push the buttocks apart, insert the tip into the anus to a depth of no more than 10 cm;

• pour in the solution;

• remove the tip, turn on your back and wait 15 minutes.

After the procedure, there will be a strong urge to defecate, it is important to restrain them only in the first few minutes, and then ensure the opportunity to spend as much time in the toilet as needed. Defecation can occur several times, so there is no need to rush.

Types of enemas for constipation

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The correct enema for constipation should be carried out taking into account the general state of health, the situation, the causes of stool retention. The characteristics of the solution used may vary depending on the type of enema.

The following solutions are used for cleansing and therapeutic measures:

• Oily: used for regular, prolonged constipation, often at bedtime. Unlike many other solutions, in this case, the laxative effect occurs after a few hours.
• Soapy: This solution is prepared with water and baby soap with glycerin. Used for a simple cleansing enema.
• Hypertonic: provides for the dissolution of salt in water, promotes the removal of excess fluid.
• Sour: Involves the use of acids (eg lemon juice or vinegar), used as a cleanser.
• Ognev’s enema solution: contains hydrogen peroxide, glycerin, soap shavings in the ratio 1:1:1. This solution is used for severe, prolonged constipation.
• Starch: this solution is used for hot enemas with temperatures up to 40-42 degrees. Also used for colitis. The composition of this solution includes starch and medicinal substances.
• Drip: The solution is a combination of drugs prescribed by a doctor. Can be used for dehydration, usually up to 4 treatments per day.
• Nutrient: May contain glucose, amino acids, etc. Also used for dehydration.

By volume, enemas are classified as follows:

Oil

It is recommended for spastic constipation, dehydration of feces. For example, in cases where constipation was the result of a poor drinking regimen. The solution is olive, castor, vaseline or other oil in its pure form.

The oil is heated in hot water to 38 ° C, drawn into a Janet syringe or syringe, injected into the anus. The urge to empty may not come immediately, but only after a few hours, so it is often more appropriate to use laxatives with a delayed, predictable effect.

Hypertonic enema

Hypertonic enema involves the use of water with salt or potassium permanganate dissolved in it. Such an enema is used, as a rule, to remove excess fluid during edema. Usually enough 0.2-0.5 liters of clean cold water. Warm water can be absorbed into the intestines, then the desired effect will not be. Salt solution increases osmotic pressure, stimulates the liquefaction of feces, the effect occurs after 20-30 minutes.

Cleansing enema

Cleansing enema for constipation involves thermal irritation with water of a certain temperature. Pure warm water is used, which mechanically stimulates the intestinal walls, has a temperature effect, and changes the consistency of feces. The effect comes immediately after the procedure.

Cleansing enema thins stools, stimulates bowel movements and can be used as part of the treatment of chronic constipation and to promote detoxification and elimination of stool in preparation for childbirth or surgery. Sometimes a cleansing enema is placed before the medicinal one. So medications based on medicinal enema are better absorbed.

In addition to pure water, it is possible to use water with the addition of 2 tbsp. l. glycerin or vegetable oil. As a preparation, you need to lay an oilcloth on the couch, lower one edge into a container on the floor.

Esmarch’s mug is filled with a solution with a temperature of 25−35 degrees, open the tap to remove air. Next, you need to close the tap and hang the mug above the couch. The person lies on his side, bending his knees.

Cleansing enema algorithm:

• Treat the tip with Vaseline.
• Insert 10 cm tube.
• Open tap, inject fluid.
• Detect 10 minutes.

If the pressure of the solution is not enough, pull the tip out a little and increase the water pressure, and if soreness is felt, reduce the pressure.

Siphon enema

Siphon enema involves cleansing the intestines with the help of a repeated washing procedure according to the principle of two communicating vessels – intestines and funnel. It differs from the cleaning one not only in the multiplicity of conduction, but also in technology. Before the procedure, you need to put an oilcloth, the edge of which is lowered into the container.

The person is laid on his side, after which the vaseline-treated tip of the rubber tube is inserted into the rectum by 10 cm. Then the funnel at the other end of the tube is filled with liquid, it is held at the level of the buttocks, then it is raised 0.5 m above the level of the body. When the waning water reaches the boundary of the constriction of the funnel, the funnel is lowered below the level of the body.

Intestinal contents will begin to flow out of it. This raising with the addition of liquid and lowering the funnel is repeated several times until the water coming out of it becomes clear. It should be remembered that only a specialist should carry out a siphon enema.

Medicinal

Typically, such enemas are indicated for inflammatory diseases of the rectum or sigmoid colon. In some cases, medicines are used as a solution, including decoctions of medicinal herbs. Sometimes general medicines are administered. systemic action. Only a specialist can prescribe a drug. It is important to do such enemas strictly in accordance with medical recommendations.

It should be understood that enema is not a treatment for constipation. In addition, in the case of alimentary constipation, it does not have any effect on the causes. Chronic constipation occurs in 15–25% of the adult population of developed countries, and in most cases it is associated with the diet and low physical activity of a modern person.

That is why the first recommendation of a gastroenterologist for constipation in a patient is almost always a menu correction – supplementing the diet with foods rich in dietary fiber. Sometimes additional fiber supplementation is required.

For this reason, the most effective laxatives are bulk ones, in particular preparations based on psyllium hulls. One such laxative is the British drug Phytomucil Norm, which contains soluble fibers in the form of psyllium seed husks and plum fruit pulp, as well as insoluble fibers.

Due to the latter, the agent stimulates peristalsis, and soluble fiber increases the water content in the feces, contributes to their softening and comfortable excretion. Plum pectin additionally promotes the growth of beneficial microflora. “Fitomucil Norm” acts without pain, swelling and sudden urges, is not addictive, unlike drugs with hay in the composition.

It is important to consult your doctor about enemas for constipation. There may be certain limitations, and only a specialist will tell you how to deal with the problem.
The article is for informational purposes only. The authors are not responsible for the quality of services provided by third parties and for possible complications.

References

• Parfenov AI Strategy and tactics of treatment of chronic constipation // Medical Council. – 2011. – No. 9−10. — S. 12−17.

• Subbotin AM Ideal preparation for colonoscopy — reality or goal on the horizon? Stages of improving its quality // Regular issues of “RMZH”. – 2010. – No. 28. – S. 1754.

• Shulpekova Yu. O. Constipation and methods of its treatment // Appendix BC “Diseases of the Digestive Organs”. – 2006. – No. 2. — S. 90.

Parfenov A.I. Strategy and tactics for the treatment of chronic constipation // Medical Council. – 2011. – No. 9−10. — S. 12−17.

Subbotin A.M. Ideal preparation for colonoscopy – reality or a goal on the horizon? Stages of improving its quality // Regular issues of “RMZH”. – 2010. – No. 28. – S. 1754.

Shulpekova Yu. O. Constipation and methods of its treatment // Appendix of breast cancer “Diseases of the Digestive Organs”. – 2006. – No. 2. – S. 90.

How to properly give an enema to a child with constipation

How to give an enema to a child at home with stool retention, Olga Glushko, pediatrician, pediatric gastroenterologist of the Semeynaya clinic network, told Gazeta. Ru.

Why an enema is needed

The specialist reminded that an enema is a device that cleans and rinses the colon or injects medicinal substances into it.

Enemas for children who suffer from constipation are done both in a hospital and at home, but in the latter case, Glushko recommended that a baby or an older child be given a medicinal enema only as prescribed by a doctor.

She advised not to consider enema as a popular way to improve bowel function and to do it only in extreme cases. In all other cases, it is more correct to establish nutrition, provide the child with sufficient drinking regimen and physical activity, and for older children, include in the diet products that have a mild laxative effect on the intestines of children who suffer from constipation.

What kind of water to give an enema to a child

For a cleansing enema prescribed by a doctor, the pediatrician recommended using water at a temperature of 36-38 degrees.

A lower temperature will cause discomfort to the child, and a higher temperature is dangerous to health. Such an enema has a cleansing effect in case of constipation in a baby.

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How to make your own cleansing enema

“Enemas can be in the form of a rubber syringe bulb or a container with a tube (Esmarch’s mug). Such large volume enemas are not used in the treatment of children who suffer from constipation.

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Regardless of the type of enema, several factors must be considered in the technique used. First, the position of the body: it is important that the patient lies on his left side with his knees pulled up to his stomach. This is due to the anatomical location of the rectum: in this position it will be more convenient to insert the tip into the rectum and give an enema to a baby who suffers from constipation. In infants, the position is slightly different: on the back with legs raised to the stomach, ”the doctor explained.

“To make it easier to insert the handpiece into the rectum of a constipated child, it can be lubricated with Vaseline oil. The volume of liquid for a single injection is calculated individually and depends on the purpose of the enema, the type of liquid injected (oily, hypertonic and others are administered in small volumes, unlike water), the age and weight of the patient also matter. Usually the volume of water for an adult does not exceed a liter, for a child it is much less,” Glushko said.

Which solution to use for an enema

According to Glushko, at present, a medicinal solution for enemas for children suffering from constipation, including small ones, is not prepared at home, but microclysters are more often used, which is associated with ease of use for children of any age.

Microclysters are considered safer than conventional ones.

“These enemas are a tube with a plastic tip with a medicinal substance. They are intended for mild stool stimulation in case of constipation, before medical procedures on the rectum or examination by a proctologist.