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How to Use an Enema for Clearing the Bowel

An enema is the introduction of liquid, most often mineral oil, through the anus and into the large intestine. An enema may be given to treat constipation, to administer medication or barium, or as part of the procedure to empty the contents of the bowel before a test (such as​ a colonoscopy prep).

Enemas may also sometimes be given before surgery on the abdomen or during labor at the end of pregnancy, but this is no longer common.

Vladimir Sukhachev / Getty Images

Using homemade enemas are not recommended, nor is using an enema containing liquids or substances other than what is recommended by a physician. There is no evidence that using an enema for “detoxing” or for reasons other than cleaning the bowel before a test or procedure or for removing impacted stool has any health benefits.

There could be harm in using enemas too often, or in using enemas with substances that may disrupt the balance of the beneficial bacteria found in the large intestine.

How Are Enemas Used?

An enema is both a verb and a noun: it refers to the actual device and the act of using it.

An enema that one buys in the pharmacy has a nozzle on the end of a small bag. The bag is filled with the liquid that’s to be injected into the body. The nozzle is inserted into the anus and the bag is squeezed, sending the liquid out of the nozzle and into the last part of the colon (the rectum). 

The liquid is usually held in the rectum for some specified amount of time. It could just be held until the urge to move the bowels comes on. In some cases, it might be suggested that the enema is held inside the body for a few minutes or longer.

When it’s time, the enema and the waste material that is in the rectum is released by sitting on the toilet and moving the bowels like normal.

Liquids Used In Enemas

In some cases, the liquid used in an enema is just salt water, and in other, it contains a laxative. Check with your doctor if you are unsure as to which type of enema is recommended for you. Here are some common types of enema liquids:

  • Bisacodyl: Bisacodyl is a laxative that is frequently used in enemas, especially in those that are used in preparation for a procedure such as a colonoscopy.
  • Mineral oil: Mineral oil is both a lubricant and a laxative, which makes it especially useful in enemas that are used to treat constipation, when the anus is sore, or if there are hemorrhoids.
  • Saline solution: In cases of constipation, a saltwater enema might be recommended. Mixing your own enema solution using tap water is not recommended.


In the treatment of some types of conditions, including inflammatory bowel disease (IBD), medication might be given with an enema. Rowasa (a 5-aminosalicylic drug), used to treat ulcerative colitis, is given this way.

This is usually to treat inflammation that is found in the last section of the colon, where the enema liquid will reach, but that might not be the case in all uses. It’s usually recommended that these enemas are used at night, and that instead of releasing the bowels, that the enema is held in all night, to give the medication time to work.

Other Substances

There are practitioners who offer enemas with other substances in them (coffee, lemon juice, milk), which are claimed to offer some health benefits. Use of these types of enemas without the supervision of a physician is not approved or recommended to treat any condition.

People with IBD should be especially wary of these types of enemas. There is the potential to introduce harmful materials into the body with the use of a nonmedical enema. In addition, the colon contains various forms of beneficial bacteria, and the use of an enema may disrupt the bacterial flora and cause harm.

A Word From Verywell

Enemas are not harmless and should be used only on the advice of a physician. Using enemas on a regular basis can have an effect on the muscles in the colon. In time, the muscles will stop working properly to move stool along, which worsens the problems with constipation.

Uses, Benefits, Risks & Procedure Details

An enema may be helpful when there is a problem forming or passing stool. The colon, also called the large intestine or large bowel, is a long, hollow organ in your abdomen. It plays an important role in digestion by removing water from digested material and forming feces (stool).

In some circumstances, due to diet, medical condition, or medication, among other possible causes, your bowel may form stool that is hard to pass easily resulting in constipation. For example, if food moves too slowly through your digestive system, the colon absorbs too much water resulting in dry stool and constipation.

Constipation is when you experience fewer bowel movements than what is normal for you. You may also strain to have a bowel movement. There is no strict definition, but you may be constipated if you have fewer than three bowel movements per week.

Your doctor may recommend a therapeutic enema to treat diseases and conditions of the colon or rectum including:

  • Constipation: hard, dry, infrequent stools that are difficult to pass
  • Excessive gas: belching, bloating, distended abdomen
  • Ulcerative colitis: inflammation and bleeding in the colon. Your doctor may order an enema that contains corticosteroids dissolved in water. Corticosteroids reduce inflammation. Doctors also prescribe enemas containing the anti-inflammatory drugs mesalamine or 5-aminosalicylic acid (5-ASA). These are known as topical therapies for colitis.

Your doctor may also order an enema before medical procedures. This type of enema (cleansing enema) makes it easier to examine your colon during certain tests, such as colonoscopy. A cleansing enema can also lower the amount of bacteria in your colon and reduce the risk of infection for certain surgeries.

Alternative reasons people perform enemas, which may not be based on scientific evidence, include:

  • Cleansing the body of toxins
  • Removing toxins from the colon
  • Improving immune system function

If you are interested in an alternative cleansing enema, first check with your primary care provider for possible harm associated with performing a self-enema, with the ingredients (such as coffee, essential oils, or herbal extracts) in the cleansing enema, or the volume of the enema (some involve very large quantities of enema solution).

How long does it take an enema to work?|Express Medical Supply


What is an enema?

An enema is a liquid laxative that is administered rectally. Enemas cannot be taken by mouth or in any other way. Enemas are never to be taken orally. The medical purpose for the enema is that it relieves constipation. You can also use an enema prior to medical procedures or examinations. Your doctor will prescribe you an enema if it is needed for the medical exam. Enemas are administrated rectally by introducing the laxative liquid into the rectum instead of the digestive system which means it won’t upset your digestive system. When you begin using enemas it is a good idea to discuss it with your doctor. Your doctor can tell you how many days in a row they would like you to use an enema and what guidelines to follow. Fleet enemas are meant to be used once and then discarded. They are not to be reused. Using more than one enema in a 24-hour period can be harmful.





How long does it take an enema to work?

There are different brands of enemas, but a Fleet enema generally starts to work within five minutes. However, every person is different so do not be surprised if the time is shorter or longer. If you have taken a saline laxative and it has not worked in 30 minutes, then you should call your doctor because you may become dehydrated.

What to do if an enema doesn’t work?

No bowel movement after an enema? Then you should contact your doctor if it has been 30 minutes and you have not been able to move your bowels. There could be a problem and your doctor will want to make sure you are not in danger of becoming dehydrated. They will also want to check and make sure that you do not have some kind of bowel impaction that is preventing the enema from working. Do not take another enema, call your doctor.

How long do you poop after a fleet enema?

This is a question we get a lot and one that people are rather embarrassed to ask, they shouldn’t be! It is normal to want to know what to expect when you are using something like an enema for the first time. You will probably not have to call off work or dedicate an entire day to using an enema. It does vary person to person though. The first time you use a Fleet enema I would recommend giving yourself a longer period from start to finish. General guides say that it will start to work between 5 and 10 minutes and bowel evacuation will last between 30 and 60 minutes. However, remember, your body is not a clock. Some people use an enema and it is fast acting and it is one trip to the toilet and they are done. This isn’t everyone though. Be patient and communicate how it works for you with your doctor. They will be able to monitor it with you to make sure you are using enemas in a healthy way that works for you specifically. You should stay close to a toilet while using an enema until you are comfortable with how it works for you.

How long should you hold the liquid laxative in before you use the bathroom?

In general, the Fleet enema should be held in for at least two minutes. If two minutes have not passed you will want to resist the urge to go until it has because this will give the medicine time to work and will make the bowel evacuation work more effectively. You need to give the active ingredients the time they need to work.

How does an enema work? Saline enemas increase water in the intestine which promotes a bowel movement. The saline draws water into the colon which helps to decrease muscle spasms or pain while promoting a bowel movement. A bisacodyl enema is a stimulant enema and promotes a bowel movement by directly acting on the intestine and causes a rhythmic action which pushes the feces through the bowels. Both styles relieve constipation. Talk to your doctor about which one they would prefer you to use. There are also suppositories that can help with constipation. A popular brand is Magic Bullets and they can be purchased by the pack of ten or the box of one hundred. If you would like more information about Magic Bullets see our blog titled, Magic Bullet Suppository and Your Bowel Program.



Enema for constipation or an enema for a doctor’s exam can be done safely and effectively. An enema should relieve you of your constipation and help you to feel more comfortable. If you are frequently constipated, you will again want to talk to your doctor about it and see what they can do for you. Constipation can be a symptom of other problems and your doctor can help you figure out why you are having problems. If you are using an enema for a medical examination and need to know when to use the enema or how long the enema lasts you can ask your doctor if they would like you to perform the enema in the morning the day of the exam or the night before. Give yourself space and time so you can be comfortable. Using an enema doesn’t have to be weird or scary, it is a normal medical procedure that can help you feel better if you are suffering with constipation. Don’t be embarrassed to ask questions about your body or your health. You are your best advocate! 

Enemas at Home | Children’s Hospital Colorado

Enemas are sometimes a necessary daily treatment for children with colorectal conditions such as anorectal malformations, constipation and encopresis. The experts at the International Center for Colorectal and Urogenital Care may recommend daily enemas for your child at home during a short amount of time to clear impacted stool from the bowel or for the daily treatment of fecal incontinence. If at-home enemas are a good option for your child, your child’s care team will show you how to properly give your child enemas.

Watch this video to learn more about how to give your child an enema at home.

Ingredients to use for a home enema solution

We prefer normal saline enemas, which can be mixed at home. The doctor will give you specific guidelines for your child’s enema. Sometimes it is necessary to add glycerin, castile soap or phosphate to the enema solution to produce a satisfactory bowel movement.

Recipe to make normal saline enema:

  1. Dissolve 1 teaspoon of table salt in 1 liter (1000 cc or ml) of water to make the correct concentration of saline.
  2. Take the recommended amount of saline prescribed by your doctor and mix in the recommended ingredients.
  3. You will deliver the enema through a soft silicon tube (known as a Foley catheter), which you can easily insert into your child’s rectum. This tube is approximately 4 inches long.
  4. Your child’s doctor will tell you how much fluid to deliver when you give the enema to your child as well as the amount of any other ingredient needed.

How to give a child an enema

To deliver an enema, place your child on their side or stomach with their knees pulled up under their chest with their bottom in the air. These two positions are most effective for giving enemas because they allow the fluid to be instilled easily into the colon by taking advantage of gravity.

Once you insert the catheter, inflate the balloon at the end of the catheter. Use 20 to 25 cc (ml) of water to inflate the balloon once the catheter is in the rectum. This forms a “plug” and prevents the enema fluid from leaking out of your child’s bottom. Once you have given the fluid, your child should remain in the “enema position” for five to ten minutes. This can be difficult for young child but keeping the child in this position will help to keep the interaction between the fluid and stool as long as possible. Use a timer so the enema’s retention time is constant every day.

After five to ten minutes of enema retention, have your child sit on the toilet for about 45 minutes to allow the bowel to empty completely. This experience can be made more pleasant by having books, art supplies or videos available. If your child is in diapers, you can simply put a diaper on your child and wait for the recommended 45 minutes.

When to give a child an enema

Enemas should be given at about the same time each day when used for fecal incontinence treatment. This will help your child stay free of stool accidents.

Things to watch out for when giving an enema

  • It is important that your child is hydrated before they receive an enema. Being hydrated means your child has had the amount of liquids recommended by their doctor.
  • Infusing the solution too fast may cause dizziness.
  • If your child has not had a bowel movement after one hour of the enema infusion, you can reinsert the Foley catheter to drain the enema fluid. Let your doctor know your child did not have a bowel movement after one hour.
  • If an enema has been working and suddenly your child starts to have stool accidents, please tell your child’s doctor because the bowel management may need to be adjusted.

How to schedule an enema training

Every month we dedicate one week for bowel management to determine the amount of laxatives that your child may need to empty their colon on a daily basis. We also determine the specific enema that you should give to a child with fecal incontinence once a day to help keep them clean.

Call our office at 720-777-9880 to find out when the next sessions are scheduled to happen.

How to administer an enema

An enema is the administration of a substance in liquid form into the rectum. This may be performed to aid bowel evacuation or to administer medicines.

This article has been updated

The evidence in this article is no longer current. Click here to see an updated and expanded article


VOL: 102, ISSUE: 20, PAGE NO: 24

Dan Higgins, RGN, ENB 998, is senior charge nurse, critical care, University Hospital Birmingham

An enema is the administration of a substance in liquid form into the rectum. This may be performed to aid bowel evacuation or to administer medicines.

The administration of an enema not only requires skill and competence on behalf of the practitioner but also requires compliance with the NMC (2004) guidelines on the administration of medicines and local drug administration policy.

Enemas for bowel evacuation

There are two different types of enema for bowel evacuation, although they are very similar. Some enemas are given to produce an immediate effect, which is to lubricate, thus facilitating the passage of faeces. The administration of a fluid into the rectum may also induce peristaltic contraction of the rectal walls.

Retention enemas, while producing the same effects, are intended to remain in the rectum for a longer period of time penetrating and thus lubricating the faeces further. Retention enemas tend to be oil based.

Enemas as a method of drug administration

Medicines can be administered rectally in enema form. This may be carried out for local effect, such as steroids and agents that reduce inflammation in the colonic mucosa. In addition, drugs may be absorbed for systemic effect by the vascular network surrounding the rectum.

Contraindications/risks of administering enemas

The administration of enemas should be avoided in patients following colonic surgery or patients with injury or obstruction, as the risk of perforation may be increased. This risk may also be raised in patients who have undergone gynaecological surgery or radiotherapy.

Enemas should also be avoided in cases of paralytic ileus as the peristaltic movement of the colon is lost. Absorption of enema fluid/solutes may occur and this must be considered in all patients.

Small-volume concentrated enemas may be contraindicated in cases of ulcerative and inflammatory conditions.

The risks associated with enema administration are considered to be low but can be detrimental and in some cases may be fatal. Expert advice should be sought from specialist practitioners in any of the circumstances stated above.

The procedure

Warming the enema solution to body temperature may be beneficial as heat stimulates the rectal mucosa. Dougherty and Lister (2004) recommend a solution temperature of 40.5-43.3 degsC for non-oil-based enemas. Cold solutions should be avoided as they may cause cramping.

Advising the patient to empty her or his bladder before the procedure may reduce the feeling of discomfort (Dougherty and Lister, 2004).

The equipment required to perform an enema is as follows:

  • Gloves and disposable apron;
  • Incontinence pads;
  • Lubricating solution;
  • Jug with water, warmed to the desired temperature;
  • Water thermometer;
  • Bedpan/commode;
  • Prepared solution.

The procedure is as follows:

  • Obtain informed consent, identifying allergies and any contraindications.
  • Provide the patient with reassurance.
  • Assess patient privacy and dignity and take steps to maximise both.
  • Ascertain prescription details if required.
  • Wash hands and don plastic apron.
  • Check the enema for expiry and intactness. Warm the solution to desired temperature (Fig 1).
  • Position the patient on left side, lying with the knees drawn to the abdomen (Fig 2). This eases the passage and flow of fluid into the rectum. Gravity and the anatomical structure of the sigmoid colon also suggest that this will aid enema distribution and retention.
  • Position an ‘incontinence’ sheet underneath the patient.
  • Assess the area and perform a digital rectal examination if this has not already been carried out.
  • Break the enema seal. Lubricate the nozzle. Air should be expelled.
  • Gently separate the buttocks, identifying the anus. Insert the lubricated nozzle into the rectum slowly to a depth of approximately 10cm (in adults) (Fig 3).
  • Gently expel the contents into the rectum, rolling the container from the bottom up to reduce backflow.
  • Keeping the container rolled/compressed withdraw the container (Fig 4). Attend to peri-anal hygiene.
  • Ask the patient to retain the enema for as long as required or suggested in the manufacturer’s recommendations, providing a commode or nurse-call system as indicated (Fig 5).
  • Dispose of any waste, remove apron, wash hands.
  • Document the procedure accurately, completing drug record if required (Fig 6).
  • Ensure effect is noted and documented accurately.


Professional responsibilities

All nurses who carry out clinical procedures must have received approved training, undertaken supervised practice and demonstrated competence in the clinical area. The onus is also on the individual to ensure that knowledge and skills are maintained from both a theoretical and a practical perspective. Nurses should also undertake this role in accordance with an organisation’s protocols, policies and guidelines.

Mini Enema Product: Definition, Type, Comparison

Mini Enema Explained

Constipation is the most common gastrointestinal complaint in primary, acute, and long-term care settings in the United States. An estimated 42 million individuals in the United States have bowel issues or constipation. And an estimated 1 million have incontinence.

For people with conditions that can require a regular bowel care program, such as spinal cord injury, Spina Bifida, and Traumatic Brain Injury. A systematic approach to bowel management is recommended to prevent further health complications and maximize quality of life. With these conditions, and others, the product used for regular bowel care must work quickly, effectively, and with little to no side effects.

There are a lot of different products available, and knowing which one is right can be confusing. Which product works best for your particular situation? What are the potential risks and side effects of each one? In this article we summarize the different types of enemas available, how they work, the pros and cons of each one, and this can help you decide which product is right for you. It’s important to note that you should always consult a physician before using any constipation medication.

About Enemas

While most people have a general idea of what an enema is, there are widespread misunderstandings about the different types of enemas and how they work. Enemas are used to relieve constipation that occurs when a person has infrequent bowel movements or difficulty emptying the bowels fully. When used regularly, the best time to do an enema is right before your normal bowel movement. Or right after having a bowel movement depending on why you are using the enema.

For people who are unable to have bowel movements due to illness or injury, there is more at stake. In these cases it is essential to have a product that fully evacuates the bowel, is easy to use on a daily basis, is fast-acting so bowel care doesn’t impede independence, and doesn’t cause potentially harmful side effects.

Most commonly, enemas are used to relieve constipation and impacted stool. For people with bowel dysfunction, enemas help treat fecal incontinence as well as constipation. Each enema works differently in the body, and treats different conditions. Some are better for short term use and/or medical procedures, while others are designed for ongoing bowel care and management.

Things to Consider When Using Enema Products

It’s important to understand the side-effects of enema products, especially for regular use. Many enema products can cause bowel irritation, systemic health problems, skin irritation and breakdown, afterburn, and/or gastrointestinal distress.

Mini-Enemas vs. Full-Sized Enemas

 Mini-Enemas: A “mini-enema” uses only a few drops of liquid stool softener. Not irritating to the bowel, and will not cause AD or afterburn. A mini-enema is ideal for regular use.

Enemeez® Mini-Enema: is a 5 cc mini enema containing an osmotic laxative called docusate sodium. Mini-Enemas Enemeez® allow quick absorption, typically work within 2-15 minutes, and help establish a more predictable bowel routine. Enemeez®Mini-Enemas come in a single use tube that contains docusate sodium and a medicinal soft soap base of polyethylene glycol and glycerine.

The active ingredient, docusate sodium, works by drawing water into the bowel from surrounding tissues and mixing with the stool to create watery bowel movements. The increased mass of stool stimulates the nerve endings in the rectum to promote bowel evacuation. Enemeez® mini-enemas are the only product on the market for daily use bowel care management.

Enemeez®Plus Mini-Enema: works the same way as Enemeez®Mini-Enema, and has the addition of 20 mg of Benzocaine. Which is non irritating for patients who experience pain with enema use. Or patients who suffer from autonomic dysreflexia with bowel movements. It is ideal for patients with spinal cord injuries or those suffering from cerebral vascular injuries. It also reduces pain for people with hemorrhoids.

Enemeez® mini-enema products have shown to be effective for bowel care needs associated with spinal cord injury, or disease and general constipation. Enemeez® products are designed for ease of use for users and caregivers, and are a trusted and preferred choice because they effectively remove bowel obstructions with a small amount of solution. They are also preferred because of their smooth applicator tip that prevents irritation and is easy to use.

Mini-Enemas and Skin Integrity

With regular use of any enema product it’s important to consider skin integrity to avoid skin breakdown that can lead to other harmful (and painful) conditions. Enemeez®mini-enemas are non-irritating to the skin and keep skin healthy even with regular use.

Types of Enemas

  • Full-Size Enemas: Any full-size enema (such as soap suds or tap water) can irritate the bowel and can potentially cause autonomic dysreflexia (AD), which is a condition in which your involuntary nervous system overreacts to external or bodily stimuli. AD can cause a dangerous spike in blood pressure and changes in your body’s autonomic functions. Occasionally, a health care provider may prescribe a full-size enema in preparation for a medical procedure or for treatment of severe constipation.
  • Saline Solution Enemas: provide a soft stool mass and increased bowel action that leads to a bowel movement. For minor constipation, just water or saline solution can be enough to get relief. It is often employed as a one-time use to cleanse the bowel before a rectal exam. Side effects include mild abdominal discomfort, cramps, gas, and dehydration and as such are not recommended for regular use.
  • Mineral Oil Enemas: lubricates and coats the stool to prevent water from being absorbed out of the stool, softening the stool and making it easier to pass. Mineral oil enemas work well for people who need to avoid straining after surgery or giving birth, but is not considered ideal for regular use. More common side effects of mineral oil enemas include bloating, gas, mild diarrhea, and stomach cramps. These side effects do not make it effective for regular use.
  • Bisacodyl Enemas: uses the laxative bisacodyl to stimulate bowel movements, can irritate the bowel, and should only be considered for short-term use. The side effects of bisacodyl enemas include rectal irritation/burning/itching, mild abdominal discomfort, cramps, and/or nausea.
  • Bisacodyl Enemas and Skin Integrity: due to the common side effects caused by bisacodyl enemas (both internally and externally) they are not recommended for regular use as they can cause skin irritation/breakdown.

Which Enema Product is Right for You?

Before making any decision about how to treat constipation, it’s important to consult with a physician to decide which product is right for you. Deciding which product to choose depends primarily on whether it is intended for short-term or regular use. The side effects of many constipation medications make them less than ideal for regular use. So it’s important to determine what your specific needs are before using any constipation medication.



Disclaimer: The material contained is for reference purposes only. Alliance Labs, LLC and Summit Pharmaceuticals do not assume responsibility for patient care. Consult a physician prior to use. Copyright 2020 Summit Pharmaceuticals and Alliance Labs, LLC.




The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon resulting in intravascular volume depletion. Second, these preparations can cause electrolyte disturbances including significant hyperphosphatemia, hypocalcemia, and hypokalemia.  A significant clinically important rise in serum phosphate can even be seen in elderly patients with normal renal function. (J Gastroenterol Hepatol. 2004;19(1):68). Lastly, phosphate nephropathy may occur due to the transient and potentially severe increase in serum phosphate combined with volume depletion from the fluid shifts.

Why the Same Holds True for Sodium Phosphate Enemas (aka Fleet enemas)

A fleet enema works as a hyper-osmotic laxative that draws in water into the gastrointestinal tract.  In healthy younger adults, this action shouldn’t pose a problem as the laxative action from a fleet enema occurs relatively quickly, so there is little absorption of phosphate.

However, what if your patient isn’t a health young adult?  What if they are older, frailer, and taking multiple medications, including some that may slow their bowels down like opioids or those with anticholinergics properties?  A recent publication by Yaacov Ori and colleagues titled “Fatalities and Severe Metabolic Disorders Associated With the Use of Sodium Phosphate Enemas” gives some evidence that great caution is warranted when prescribing Fleet enemas in this population.

Yaacov Ori and colleauges conducted a retrospective case series of 11 elderly patients (mean age of 80) at the Rabin Medical Center in Israel. Ten of these patients received Fleet enemas for relief of constipation and one received it as a proctoscopy prep. Three of these patients received 500-800 mL of sodium phosphate and 8 patients received approximately 250mL (for a comparison, a typical over-the-counter Fleet enema comes in either a 118 and 197 ml dose). Baseline renal function was normal (eGFR by MDRD of 60mL/min) in 4 patients with a range of 25 to 57 mL/min in the other seven.

What they found was that renal function deteriorated in all 11 patients. Hypotension and extreme hyperphosphatemia was prominent in 8 of these patients. The serum calcium level was dangerously low in 8 patients. Five patients died. An autopsy on one patient revealed calcium phosphate calcifications within the renal tubular lumens.

The Take Home Point – Just Don’t Use It

There are some medications that despite years of use should be clearly abandoned in older individuals or those with advanced illness (i.e. the GeriPal population). Colace is an excellent example of a medication that offers little benefit but also little harm in younger, healthier populations. However, in patients that are frail, hospitalized, or approaching the end of life, the risks begin to significantly outweigh any possible benefit.

Fleet enemas should also be relegated to this list of medications that should generally be avoided unless your patient is a very robust older adult.  We should also teach others that if you do happen to order a Fleet enema for a hospitalized or nursing home patient, you should never give a second dose in succession if the first trial fails.   Lastly, we should educate patients and their caregivers that medications, like the pictured Fleet product with “70% more volume,” should not be considered safe just because it can be found in the over-the-counter aisle.

by: Eric Widera (follow on twitter at @ewidera)

How to do an enema correctly: detailed instructions

What is an enema

An enema is called a procedure, during which liquid is injected into the rectum. This contributes to the fact that the intestines are emptied – together with the water, feces come out of it.

Photo: YAYImages / Depositphotos

This manipulation is performed using a container attached to a flexible tube or nozzle – this device is also called an enema. The container (most often rubber) is filled with liquid, which is then gradually introduced into the rectum through the anus using a nozzle.

An enema is required before certain medical examinations such as colonoscopy or rectal medication. But doing it without evidence is dangerous: sometimes it can lead to serious health problems.

Who should not do an enema and when

Enema is a fairly popular procedure. And often it is used excessively – in the hope of an effect that it will not give.

A striking example is attempts to “cleanse” the body with the help of an enema. The bad news is that there is no scientific evidence that this detoxification works.The rectum and large intestine, of which it is a part, perfectly self-cleanse naturally. Another example is the tradition of giving an enema to pregnant women entering childbirth. WHO no longer recommends this procedure, as it is not beneficial and causes discomfort for the woman in labor.

In some cases, an enema is not only not recommended – it is even dangerous. Here’s who can’t do it :

  • People suffering from chronic constipation. If this condition is rare, the use of an enema is warranted.With the help of liquid injected into the anus, you can actually soften the stool and help it leave the intestines. But an enema should never be used with regular constipation. Firstly, for the reason that frequent constipation can indicate a serious illness and this problem should be addressed to a therapist, and not masked by washing the rectum. Secondly, the body can get used to the fact that no effort is required to empty the intestines. As a result, the muscles will begin to weaken and pretty soon you will find that you can no longer perform a bowel movement on your own, without the help of an enema.
  • Those with a weakened immune system. People with impaired immunity caused by diseases such as AIDS or leukemia should not be given an enema due to the risk of introducing pathogenic bacteria into the intestines. The immune system may not be able to cope with the bacterial attack.
  • People with hemorrhoids or rectal prolapse. Enema is contraindicated in this case due to the high risk of accidentally damaging the intestinal mucosa.
  • Those who have had colon surgery or have ever been diagnosed with intestinal obstruction. This means that the intestinal wall may become thinner. Under the influence of the liquid injected with an enema, they can break through.

How to prepare for an enema and make it

For people who have no contraindications, an enema is safe. To cleanse the rectum as efficiently as possible, it must be carried out according to certain rules. Here is what the experts from King’s College London Hospital recommend.

1. Refuse food at least half an hour before the procedure

This is necessary so that excess feces do not accumulate in the intestines.

2. Make sure you have enough time

The emptying effect of an enema can last for about an hour. It is important that during this time you have the opportunity to go to the toilet.

3. Prepare a comfortable place for the procedure

Best of all – on the bathroom floor, so that you can quickly get to the toilet or basin if necessary. Place a soft towel on which you can lie down. Place a couple more towels or a bundle of napkins nearby.

4.Carefully read the instructions for your set

Enema is a simple procedure, so the instructions for the sets from different manufacturers are often almost identical. But there are some nuances. For example, it should be indicated how much water to use. Never exceed the recommended volume.

Also, the instructions will indicate to what height the container must be raised in order to provide the required water pressure.

5. Prepare warm drinking water

It’s a matter of comfort.If the water is too cold or, on the contrary, hot, the procedure can become unpleasant, if not dangerous. Pour liquid into the enema.

6. Wash your hands thoroughly

With warm water and soap. Lather your palms for at least 20 seconds. Then dry it.

7. Remove clothing from the lower body

This is necessary to avoid staining it.

8. Lie on a prepared towel

Sit on your left side if you are right-handed, or on your right if you are left-handed. This will make it easier for you to complete the procedure.

9. Bend your upper leg at the knee

Try to bring your knee to your chest. To keep your foot off the ground, place a rolled-up towel under it.

10. Remove the cap from the enema tip and lubricate if necessary

Quality kits have already lubricated the tip with lubricant. If it is not enough or not at all, apply additional lubricant. It can be petroleum jelly or an intimate lubricant gel.

11. Insert the tip of the nozzle into the anus

Insert to a depth of about 7 cm.Do this as carefully as possible. If the nozzle bumps into an obstacle (for example, hard feces), pull it back 1–1.5 cm.

12. Slowly inject the contents of the enema into the intestine

) or by squeezing the container with your hand. Once the liquid runs out, remove the tip from the anus and cover it with a tissue or towel.

13. Wait for the enema to work

Try to keep the fluid in the intestines as long as possible – at least a few minutes.When the urge to defecate becomes unbearable, go to the toilet to empty yourself.

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Micro enema MICROLAX® – remedy for constipation!

MICROLAX ® is a laxative in micro enema with a high safety profile. Each micro enema contains 5 ml of the drug, which is a thick liquid. Acts quickly and gently.The effect occurs in 5-20 minutes 1 .


Constipation is an urgent problem for all categories of the population. Therefore, the search for a safe solution to the problem of constipation in adults and children remains always relevant. MICROLAX ® is the optimal start of therapy for each episode of stool retention, including chronic constipation.

MICROLAX ® helps relieve constipation in people suffering from this ailment who find that constipation affects many aspects of their life, including the quality of life, work, as well as social and private spheres.MICROLAX ® , recommended for constipation for all age groups

Advantages of the drug

MICROLAX ® is a remedy for constipation in adults and children with a high safety profile, presented in the form of single use micro enema. Its main advantages are hygiene, speed and ease of use.

Hygiene. Micro enema contains the required dose of laxative, which is administered once.Unlike usual enemas, microclysters for constipation MICROLAX ®

do not need preliminary antiseptic treatment and are completely ready for use.

Action time . Micro enema MIKROLAX ® takes effect in 5–20 minutes 2 : the laxative softens dense stool, facilitating their excretion and promoting gentle bowel movement.

Security Profile. Being a fast-acting laxative of local action, MICROLAX ® acts directly on dense feces accumulated in the rectum, and does not affect the organs of the digestive system located above.The laxative is suitable for children from the first days of life. It is also allowed to use microclysters during pregnancy (in all trimesters) and during breastfeeding.

Convenience . When using this remedy for constipation, there is no need to select an individual dosage: the tube contains the amount of the drug that is optimal for the laxative effect (5 ml). Micro enema is a container with a flexible applicator tip, the edges of which are rounded. This allows the laxative to be administered safely.Adults need to insert the tip to its full length, children halfway. For the convenience of setting the MICROLAX ® enema to children under 3 years of age, the applicator is marked with a mark corresponding to the required depth of insertion into the rectum.

How does MICROLAX ® work?

How does the MICROLAX ® laxative work? Mikrolax drug with a high safety profile affects the feces that create a “congestion” in the rectum, without penetrating into other parts of the gastrointestinal tract.After the introduction of the drug, a complex of active substances of the drug (sodium citrate, sodium lauryl sulfoacetate and sorbitol solution) helps to soften dense feces, have a laxative effect and gently eliminate constipation.

1 According to the instructions for use of the drug Mikrolax ® , the active ingredient – sodium citrate – displaces bound water, which is contained in the feces. The process of displacing bound water by chemical and mechanical means is called peptization.An increase in the amount of water due to peptization and liquefaction helps soften stool and facilitates bowel emptying

2 INSTRUCTIONS for the use of the medical drug MICROLAX ® (MICROLAX ® )

Advertising of the drug. Before use, you must read the instructions and consult a doctor. RU No. UA / 15636/01/01 dated 01.12.2016, order of the Ministry of Healthcare No. 1299

Coloproctology Department – Medical Center (proctologist)

Main complaints

    • diarrhea, constipation, false urge to stool
    • Pain in the anus, pain with stool or after it;
    • Lump formation, swelling around the anus, mucous discharge, redness, swelling, itching in the anus or anus;
    • traces of blood on toilet paper the appearance of traces of blood on the stool, scarlet blood from the anus either after stool or on paper, or very dark, discharge of fecal pus through fistulas;
    • foreign body feeling in the anus; exit of the hemorrhoid outside after defecation, the presence of “bumps”

How to prepare for an appointment with a proctologist?

If the patient has acute pain in the anus, an increase in body temperature, then it is impossible to prepare , just sign up urgently and come to an appointment with a proctologist.Routinely to shorten doctor visits, especially if a nonresident patient is needed:

  1. Remove vegetables, fruits, black bread from the diet per day, switch to cheese, eggs, cottage cheese, chicken, fish.
  2. The night before, make two cleansing enemas with ordinary raw tap water at room temperature and in the morning of the study day, two cleansing enemas.
  3. No enemas should be done before the doctor’s appointment.
  4. Before administering the enema, grease the tip with any fat (vegetable oil, petroleum jelly, liquid paraffin).
  5. Control the volume of water injected into the intestine by pain in the abdomen and the desire to empty the intestines (pain cannot be tolerated).
  6. Instead of enemas, you can use microlax microclysters in the evening at 20 and 21 hours (2 microclysters) and in the morning at 7 and 8 hours (2 microclysters).
  7. As a result of this preparation, the proctologist can examine the rectal mucosa (sigmoidoscopy) and already make a preliminary diagnosis.
  8. Any non-alcoholic liquid on the day of manipulation is permitted.
  9. Patients with diabetes mellitus and if the appointment is planned in the afternoon, then you can take a boiled egg, a small piece of cheese, cottage cheese. For 2 hours, you need to stop taking food and fluids before manipulation.

Preparation for manipulation of operations on the rectum (hemorrhoids, fissures, fistulas, polyps)

  1. Remove vegetables, fruits, black bread from the diet per day, switch to cheese, eggs, cottage cheese, boiled chicken, fish, any liquid without pulp (juices, fruit drinks, tea, coffee).
  2. The night before, make two cleansing enemas with ordinary raw tap water at room temperature and in the morning of the study day, two cleansing enemas.
  3. No enemas should be done before the doctor’s appointment.
  4. Before administering the enema, grease the tip with any fat (vegetable oil, petroleum jelly, liquid paraffin).
  5. Control the volume of water injected into the intestine by pain in the abdomen and the desire to empty the intestines (pain cannot be tolerated).
  6. Instead of enemas, microlax microclysters can be used in the evening at 20 and 21 hours.(2 microclysters) and in the morning 7 and 8 hours (2 microclysters).
  7. Any non-alcoholic liquid on the day of manipulation is permitted. If anesthesia is planned, stop taking fluids 4 hours before the procedure.
  8. Patients with diabetes mellitus and if the appointment is planned in the afternoon, then you can take a boiled egg, a small piece of cheese, cottage cheese. For 4 hours, you need to stop taking food and fluids if anesthesia is planned, without anesthesia, then two hours before the manipulation.

Postoperative period (recommendations)

After minimally invasive operations (the imposition of latex rings, sclerotherapy, photocoagulation), there are no special restrictions in nutrition and physical activity, it is necessary to refuse spicy food, alcohol for 5-7 days.Diet after complex operations: the first days of a slag-free diet, the exclusion of spicy smoked foods, alcohol for 4 weeks. From day 3, meat dishes, vegetables, fruits, salads in any culinary treatment are allowed. It is advisable to be at home for the first two to three days, then part-time. The average period of incapacity for work is 2 weeks. Heavy physical activity is allowed after 4 weeks. Disability will mainly be associated with the use of sitz baths after stool, frequent washing of the anus with a shower and wearing pads.Finding a home is mandatory under the telephone control of the operating doctor. The patient can be released immediately after the operation only if there are other family members in their right mind and good memory.

Preparation for colonoscopy

  1. Remove vegetables, fruits, black bread from the diet in 3 days, switch to cheese, eggs, cottage cheese, boiled chicken, fish, any liquid without pulp (juices, fruit drinks, tea, coffee).
  2. If the patient has constipation, then it is necessary to take Forlax, 3 packets per day for 3 days.
  3. A pharmaceutical preparation macrogol (Fortrans, lavacol) is purchased. 4 bags of powder are diluted in 4 liters of water and drunk in 4 hours, a liter per hour, a glass in fifteen minutes. If the patient is registered for the procedure in the morning, the drug is taken the night before from 6 pm to 10 pm, if it is afternoon, then in the morning of the day of the procedure from 6 am to 10 am. If the patient is less than 60 kg, you can take 3 bags of powder diluted in 3 liters of liquid.
  4. Any non-alcoholic liquid on the day of manipulation is permitted.If anesthesia is planned, stop taking fluids 4 hours before the procedure.
  5. Patients with diabetes mellitus and if the appointment is planned in the afternoon, you can take a boiled egg, a small piece of cheese, cottage cheese in the morning. 4 hours before the manipulation, you need to stop taking food and fluids if anesthesia is planned, without anesthesia, then two hours before the manipulation.

90,000 Methods for the treatment of constipation during pregnancy

What is the problem?

The term “constipation” is defined as difficulty in passing stools and a decrease in stool frequency (bowel movements – bowel movements to empty it).Constipation is characterized by discomfort, excessive exertion, hard or lumpy stools, a feeling of incomplete emptying, and infrequent bowel movements. Constipation is a common symptom during pregnancy. This may be the result of a combination of factors, including hormonal changes (shifts) during pregnancy, affecting the digestive system, low physical activity, and changes in dietary habits during pregnancy. In addition, as the fetus (baby) grows, it can squeeze the mother’s intestines and thereby cause delayed bowel movements / obstructions.

Why is this important?

Constipation during pregnancy is associated with impaired quality of life and distress for pregnant women, as well as physical problems, including the development of hemorrhoids. A number of treatment options have been proposed, including the use of drugs, nutritional supplements, or dietary changes.

As a rule, it is initially recommended to use non-drug interventions (changes in diet, water intake and exercise), and if they are ineffective or insufficient, drug (pharmacological) interventions.Medication interventions include a wide range of medications: lubricants (lubricants), stools, osmotic and stimulant laxatives, stool softeners (emollient laxatives), enemas and suppositories (suppository and enemas laxatives).

This review examined the benefits of drug and non-drug interventions in the management of constipation in pregnancy and whether they are safe for women and children.

What evidence have we found?

We identified four studies, but only two studies (a total of 180 women) provided data for analysis. These studies compared stimulant laxatives with bulk laxatives and dietary supplements (dietary fiber) with no intervention. The included studies were considered to be of moderate (moderate) quality.

We have covered two main comparisons.In a first comparison, we found that stimulant laxatives may be more effective in treating constipation than bulk laxatives ( average quality of evidence ). However, it can also lead to more abdominal discomfort ( low-quality evidence ) and diarrhea ( moderate-quality evidence ). We found no difference in women’s satisfaction ( mean quality evidence ). A second comparison, between fiber supplementation and no intervention, found that fiber supplementation may be effective in increasing stool frequency ( mean quality evidence ).The use of dietary supplements (fiber) was associated with improved stool consistency as determined by the testers (hard stool frequency decreased by 11% to 14%, normal stool increased by 5% to 10%, and loose stool frequency increased by 0% to 6 %).

There were no studies that looked at other types of interventions such as osmotic laxatives, stool softeners (laxatives that soften stool), lubricants (lubricating laxatives – lubricants), enemas and suppositories (suppositories).

What does this mean?

Little evidence exists to suggest that dietary supplements rich in fiber (or fiber — bulking laxatives or fillers) may increase stool frequency. When choosing between stimulant laxatives or bulk laxatives: stimulant laxatives may better relieve constipation but are more likely to cause abdominal discomfort and diarrhea.

More research is needed in this area.

CHAMOMILE TONES INTESTINAL WALLS – Spark No. 13 (4640) dated 04.16.2000

Our all-terrain vehicle Alexander NIKONOV received treatment from Viktor CHEREPKOV


Fans of the former mayor of Vladivostok claim that even Cherepkov’s portraits are healing. They need to be applied to sore spots. And the sadness will leave. And the longing will pass.

T But don’t tell me that Viktor Ivanovich is crazy.Not at all … No, he is, of course, an unusual person. But the main thing here is that he himself admits it. And what madman admits his madness? This means that Viktor Ivanovich is not crazy. There are simply people with whom something happens all the time. Who are being chased by the mafia. They are either elected as mayors, then arrested, then acquitted, and then the team that arrested them is arrested.

Viktor Ivanovich Cherepkov is a soul-man, whose face is ready to blur into a anticipatory smile, as soon as your lips hint at the possibility of a smile.Perhaps that is why he is so loved by the people of all Russia.

Here, for example, a man with whom Cherepkov is staying now, “took” him right on the street. “Will you be Viktor Ivanovich Cherepkov?” – “I”. – “I wish you success in your struggle!” So we met. And now Viktor Ivanovich is hiding from the long arms of the mafia in the apartment of this patriot.

Did you know that Viktor Ivanovich was even drafted into the army twice? The first time he served as an urgent in the navy, and there he – a man without higher education – was promoted from sailors to lieutenant.Moreover, some admiral liked him so much that after Cherepkov’s demobilization, the admiral specially went from the Far East to Moscow to petition for Cherepkov to be drafted into the army again. And Viktor Ivanovich again received a summons! And he again came to the Far East to serve. There he took root.

The nugget really could not boast of education. When Vitya was in a rural school, he did not even have textbooks (poverty, Soviet power, 12 children per family), and little Vitya went to school with only one pen in his fist.But, despite this, the frontal lobes of his brain (about them below) developed so much that subsequently Cherepkov, according to him, made more than five hundred and forty inventions! Moreover, more than half of them are from the field of medicine, and in particular urology.

How could I, having learned this, not talk to Cherepkov about living, human people!

– Viktor Ivanovich, in my opinion, this side of your arduous activity is completely unknown to wide strata. How did you manage to make an invention in the field of urology?

– It’s very simple! When there is a problem, you start solving it.Do you know what problem number 1 is in the army?

– Hazing? Non-payment of wages? ..

– No. The number one problem is bedwetting. Five percent of conscripts suffer from enuresis. And not only new arrivals, but also combatants. For example, shell-shocked Afghans. They generally have constant urinary incontinence.

– How did you solve this problem?

– An electronic device, which, by the way, was awarded the VDNKh gold medal even during Soviet times.It works as follows: as soon as the urge occurs, the detruser of the bladder gets relaxation …

– What gets relaxation?

– Detruser. This is such a muscle knot. It is arranged according to the principle of a loop – muscles on one side and the other. The fuller the bladder, the more the muscle knot tightens.

– Very interesting. I didn’t know …

– But as soon as the signal comes, the muscle relaxes and urination occurs!

– Look how it is…

– Of course! And in a person suffering from enuresis, the cerebral cortex is so inhibited that this muscle is always in a relaxed state.

– How does your device help?

– It catches the urge and delivers an electronic discharge to the nerve fibers. And the detruser starts to shrink.

– And why, this device is implanted into a living person?

– No, the device is in a badge on the belt. And the electrodes supply current to the active points of acupuncture.

– So, instead of a branded badge, a soldier has such a device on his belt?

– Yes, not on a belt! On swimming trunks, so that the electrodes are in contact with the body. And so that at night the device was on the soldier. He will not wear a uniform belt at night.

– Right. And no need for buckles! And then the demobilization will fight with buckles, spoil thin devices on each other’s heads … And what kind of battery is there? Swimming trunks are not delaying? Because if, say, the 373rd element …

– No, there is a simple flat battery, we took them from hydroacoustic devices.It is enough for a long time.

– Great, listen … Good invention.

– I also have huge methods of psychotherapy. Treatment methods. Well, let’s say, one of the techniques … The cardiogram shows a pre-infarction state. And in fact there is no such thing! Just pinching that nerve fiber that goes from the spine to the heart muscle. The person is prescribed bed rest. And I say: lie down on a wooden trestle bed, three movements on the spine, crunch… And that’s all – a normal cardiogram.

– And if you make a mistake? He really has a pre-infarction, and you crunch him.

– And there are secondary signs of the disease! For example, ordinary nails can diagnose more than 30 types of diseases.

At this point I immediately handed Cherepkov my clean, well-groomed paws that did not know black labor.

Cherepkov carefully examined my nails.

– You have nothing. The only thing is a violation of the metabolic process, do you see these white marks?

– Tell the truth, doctor! How much is left for me?

– How will you eat.You just had an excess of calcium. You probably drink a lot of milk.

– I hardly drink at all. And now, in general, I’ll quit with this muck … But what are we all about me … Health worries everyone! Tell us how to protect yourself in our poisoned time.

– Here’s one simple example. Let’s say a headache. And the doctor gives you analgin. Never drink! Pain is an alarm in the body, and you turn it off! Another time you have a fever, and you are given an antipyretic! Well, what is this technique?

– Indeed, somehow illogical.I’ll think it over …

– Or here’s an upset stomach. Nature itself says: it is necessary to remove the pathogenic bacteria! And the patient is given a strengthening!

– Konovals are just some …

– Yes, it was necessary the other way around – rinse with an enema.

– And with what is it better to put an enema?

– If this is just a cleansing enema, then it is better with chamomile infusion. Chamomile tones the intestinal wall. If, for example, you start therapeutic fasting, you need to cleanse the body with enemas, otherwise, on the sixth day, fatal intoxication of the body with feces may occur.

– It’s unpleasant.

– It is necessary to cleanse the body with enemas! Those who do cleansing enemas, even the skin color is different, much better than those who do not indulge in enemas. But, on the other hand, it is impossible to abuse enemas: it washes out the beneficial intestinal flora, and certain problems arise.

– How do you know all this, I’m just amazed! It would never have occurred to me to consider the skin of a person who gives himself cleansing enemas!

– I have a non-standard approach to everything.Everyone sees the chair and thinks it is normal. And I approach the problem from a completely different angle: everything that has been done is abnormal and needs to be improved.

– The chair can only be improved by changing the diet … Wait, you switched to furniture? ..

– Yes. All my furniture at home is non-standard.

– Let’s not be distracted by furniture. Tell us a case from your medical practice.

– A simple example. I was a captain of the first rank then.And then a man comes to me, a sailor. I can even give his last name. From Perm. Sportsman. He cannot come to terms with the fact that he was an athlete, and doctors prescribe a regime of immobilization for him. He has a pressure of 220!

– A 220 by how much?

– 110.

– Like in America!

– This is a hypertensive crisis. He was prescribed everything, but he has more and more pressure. He was already exhausted, he came to me: Victor Ivanovich, help! He knew that I had inventions in medicine.I ask: what did they prescribe to you? He: this and that! And do you want to be cured? Want! Well then, put all the pills that they give you in a jar, and don’t tell the doctors. They won’t tell you to run, but tomorrow you put on a woolen suit and a woolen hat – and run! Before that, drink more water. And do not eat salt at all (that sailor was very fond of salty)! And ask the doctors for a diuretic. Are you not allowed to play football? And you play! Is the sauna not allowed? And you go to the sauna! .. That’s it.

– Died?

– No.After three weeks, he was a healthy person. And then he cut off all the telephones of all the military doctors, because he worked at the telephone exchange. Cut off all the doctors’ connection and refused to turn it on! The commander calls him: why did you turn off the doctors’ phones? And the one: as they treated me, so I provide them with a connection!

– What was the secret?

– The sailor was the brightest choleric. You say three words to him, his pupils are already dilating – an adrenaline rush. And I realized that the sodium in his blood combines with adrenaline, a reaction takes place, and the blood foams like champagne.The bubbles settle in the capillaries of the brain, and they are inflated, like central heating batteries, and no heat is supplied. We must purge! Oxygen starvation occurs in the brain due to these air congestions, and it gives the command to the heart: pump it, or it’s not enough! Heart and pumps, trying to blow, the pressure rises. This means that you need to reduce the sodium content, remove it through sweat and urine.

– Here it is, people’s ingenuity! You are just some kind of homemade product! .. Listen, you probably know how to live right.I read in the book of some also folk healer that living right means eating right, breathing right and thinking right. Do you know how to do it right?

– Naturally.

– And how do you need to think correctly?

– I’ve never really thought about this problem.

– Then advise your readers on how to eat right.

– Stomach dumplings – pomegranate. And the cake is an atomic bomb. After all, the stomach digests everything differently.The stomach should release alkali for the meat. I say this figuratively, because in fact it must release acid on the meat. And he must allocate alkali to the dough. For a dumpling, he allocates both. Neutralization occurs, there is nothing to digest food. And then an ulcer or gastritis. Meat can be eaten with cabbage. But tomatoes are not allowed.

– Can I have meat with porridge?

– No. Only with buckwheat.

– And with vodka?

– Vodka in small doses is useful.But I don’t drink or smoke. I do not drink out of conviction. Because vodka cuts off the frontal lobes from the cerebral cortex.

– Isn’t the frontal lobes the cortex?

– Nothing of the sort! The frontal lobes are imagination. For example, I have a very developed imagination, analysis … And the cortex is just a memory. Here we are talking. And a neuron, having synopsis … they kind of turn into a spiral, and when we start sleeping at night, they kind of unfold. And the information is transferred to long-term memory.This is how the cortex works … And in the frontal lobes, information is analyzed. By the way, each of the four types of temperament has a different signal transmission speed. Vodka turns off the frontal lobes. And only a sanguine person can drink vodka: he knows when to stop.

– I am a sanguine person.

Cherepkov looked at me closely:

– Yes, judging by the squint of your eyes, you are sanguine. You have maternal eyes!

– How do you know?

– Signs are transmitted in this way. Have you ever wondered why 500 million sperm are released during ejaculation?

– Just in case, I guess.Suddenly they will come in handy …

– No! This is natural selection of the third level! Why are boys of about seventeen so pugnacious?

– Uh … In what sense? Is there, in this word, “a” or “o”? Fighting or …

– Fighting. Testosterone is released, aggressiveness increases.

– By the way, about aggressiveness … Let’s get back to vodka. The frontal lobes, you said, are disconnected from something there.

– Yes. And the person loses the analysis! Sometimes, for example, they even ask me: Viktor Ivanovich, why did this midshipman stab his comrades with a dagger? I say, the frontal lobes are disabled.

– Let’s drink so that our frontal lobes never turn off! And for love! .. By the way, Viktor Ivanovich, what is love?

– This is also invented by nature for reproduction … If people divorced, then it was not love. And vice versa – let him drink, beat her, but if they have true love, everything else fades.

Alexander NIKONOV

Photos used in the material: Yuri FEKLISTOV

90,000 Putin received the “Tsar-enema”

In St. Petersburg, the annual anti-award “Golden Enema” was awarded in eight nominations – for outstanding “achievements” in the field of homophobia.

If it is still impossible to stop the flow of legislative initiatives such as prohibiting gays from being donors or proposals to remove children, including relatives, from homosexual families, one can only laugh – so the activists of the Alliance of Heterosexuals for LGBT Equality decided and came up with the Golden Enema anti-award. It was a year ago, and then the prize was awarded to the Children’s Rights Commissioner under the President of Russia Pavel Astakhov, TV journalist Dmitry Kiselev, State Duma deputy Elena Mizulina, deputy of the St. Petersburg Legislative Assembly Vitaly Milonov and many others who became famous for homophobic legislation and no less vivid statements on the relevant topic.

Painting by Konstantin Altunin “Rainbow Milonov”

At the same time, a motley bouquet of nominations was invented: “Kuzkina’s mother” – “for the exploitation of children in the fight against human rights”, “Organ of morality” – “for the contribution to the separation of Russia from Europe”, “Zalivnaya language” – “for the true Nordic homophobic rage “,” Electoral dysfunction “-” for defending federal morality in a perverse way “and so on. It seemed that the fantasy should inevitably be exhausted, but this did not happen – obviously, because life was not exhausted, giving more and more reasons for sarcasm.

Indeed, how could one ignore such a desperately bold assumption that gays are the cause of the fall of the Chelyabinsk meteorite? The organizers of the award did not pass – the correspondent of VGTRK Arkady Mamontov , who put forward a similar hypothesis, became the laureate “for cave flatulence of the brain”, defeating the journalist and member of the Public Chamber Maxim Shevchenko and the deputy and former TV presenter Alexey Pushkov , nominated for the prize of the same nomination: “The Goebbels Faculty of Journalism”.

Senior officials competed in the “Homophobe Profession” nomination: Minister of Culture Vladimir Medinsky , who declared the composer Tchaikovsky heterosexual, the Russian Ministry of Foreign Affairs and Chairman of the Constitutional Court Valery Zorkin . As a result, the Foreign Ministry won with the wording “for unlimited shame.”

This year there was a nomination for the “Olympic Village”. Pole vaulter Yelena Isinbaeva received the “Golden Enema” – “for a virtuoso jump into a puddle”, that is, for her words that “homosexuality is not peculiar to Russians.”

Actor and former priest Ivan Okhlobystin in the cultural nomination “Creators with Regime” defeated director Nikita Mikhalkov and writer Mikhail Weller . The “Golden Enema” was awarded to Okhlobystin “for serving the demon of Nazism under the guise of spirituality,” that is, for his declared readiness to personally burn gays in ovens.

This time there was also a special St. Petersburg nomination – “Hysteria of one city”. “It was our city that pioneered the spread of homophobic politics, which earned it the notoriety of the capital of obscurantism,” the organizers explain.Among the nominees-Petersburgers – the deputy of the city Legislative Assembly Anatoly Krivenchenko , who added the “sin of sodomy” to the list of biblical prohibitions, and the vice-governor for culture Vasily Kichedzhi . But the laureate still became the Committee on Legality, Law Enforcement and Security of the City Government and personally the head of the Committee Leonid Bogdanov – “for lawlessness in the law.”

– The activists have special scores with the committee – it is this structure that in every possible way prevents the LGBT community from holding public actions in the city, it is they who forbid us everything, – explains Natalya Tsymbalova, coordinator of the Alliance of Heterosexuals for LGBT Equality.- And in general, all homophobic trends, all instructions to press us one way or another come from above.

Therefore, the grand prix was won by none other than Vladimir Putin – he became the owner of “Tsar-enema”, the only one that was made especially for the ceremony, the rest were simply bought at the pharmacy and gilded. Prizes at the ceremony were administered by “orderlies” – civil activists, one of them – Vladimir Volokhonsky:

– I am opposed to state restrictions on freedom of speech, but I think that a person should be responsible for the consequences of his statements.And public condemnation of certain statements must exist. We have just another problem – state condemnation of statements, for example, of a nationalist nature – it exists, but it is in no way backed up by the condemnation of society. This means that we do not have any intelligible forms of public influence on journalists who allow themselves to make incorrect statements. Rather, society condemns those who support human rights and freedoms.

During Vladimir Putin’s visit to the Netherlands, he was greeted by demonstrators with rainbow flags of the LGBT community

The very fact of the existence of such prizes as the “Golden Enema” is useful, says the deputy of the Legislative Assembly of St. Petersburg Boris Vishnevsky:

– With such brethren one must fight with the help of laughter – this is the main weapon.I believe that it would be useful to elect our well-known local deputy as an honorary member of all the local gay clubs, solemnly hand him a free subscription to visit them – he is afraid of such things more than anything else. If there is, God forbid, physical violence, then you need to defend yourself with the help of the law, in other cases – with laughter and mockery. It would be nice, for example, to name some gay club by the name of this deputy. Imagine a scene on the street – two gay men say to each other: “In the evening we meet at Milonovo, as always.”It would be much more useful than all the actions on the Champ de Mars that do not end well. You just have to make fun of homophobes in every possible way.

Awards – “golden enemas”, including “Tsar-enema” – will be sent to the laureates by mail.

Enema for a child – Scarce School

Enema for a child is sometimes a forced necessity.

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Parents do not always know how to properly carry out this procedure.
An enema is a procedure for injecting a liquid or drug through the anus into the rectum.

There are several types of enemas, but in children they are most often used: cleansing, laxative (often the same thing) and medicinal.

• A cleansing enema is given to cleanse the intestines (for example, in case of poisoning)
• A laxative enema is often used for constipation
• A medicinal enema is aimed at administering drugs that will have a local or general effect on the body.


• Inflammatory processes in the rectum
• Anal fissures

Volume of enema for the child
The amount of solution depends on the weight and age of the baby:

  • • 1-2 months – 30-40 ml
    • 2-6 months – 50-60 ml;
    • 6-8 months – 60-100 ml
    • 8-12 months – 120-130 ml;
    • 1-2 years old – no more than 200 g
    • from 2 to 5 years old – 300 g
    • from 5 to 9 years old – 400 g
    • over 10 years old – 0.5 l.

Enema child: sequence of actions

1. Prepare a pear, petroleum jelly or baby cream, an enema liquid, and an absorbent diaper.
The fluid for the enema should be determined by the physician. It can be boiled water, herbal decoction, medicinal substance, or sterile oil.
Water is most often used at home. The water temperature can be different depending on the purpose.
Usually the temperature is 22-26 degrees, a cleansing enema is made with cooler water (18-20 degrees), and in case of spastic constipation, on the contrary – warm (28-30 degrees)
2.Warm up the room (the child should be comfortable)
3. Squeeze the pear, fill the pear with liquid, remove all excess air by squeezing the pear
until water appears from the tip.
4. Lubricate the tip with Vaseline or baby cream. The tip of the enema is different: rubber and plastic. The younger the child, the more vulnerable his mucous membrane, so it is better to choose enemas with a rubber tip.

5. A child under 1 year old is placed on its back, and older children – on its side, pulling the legs up to the stomach

6.A 3-5 cm pear tip is carefully inserted into the anus for children under 1 year old and 6-8 cm for older babies.
7. Squeezing the pear slowly, introduce the entire solution.
8. Without unclenching the pear, remove it from the anus
9. You can pick up a small child, leave an older child on the couch, squeeze the baby’s buttocks for a while so that the water stays in the intestines.
10. Let the baby lie down for 10-15 minutes, after which he can empty.

Some tips for parents:
• The older the child, the more shy he becomes.You should not carry out the procedure in the presence of strangers
• If the cleansing enema has not produced the desired effect, you can repeat it after 5-6 hours
• You should not get carried away with enemas, except for medicinal enemas prescribed by the doctor in a certain course.

How to Prepare Enema Stock Solutions

1. Boiled water.
Boil water and cool to the desired temperature (22-26 g)
2. Hypertonic solution (good for constipation)
Add ½ tsp to 1 glass of water.l salt, boil water and cool to the required temperature
If the child is under 1 month old, then add less ¼ tsp salt.