What are the different types of enemas for diarrhea? How do you properly use an enema at home? What are the potential side effects of enemas? Get all the answers in this detailed guide.

Understanding Enemas for Diarrhea

Enemas are a well-established medical procedure used to treat a variety of gastrointestinal issues, including diarrhea. An enema involves the injection of fluids into the rectum to cleanse the colon or stimulate bowel movements. This process has been utilized for years to address conditions like constipation, fecal incontinence, and the need to prepare the bowel before medical tests or surgeries.

Types of Enemas

There are several different types of enemas that can be used to address diarrhea and other bowel problems:

Cleansing Enemas

Cleansing enemas use water-based solutions to thoroughly flush out the colon. They can be further divided into two subcategories:

• Large Volume Enemas: These enemas use 500-1,000 ml of fluid and are an effective treatment for severe constipation, as they cleanse a large portion of the colon.
• Small Volume Enemas: Utilizing less than 500 ml of fluid, these enemas are designed to clean the lower part of the colon and are recommended for those not suffering from upper colon constipation.

Oil-Retention Enemas

Oil-retention enemas, usually containing 90-120 ml of solution, are used to soften hardened stool. Patients are typically instructed to retain the solution for at least an hour to achieve the desired effect.

Return-Flow Enemas

Also known as a Harris flush, return-flow enemas are administered to individuals experiencing difficulty with bowel movements due to intestinal gas. In this process, large volumes of fluid (100-200 ml increments) are injected and then drawn out along with the gas, repeating until the flatulence is fully cleared.

Cooling Enemas

If a patient’s body temperature is extremely high, a cooling enema may be used to lower their temperature. This is not a common procedure, however.

Rectal Medication Instillation

Enemas can also be utilized to administer medications directly into the colon, helping to relieve intestinal mucosa and balance electrolytes or fight infections.

Preparing and Administering an Enema

Whether you are self-administering an enema or assisting a child, the process follows a similar set of steps:

1. Wash your hands thoroughly before beginning.
2. Gather all necessary supplies, including the enema solution, enema bag, catheter, syringes, towels, and lubricant.
3. Prepare the enema bag by pouring in the prescribed amount of solution, opening the clamp to allow a few drops to flow out, and then re-clamping the tube.
4. Lie on your side or knees with your buttocks elevated, using a pillow for support.
5. Lubricate the catheter and gently insert it 4-5 inches into the rectum.
6. Inflate the balloon on the catheter using the syringe, then slowly pull the catheter back until you feel resistance.
7. Connect the enema bag to the catheter and open the clamp to allow the solution to flow in.
8. Retain the solution for the recommended time, then release and allow the bowels to evacuate.

Enema Solutions and Their Uses

There are several common enema solutions that can be used to address different gastrointestinal issues:

Normal Saline Solution

A mixture of salt and water, normal saline solution helps to soften hardened stool by drawing water into the bowels.

Glycerin

Glycerin is a stimulant that encourages the colon lining to trigger bowel movements.

Castile Soap

A mild, oil-based soap added to saline solution, castile soap enemas also serve to stimulate the bowels.

Coffee

Coffee enemas are used to remove bile from the colon.

Phosphate Solution

Phosphate solutions draw water into the bowel to soften hardened feces, but should be used with caution due to potential health risks from excessive phosphate intake.

Potential Side Effects of Enemas

While enemas are generally considered safe when used properly, there are some potential side effects to be aware of:

• Abdominal cramping or discomfort
• Bloating or gas
• Rectal irritation or burning
• Dehydration from fluid loss
• Electrolyte imbalances
• Infection or perforation of the rectum (rare)

It’s important to follow all instructions carefully and consult a healthcare provider if any concerning symptoms arise.

When to Seek Medical Attention

While enemas can be a helpful tool for managing diarrhea and other bowel issues, there are certain situations when it’s advisable to seek medical guidance:

• Persistent or worsening diarrhea
• Inability to retain the enema solution
• Rectal bleeding or severe abdominal pain
• Underlying medical conditions like kidney disease or heart failure
• Use of certain medications that may interact with enemas

A healthcare provider can properly evaluate your symptoms and determine the most appropriate treatment plan.

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 Rectal: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

This medication may be used to relieve occasional constipation. However, when treating constipation, you should use milder products (such as stool softeners, bulk-forming laxatives) whenever possible. Talk to your doctor or pharmacist about other treatment options. Your doctor may also prescribe this product (usually along with other products) to clean stool from the intestines before surgery or certain bowel procedures (such as colonoscopy, radiography). Use it only as directed by your doctor.Sodium phosphate is a saline laxative that is thought to work by increasing fluid in the small intestine. It usually causes a bowel movement after 1 to 5 minutes.Do not use this medication in children younger than 2 years of age.

How to use Enema Hypertonic Laxatives

This product is for rectal use only. Follow all directions on the product package. If you have any questions, ask your doctor or pharmacist. Since your bowel movements can be very large/watery, drink plenty of clear liquids so that you do not become dehydrated.

Wash your hands before and after using this product. Remove the protective shield from the enema. Lie on your left side with knee bent. Or if you find it more comfortable, you may kneel, then lower your head and chest forward until the left side of your face is resting on a flat surface with your left arm folded comfortably. With steady pressure, gently insert enema tip into the rectum with a slight side-to-side movement, pointing the tip toward the navel. Do not force the enema tip into the rectum because you could hurt yourself. Squeeze the bottle until the recommended amount of the drug is inside the rectum. You do not need to empty the bottle completely because it has more liquid than needed. Remove the bottle tip from the rectum. Stay in position for 1 to 5 minutes until you feel a strong urge to have a bowel movement.

If your doctor has directed you to use this product before surgery or a bowel procedure, your doctor should tell you how long before the surgery/procedure you should use this product. Follow your doctor’s directions closely. After using the medication, drink plenty of clear liquids as directed by your doctor. Doing so will help prevent serious side effects (such as kidney problems, dehydration). Talk with your doctor about types of liquids you can drink before your procedure.

The dosage is based on your age, medical condition, and response to treatment. Do not use more of this medication than directed, use this medication more often than once in 24 hours, or use this medication for more than 3 days unless directed by your doctor. Also, do not use any other laxative products while using this product unless directed by your doctor. Doing so may increase your risk for serious side effects.

This medication may cause a condition known as laxative dependence, especially if you use it regularly for a long time. In such cases, your bowel may stop working normally and you may have ongoing constipation. For most people with occasional constipation, a bulk-forming laxative (such as psyllium) or a stool softener (such as docusate) is a better and safer product. To prevent laxative dependence, consult your doctor if you need to use this medication or other laxative products for more than 7 days.

Tell your doctor right away if the enema tip causes rectal bleeding/pain, if you do not have a bowel movement within 30 minutes of using the product, if you have symptoms of dehydration (see Side Effects section), or if you think you may have a serious medical problem.

Side Effects

Mild abdominal discomfort/cramps or gas may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

If your doctor has directed you to use this product, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this product do not have serious side effects.

Diarrhea that doesn’t stop may result in dehydration. This may cause serious side effects to the kidneys and heart. Contact your doctor promptly if you notice any symptoms of dehydration, such as unusual dry mouth/increased thirst, lack of tears, dizziness/lightheadedness, or pale/wrinkled skin.

Tell your doctor right away if you have any serious side effects, including: stomach/abdominal pain that is severe or doesn’t go away, diarrhea that doesn’t stop, signs of kidney problems (such as change in the amount of urine), bloody stools, rectal bleeding, mental/mood changes (such as confusion, unusual drowsiness), muscle weakness/spasm, swelling of the hands/ankles/feet.

Get medical help right away if you have any very serious side effects, including: slow/irregular/fast heartbeat, seizures.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www. fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using sodium phosphate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: dehydration, high/low levels of certain minerals in the blood (such as potassium, calcium, sodium, phosphate), kidney disease, current stomach/abdominal symptoms (such as nausea/vomiting that doesn’t stop, pain, cramping), bowel problems (such as blockage, ulcerative colitis, hemorrhoids), laxative use for constipation in the past week, heart disease (such as heart failure, irregular heartbeat), liver disease, sodium-restricted diet.

Consult your doctor before using this product if you have had a sudden change in bowel habits lasting more than 2 weeks or if you need to use a laxative daily for more than 1 week. These could be symptoms of a serious medical problem.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Young children may be more sensitive to the side effects of this drug, especially dehydration and kidney problems.

Older adults may be more sensitive to the side effects of this drug, especially dehydration and kidney problems.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: other drugs that may affect the kidneys (including ACE inhibitors such as lisinopril, ARBs such as valsartan, diuretics/”water pills” such as furosemide/hydrochlorothiazide, NSAIDs such as ibuprofen/naproxen).

The watery bowel movements from sodium phosphate may cause your body to absorb less of your regular medicines and get less benefit from them. Consult your doctor or pharmacist about how to reduce this effect.

Does Enema Hypertonic Laxatives interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: muscle weakness, fast/slow/irregular heartbeat, mental/mood changes (such as confusion), change in the amount of urine.

Lab and/or medical tests (such as kidney function, blood mineral levels) may be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

To maintain normal bowel habits, it is important to drink plenty of fluids (four to six 8-ounce glasses daily), eat foods high in fiber, and exercise regularly.

Not applicable.

Refer to storage information printed on the package. If you have any questions about storage, ask your pharmacist. Do not freeze. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

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Enema 19 gram-7 gram/118 mL

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Why is the passion for laxatives and enemas dangerous?

• home
• Interviews with doctors
• Why is the passion for laxatives and enemas dangerous?

Volodchenkova N.D.
Proctology

Why do people use laxatives and enemas on a regular basis? For the purpose of losing weight and as a remedy for chronic constipation. But in some cases, experts evaluate these methods as controversial, and sometimes as detrimental to the health and normal functioning of the intestines. Natalya Dmitrievna Volodchenkova, a practicing proctologist at the Class Clinic Kaliningrad Medical Center, Candidate of Medical Sciences, tells about the harm that excessive use of enemas and laxatives can cause.

What do you think is the reason for the wave of laxatives and enemas, why have these methods become so popular today?
One of the main categories of people who use enemas and laxatives is those who want to lose weight quickly. The second category, also due to an unbalanced diet, suffers from frequent constipation, and in turn, also strive to get rid of them. I emphasize that in both the first and second cases, the root of the problem is nutrition. The popularity of fast food naturally leads to the fact that people begin to get fat, and digestion is disturbed.

What are the consequences of overuse of laxatives and enemas?
It is necessary to understand well that the body is an integral interconnected complex of systems, like a clockwork. If one of the systems fails, it affects all the others. Easy to explain with an example. One of the patients came to me with chronic constipation and said that he did not follow the recommendations of the gastroenterologist, but used enemas and laxatives. I had to explain that the processes taking place “below” begin “from above”. It is necessary to understand very clearly what we eat, for what purpose and how it will affect the digestive tract.

By regularly using enemas and laxatives, the patient is effectively shutting the intestines out of the normal process of digestion and constantly forcing them to use “crutches” in the form of excessive treatments and drugs. Because of this, peristalsis worsens, since the body, with such “help”, does not see the point in moving the intestinal walls on its own. As a result, this leads to persistent intestinal atony, i.e. to weak peristalsis, which directly depends on the intake of laxatives and enemas. This is directly related to the “memory” of muscle cells and the formation of a kind of conditioned reflex. As a result, the intestines practically lose their ability to empty themselves without the help of enemas and laxatives.

Is this some kind of addiction?
Quite right, but physiologically conditioned dependence. With regard to laxatives, we can also talk about addiction, i.e. about the persistent need for them when the possibility of normal defecation is lost. Moreover, many patients themselves note the effect of addiction and regard their “hobby” as an addiction.

If we talk about constipation, we can say with confidence that despite the symptomatic effect, the problem, in most cases, is aggravated, and enemas and laxatives become a constant necessity.

Do people who try to lose weight in this way get addicted?
In situations with weight loss, even if severe cases of psychogenic anorexia are not taken into account, the same signs of dependence can be traced. Without correction of eating behavior and lifestyle, a person begins to get fat again and resorts to the well-known recipe “laxatives + enemas”, bringing the intestines to a state of persistent atony, in which these drugs and procedures become permanent.

Do these products help to lose weight for a long time with a normal diet?
Only for a short time and without warranty. Losing weight, as a rule, combine a diet with enemas and laxatives. As a result, as a reaction to a debilitating diet and undermining digestion with laxatives, the body turns on compensatory mechanisms, one of which is a constant feeling of hunger. At the same time, digestive substances are constantly produced that process food almost completely in order to get the most out of it, which even with small portions does not allow weight loss.

The excess that comes from food is stored as fat, as the body uses it as a response to hunger. And such an organism regularly encounters hunger and, accordingly, seeks to store as much fat as possible. In addition, a person is not satiated, but with this approach, he sooner or later starts, which actually leads to the fact that body weight becomes the same, and in some cases increases.

What other negative effects can there be from the constant use of enemas and laxatives?
A detrimental effect on the microflora, not only harmful, but also beneficial, necessary for normal digestion. Beneficial microorganisms are mechanically washed out of the intestines, including the very bifidobacteria that we get with fermented milk products.

Moreover, when pathogenic bacteria, which are normally found in small quantities in our intestines, are destroyed, a serious blow is dealt to the immune system. Such “sterilization” of the intestine leads to rapid fatigue, reduces efficiency.

In addition to the problems already described, hemorrhoids can often occur from such regular “treatment” and “recovery”, and if it has already been, the process goes to the next stage. Irritable bowel syndrome can occur, with a huge number of unpleasant manifestations – from discomfort and bloating to cramping pain, diarrhea and constipation.
Regular use of enemas and laxatives is not effective in the long term for either constipation or excess weight. On the contrary, the use of these methods of “cleansing the body” on an ongoing basis is fraught with intestinal atony, addiction, decreased immunity, loss of strength, as well as weight gain and aggravation of constipation.

Make an appointment with Natalya Dmitrievna Volodchenkova on the website or by phone (4012) 33-44-55.

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Treatment of antibiotic-associated diarrhea | Haleon HealthPartner

Principles of treatment of AAD

Treatment of AAD depends on the severity of the disease. For the treatment of mild cases of ADD, both caused by C. difficile and other etiologies, it is necessary to cancel antibiotic therapy, prescribe probiotics, and adjust the diet.

Peculiarities of treatment of AAD of different disease severity

Severe AAD caused by C. difficile requires specific antibiotic therapy ¹ :

First line therapy for AAD

First line therapy is stopping antibiotics and maintaining adequate hydration.

• The first line of treatment for mild to moderate infection is oral metronidazole. Patients with severe and refractory C. difficile infection are given oral vancomycin. Rectal vancomycin may be used in severe cases.
• Colonoscopy and colectomy may be considered in patients with severe refractory C. difficile infection.
• Hospitalization should be considered for patients with severe C. difficile infection defined by the presence of fever, leukocyte count greater than 15,000 cells/mm ³ , albumin less than 3 g/dl, creatinine 1.5 times higher than before infection, and with symptoms of dehydration.
• Avoid use of loperamide if C. difficile infection is suspected.
• ^{The effectiveness of fecal transplantation in restoring normal microbiota is under investigation 2 .}

Probiotics are used for at least 3 months to prevent recurrence of C. difficile disease after completion of treatment with metronidazole or vancomycin ³ .