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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Should You Use An Enema for Constipation Relief?

Having been used for thousands of years, enemas are one of the oldest methods of getting the bowels moving again if you’re suffering from constipation. Historically, the use of enemas makes sense, developing before the invention of oral and intravenous medication, notes the Canadian Society of Intestinal research.

In recent years, some celebrities have touted enemas as a way to “flush out” the digestive system and detoxify the body. However, this advice is a load of nonsense, and the regular use of enemas can actually be dangerous.

Today, better and safer treatment options, including laxatives, suppositories, and a high-fiber diet, mean enemas are typically recommended as a last resort for constipation because of possible side effects.

The Back Story: How Does an Enema Treat Constipation?

Treating constipation with an enema involves introducing fluid into the intestines via the rectum. This helps soften and break up the stool, says Bryan Curtin, MD, a gastroenterologist and director of the Center for Neurogastroenterology and GI Motility at the Melissa L. Posner Institute for Digestive Health and Liver Disease at Mercy in Baltimore.

There are several types of enemas, including tap water, sodium phosphate (such as Fleet enemas), saline, glycerin, soap suds, and mineral oils.

“While phosphorus-based enemas are traditionally considered the most potent, I find that any enema can be effective if done correctly,” Dr. Curtin says. “The oil-based enemas are fairly messy and I typically avoid those.”

How to Administer an Enema

To administer an enema, follow the instructions on the box or leaflet closely.

Bharat Pothuri, MD, a gastroenterologist at Memorial Hermann in Houston, offers the following tips for using an enema safely and effectively:

• Drink 16 ounces of water (two glasses) prior to the enema, as an enema can cause you to become dehydrated.
• Lie on your stomach with your knees pulled to your chest. If you are unable to, lie on your left side with both knees bent and your arms resting comfortably.
• Lubricate the enema tube and gently insert it into your rectum, squeezing the enema so that the contents can enter your rectum.
• Wait in that position until you feel the need to move your bowels. Try to hold the enema in for at least five minutes to achieve maximum benefit.

“It’s important to make sure you hold onto the enema until the urge to defecate is strong,” Curtin says.

Possible Side Effects of Enemas

While enemas can be a useful tool for treating severe constipation, they do come with some risks and are not meant for frequent use.

“Like any other medication, enemas can be abused,” Curtin says. “Too much enema use can lead to anorectal pain disorders. Generally, you should avoid using enemas regularly unless instructed to by your doctor.”

Enemas that are administered incorrectly can damage the tissue in the large intestine and cause bowel perforation, research such as a case report published in 2020 in SAGE Open, has shown. If an enema is not sterile, it can put you at risk of an infection, including sepsis, Dr. Pothuri notes.

One study notes that perforation, hyperphosphatemia (a condition characterized by too much phosphate in the blood), and sepsis following enema use may cause death in up to 4 percent of cases.

Long-term use of enemas can lead to electrolyte imbalances, which can cause uncomfortable symptoms like fatigue, headache, muscle cramping, nausea and vomiting, per the Cleveland Clinic.

People with colorectal cancer, an enlarged distended colon which may be more prone to perforation, and people who have active inflammatory bowel disease should avoid using enemas, Pothuri says.

If you have any questions about the safety of enemas, talk to your doctor. It’s best to consult your healthcare provider before using an enema and to exhaust all other ways of treating constipation first.

Safer Options for Constipation Relief

Because of the possible side effects of enemas, it’s usually only advised as a last-resort option to treat constipation.

Before considering an enema, make sure you’ve tried the following options:

High-Fiber Diet “Generally, your doctor will first start by recommending dietary changes,” Curtin says. Adding fiber to your diet increases the bulk of your stool, speeding up its passage through the digestive system. Curtin says patients who are constipated should aim for 20 to 30 grams of daily fiber. A good starting point is to add more fruits and vegetables into your diet, as well as whole grains. A sharp increase in fiber can cause bloating and gas, per the Mayo Clinic, so aim to gradually increase the amount over a few weeks. Over-the-counter supplemental fiber, such as Metamucil, is also available. Talk to your doctor to learn if this is a good option for you.

Stay hydrated. Drinking enough water is important for overall health, including digestion. “The main purpose of the colon is to reabsorb water from the stool, and if you are dehydrated more water will be taken in, leading to harder to pass stools,” Curtin says. The National Academies of Sciences, Engineering, and Medicine suggests that women get a total of about 2.7 liters (11 cups) of fluid per day and that men get about 3.7 liters (16 cups) per day. Note that not all of this fluid has to be water; it can also include nutrient-rich foods and beverages like fruit, vegetables, juice, and tea. Also, it’s important to spread out the fluids over the day. Alcohol and caffeinated drinks can cause dehydration, so you’ll want to avoid those if you’re constipated.

Laxatives Laxatives, or stool softeners, such as docusate or milk of magnesia, are available over the counter. Talk to your doctor or pharmacist if you have any questions about these medications. Overusing laxatives can lead to worsening symptoms, per the Cleveland Clinic, so you should not use the treatment for more than two weeks without talking to your healthcare provider.

Other lifestyle changes like exercise can help get things moving in your digestive tract. It’s also smart to keep a food journal so you can see which foods trigger your constipation. Certain medications and supplements may also cause constipation, so if that is a concern, talk to your doctor, who may adjust your dose or switch your prescription.

Some prescription drugs are also available to treat chronic constipation. Your healthcare provider will work with you to decide on which one is best for you. If there’s a structural problem in your colon that’s causing your constipation, your doctor might recommend surgery.

Call your doctor to talk through options if constipation is a new issue for you or you’ve been constipated for more than a few weeks.

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How is an enema done for constipation at home?

Contents

• Is it really necessary: ​​advantages and disadvantages of the procedure
• What are enemas?
• Which enemas are suitable for adults and which are suitable for children?
• How to properly carry out the procedure at home?
• Precautions: what not to do?

Various laxatives, herbs, prebiotics and even diets can be used. But it also happens that all these means do not have the expected result, and then the last, most powerful and effective way is enema.

This is a medical procedure and should therefore be approached responsibly and competently. There are even a number of specific rules, on the implementation of which the success of self-help depends.

Those who suffer from chronic constipation will benefit from knowing who, when and how to properly administer an enema.

Contents

Is it really necessary: ​​the advantages and disadvantages of the procedure

Enemas can be classified into several main types: medicated, rinsing, voiding, and subaqueous. Each of them can be hypertonic, oily and cleansing.

And there are two radically different opinions about the benefits and disadvantages of enemas. Traditional medicine is of the opinion that the abuse of such procedures can lead to thinning of the intestinal walls, so the use of an enema is recommended only for acute toxic poisoning. Traditional medicine advises the use of enema for almost any disease.

But both of them agree on one thing, besides the obvious cleansing advantages, the method also has no less pronounced disadvantages:

• With regular use of enemas, the natural acid balance in the large intestine is disturbed.
• Dysbacteriosis may develop, as unnatural disturbances of the microflora occur.
• The walls of the large intestine are stretched under the influence of the volume of injected fluid, which leads to muscle atony and the so-called “lazy bowel”. This only exacerbates the problem of constipation.

But if you approach such an influence wisely, using an enema only as an extreme option, then there is nothing wrong with that. The advantages of the method include its indispensability in the paralytic postoperative state of the intestine, during infectious diseases of the gastrointestinal tract, in case of poisoning and after a heart attack. An enema is the only way out when it is impossible to treat with laxatives, when its use is not only justified by the indications, but also extremely necessary. But resorting to intensive cleansing techniques with an enema is not only harmful, but also dangerous.

What are enemas?

Enemas can be divided according to the amount of liquid to be injected into micro, medium and large. For the first, the volume of liquid is 100 ml, and often these are medicinal solutions. For medium – 500 ml, and for large ones, up to 2 liters are introduced. At home, you can do:

• Cleansing enema – does not affect the muscles of the intestine, but simply flushes the feces with water.
• Hypertonic enema is a type of microclyster designed to provoke receptors in the intestinal mucosa and stimulate the process of self-cleansing.
• Oil enema – in which olive, sunflower or vaseline oil is added to 100 ml of solution.
• “Mikrolaks” enema – is made on the basis of a viscous solution, which is sold in pharmacy kiosks ready-made. It contains sodium citrate, sodium lauryl sulfate and sorbitol in different dosages. The tool starts working after 10 minutes, and to get the effect, it is enough to use only 5 ml of the drug. Such drugs cannot have a prolonged action, and therefore do not affect the functioning of the intestines, there is no addiction.

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Which enemas are suitable for adults and which are suitable for children?

A child has a problem with stool much more often than an adult. For young children, problems with stools are very typical due to the partial immaturity of the intestines, as well as the lack of the necessary bacterial microflora, which will appear only in the first few months of life. Before giving an enema to a baby, you need to determine the causes of constipation. And for this it is better to bring him for a consultation with a local pediatrician or surgeon.

Very often, constipation is provoked by dysbacteriosis, which manifests itself after antibiotic treatment or with weakness of the intestinal muscles. But in this case, you can avoid enema, just give the child prebiotics that help normalize the digestive process.

Enemas are not recommended for children under 5 years of age, it is better to simply lubricate the anus with oil and inject a little into the rectum. If the cause of difficult emptying is dryness of the anus, then this is the best way to avoid problems.

To give an enema to an adult, it is enough to get a syringe or Esmarch’s mug. Prepare two liters of warm and boiled water. The container is filled with water half of the free volume, while the faucet must be closed.

The mug is hung up so that it is much higher than the lying person. The speed at which the liquid will flow into the intestine depends on the height at which it will hang. An adequate height is 1.5, if the mug hangs higher, then there is a chance of damaging the intestinal walls.

For adults, any of the components of the enema solution will work. These can be pharmaceutical antiseptics, herbal infusions, and even a very weak solution of citric or acetic acid. For 2 liquids, you need a few drops of apple cider vinegar or freshly squeezed lemon juice.

Strongly infused chamomile, peppermint, pomegranate peel or oregano herb can be used as a medicinal decoction. All of them have anti-inflammatory and laxative qualities. Acetic and citric acids increase peristalsis.

Salt solution is also suitable for adults, which irritates receptors in the rectum. This type of enema is called hypertonic. Such a tool attracts fluid from the walls of the intestines, which helps to soften and remove feces.

Buy a solution as in finished form, which includes heptahydrate and magnesium sulfate, current and prepare at home. In a glass of warm water, it is necessary to dilute a teaspoon of salt, fine-grained, without a slide. Or dissolve 20 g of powdered magnesia in 250 ml of water.

Hypertonic enema is done using an ordinary medical pear, the volume of which is 250 ml. The methodology is very simple: the solution is injected into the rectum of a person lying on their side. The urge to go to the toilet will begin in about 25 minutes.

Hypertonic enemas should not be given to children as the saline solution can seriously damage the intestinal walls. And adults should not resort to this method more than once every 7 days. And only with the approval of a doctor.

[warning] Amounts of liquid that children of different ages are allowed to give in the form of an enema solution:

• infants: 30-50 ml;
• 1 to 8 years: up to 300 ml;
• 8 to 12 years old: 500-700 ml.[/warning]

Use only a bulb or syringe and buy one with a soft tip. The temperature is also important: the solution should not be colder or hotter than 26C. This temperature is comfortable for the baby’s intestines.

How to carry out the procedure at home?

To get the maximum effect from an enema, you need to know how to do it correctly. It is best to carry out the procedure in the bathroom, or, if space permits, then directly in the bathroom. It is better to cover the floor with oilcloth. The solution is prepared in advance, if the enema is oil, then it must be warmed up and not tightened with the enema.

The person lies on the left side, bends the legs at the knee and pulls them slightly towards the stomach. With a cleansing enema, air must first be released from the hose, until water drips from the tip. After the faucet can be blocked. The tip of a syringe or an Eismarch mug is lubricated with Vaseline, and then gently, with the help of rotation, is inserted into the anus.

[warning] When using an oil mini enema – the solution must be injected very slowly, and if the volume of liquid is large, then just open the tap. If pain occurs, the procedure is stopped, allowing the liquid to move through the intestines. [/warning]

There is one important nuance with the cleansing enema. The fluid is not injected all at once. First, 500 ml is poured in, the fecal plugs that block the rectum are removed, and only after that the remaining 1.5 liters are used. You need to lie down and wait 20 minutes, and then slowly go to the toilet.

If there is no urge to defecate, then begin to massage the stomach, smooth movements, directed from the pubis to the sternum. Or you can simply lie on your right side, helping the fluid to penetrate further, following the direction inside the colon.

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Precautions: what not to do?

It is strictly not recommended to use soap and soda as additives to the enema solution. These two agents lead to erosive destruction of the walls of the large intestine.

Being highly concentrated, they cause severe irritation of the mucosa, which provokes the formation of micro-ulcers, tenzemas and edema.

If an ordinary enema does not work, it is better to seek help from a pharmacy. For example, Microlax is a viscous solution intended for rectal administration.

Enema is strictly contraindicated in:

• Appendicitis, internal bleeding, peritonitis, other acute conditions and diseases of the gastrointestinal tract.
• During recovery from abdominal surgery.
• Hemorrhoids, hemorrhoidal bleeding;
• Inflammatory processes in the cavity of the rectum, with erosion and ulcerative lesions.
• Prolapse of the rectum.
• Tumors of the intestine, regardless of where it is localized.
• Severe degree of ischemia.
• Bleeding in the stomach or uterus.
• Pain in the retroperitoneal space and suspicion of the need for surgery.

Many people solve the problem of constipation without going to the doctor by giving themselves an enema. But this is a fundamentally wrong approach, since in 30% of such cases forced bowel movements lead to serious consequences. If you have problems with regular stools, you do not need to immediately purchase a douche, but it is better to take care of your health and visit a specialist.

Enema for hemorrhoids: when and how to use

Can (and should I) give an enema for hemorrhoids? Are there any contraindications? In what cases will an enema be beneficial, and when, on the contrary, will it be harmful? We answer popular questions.

When is an enema required?

Enema is a proven and effective cleansing agent. It cannot cure health problems such as constipation or hemorrhoids. But in some cases it is necessary.

Before examination and examination by a proctologist

If you plan to make an appointment with a proctologist to diagnose diseases of the anus, including internal or external hemorrhoids, then an enema is a must:

• A clean intestine is the key to the highest quality and accurate diagnostics.
• The absence of stool and gas in the rectum will help you feel more confident during the examination.

It is necessary to prepare not only for the first examination, but also for all return visits. This will allow the doctor to most accurately assess the dynamics of your condition during or after treatment.

If treatment is planned for hemorrhoids

Preparation for removal of hemorrhoids includes examining the patient, improving bowel function, stopping food intake 5-6 hours before the procedure, and using a cleansing enema.

When is an enema available?

An enema is NOT a MEDICINE. With its frequent use, problems with the muscles in the gastrointestinal tract are possible – over time, the muscles simply “forget how” to work on their own. Therefore, without fail, it is used only before examination by a proctologist and before treatment. In rare cases, it can be used after the removal of hemorrhoids and with the simultaneous presence of hemorrhoids and constipation.

After removal of hemorrhoids

After removal of hemorrhoids, there is usually no need for an enema. The exception is the so-called “psychological constipation”. This is the fear of defecation after the procedure. In this case, an enema may be prescribed by a doctor. But more often, doctors still prescribe drugs (tablets, powders, drops) to treat constipation.

Hemorrhoids and constipation at the same time

In order to treat hemorrhoids successfully, the cause of the disease must be eliminated. Therefore, with constipation, the first thing to do is to establish the work of the digestive tract. For this, you should contact a gastroenterologist. If at the moment this is not possible, then as a first aid, you can resort to a cleansing enema. However, it should never be abused. And at the first opportunity, consult a gastroenterologist, get rid of constipation, and then turn to a proctologist for the treatment of hemorrhoids.

When is an enema forbidden?

A complete ban applies in two cases:

• in severe, unbearable pain in the anus;
• for profuse bleeding from the anus.

What to do about pain and bleeding?

For pain and bleeding, contact a clinic that provides patients with emergency proctology care, including without prior preparation for a proctologist’s appointment.

In most cases, getting rid of hemorrhoids and their symptoms is possible immediately, on the day of the first dose. Cleaned the rectum –> received first aid –> underwent diagnostics –> cured hemorrhoids. But in the absence of preliminary purification, this chain is broken. Diagnosis becomes impossible, which means that treatment is delayed.

Without preparation, you will receive first aid for hemorrhoids: they will eliminate pain and / or bleeding. Further, as soon as the symptoms become less pronounced, you will be advised to come again with a cleansed intestine in order to undergo a comprehensive examination and treatment.

How to give an enema

It is recommended to do an enema twice before the examination:

1. in the evening before the visit to the doctor;
2. in the morning three to four hours before the examination.

To carry out the procedure at home, you need to buy an Esmarch mug at any pharmacy. It is a rubber heating pad with a long tube and a smooth tip. The latter has a screw to regulate the water pressure.

In order to avoid injuries to the rectum, mucous membranes and the appearance of anal fissures, we recommend that you follow the instructions that you will find at the link https://alanclinic.ru/proctologiya/podgotovka-k-proctologia/#klizma_kruzhka_esmarha

Most people can easily cope with the cleansing procedure. If there are any difficulties, then there are several ways to solve them:

1. Enlist the help of someone close to you.
2. Take a medication mini enema “Microlax”.
3. Get trained directly at the clinic. Many modern private medical centers provide this service. If this is important to you, specify this nuance when making an appointment with a proctologist.

Microlax Gel – a convenient alternative to enema

Due to the special oil solution contained in the gel, cleansing is gentle and fast.

Already 15 minutes after the injection of the gel into the rectum, a single bowel movement occurs. For constipation, it is recommended to cleanse twice. If the stool is regular, then in most cases one procedure is enough.

It is also convenient that with the help of a mini enema you can prepare for an examination in almost any conditions (at home, at work, etc.). In other words, in any place where there is a toilet room.

For more information on the use of Microlax microclysters, read the article on the page https://alanclinic.ru/proctologiya/podgotovka-k-proctologu/#mikroklizma_mikrolaks

Water enema or Microlax – which is better?

There is probably no definite answer to this question – the choice always depends on the specific situation. To help you make your choice, here are the pros and cons of each of these methods.

Water enema – pros and cons of use

Benefits:

• A safe method of colon cleansing (when done carefully and following the instructions).
• Effectively removes feces.
• For severe constipation and in the presence of large hard lumps, water is the most effective method, since medical microclysters may not cope.
• Low financial costs. To carry out the procedures, you need to buy an Esmarch mug once and use it repeatedly over many years.

Disadvantages:

• Giving yourself such an enema can be a difficult task, especially when you feel unwell, at a long pregnancy, if you have disorders of the musculoskeletal system, or even simply if your body is not flexible enough. Because of this feature, the procedure can take a long time.
• For some people, these procedures cause a feeling of fear or strong dislike.
• Often there are bursting pains and other unpleasant sensations.
• During bowel movements, water does not come out completely, part of the liquid remains on the inner walls of the rectum. Therefore, a person constantly feels a false urge to defecate, and with each attempt to empty the contents of the intestine, the liquid comes out in small portions, thereby creating certain inconveniences.
• Esmarch’s cup tip must be disinfected after each use to avoid accidental penetration of infection through microscopic breaks in the skin of the anus. And if several people in a family use one mug of Esmarch, then each family member should have their own tip.

Microlax – the pros and cons of using

Benefits:

• A safe product recommended even for newborns, pregnant and lactating women, the elderly. Of course, in the absence of allergic reactions to the substances contained in the preparation.
• There are no bursting pains, since the volume of the gel for a single application is only 5 ml.
• Easy to use. It is enough to insert a thin tip of the tube into the anus to a shallow depth, squeeze out the gel and carefully remove the tube. Then wait 15 minutes and empty the bowels as usual. If necessary, repeat the procedure using another tube.
• The gel is almost completely thrown out during defecation, so there are no further false urges to defecate.
• Easy to use. Almost any capable person, regardless of age, build and state of health, can cleanse the intestines on their own, without outside help.
• Sold in almost any pharmacy at affordable prices.
• Each tube is supplied with a disposable tip that does not require disinfection.

Disadvantages:

• Allergic reactions possible. At the first application, it is recommended to check the reaction by applying a small amount of gel to the elbow area. If there is an allergic reaction, it will appear within 5 to 30 minutes. With a positive allergic reaction, you must immediately take an antihistamine and stop further use. To select another drug, consult an allergist or dermatologist.
• With increased sensitivity, discomfort is possible (itching, burning in the anus or inside the rectum). Unpleasant sensations pass almost immediately after defecation.
• Rarely, side effects such as abdominal pain and/or loose stools may occur. If these symptoms do not go away on their own within 2-3 hours, you should consult a gastroenterologist. If pain, burning, or loose stools are severe, seek emergency medical attention.

Is it possible to treat hemorrhoids with an enema?

The answer to this question is “definitely not”. Even if you add a decoction of chamomile, potassium permanganate or any other healing agents to Esmarch’s mug, you, unfortunately, will not receive a magical healing enema. Neither hemorrhoids nor constipation can be cured with an enema!

Do not self-medicate, see a proctologist.

Treatment of hemorrhoids at Alan Clinic

• Non-surgical instrumental treatment of hemorrhoids is performed in all medical centers of the Alan Clinic Network.
• All our clinics are equipped with the latest equipment from leading Russian and foreign manufacturers.
• Reception is conducted by proctologists with many years of practical experience in the treatment of hemorrhoids of all stages, types and forms.
• We accept adult patients over 18 years of age for diagnosis and treatment in the following cities: Moscow, Kazan, Izhevsk, Cheboksary.
• Most of our patients get rid of hemorrhoids in just 1 – 3 visits to the proctologist. Therefore, patients from other cities often turn to us.
• We work on the principle of “All Inclusive”. Immediately after the diagnosis is made, the doctor selects the optimal course of treatment. The price is fixed in the contract and does not change in the future, even if the patient needs more procedures or drugs than was originally agreed. The cost of the course of treatment includes absolutely everything necessary for the patient:
  • Local anesthesia;
  • Minimally invasive (bloodless) procedures for the treatment of hemorrhoids;
  • All necessary drugs for use in the clinic and at home;
  • All follow-up examinations and consultations with a proctologist;
  • Analyzes;
  • 24-hour telephone consultations – with the attending physician or clinic consultants;
  • Additional procedures and/or drugs to promote tissue healing;
  • Proctologist follow-up free of charge after completion of treatment.