How effective are enemas for constipation relief. What are the potential risks of using enemas. Are there safer alternatives to enemas for treating constipation. When should enemas be considered as a treatment option. How to properly administer an enema for maximum benefit.

The History and Evolution of Enema Use

Enemas have been a part of medical practice for thousands of years, serving as one of the oldest methods to address constipation. The Canadian Society of Intestinal Research highlights that enemas were developed before the advent of oral and intravenous medications, making their historical use logical. However, the landscape of constipation treatment has significantly evolved over time.

In recent years, some celebrities have promoted enemas as a means to “detoxify” the body and cleanse the digestive system. It’s crucial to note that these claims lack scientific backing and can be potentially harmful. The regular use of enemas, especially without medical supervision, can lead to various health complications.

Today, medical professionals generally recommend enemas as a last resort for constipation treatment. This shift in approach is due to the development of safer and more effective alternatives, including laxatives, suppositories, and dietary modifications. The potential side effects associated with enema use have also contributed to this change in medical perspective.

Understanding the Mechanism: How Enemas Work

An enema is a procedure that involves introducing fluid into the intestines through the rectum. Dr. Bryan Curtin, a gastroenterologist and director of the Center for Neurogastroenterology and GI Motility at the Melissa L. Posner Institute for Digestive Health and Liver Disease at Mercy in Baltimore, explains that this process helps soften and break up stool, facilitating bowel movements.

There are several types of enemas available, each with its own composition and purpose:

• Tap water enemas
• Sodium phosphate enemas (such as Fleet enemas)
• Saline enemas
• Glycerin enemas
• Soap suds enemas
• Mineral oil enemas

While phosphorus-based enemas are traditionally considered the most potent, Dr. Curtin notes that any enema can be effective if administered correctly. He typically avoids oil-based enemas due to their messy nature.

Proper Administration of Enemas: Step-by-Step Guide

Administering an enema correctly is crucial for its effectiveness and safety. Dr. Bharat Pothuri, a gastroenterologist at Memorial Hermann in Houston, provides the following guidelines:

1. Hydrate properly: Drink 16 ounces (two glasses) of water before the enema to prevent dehydration.
2. Position yourself: Lie on your stomach with knees pulled to your chest. If this isn’t comfortable, lie on your left side with both knees bent and arms resting comfortably.
3. Prepare the enema: Lubricate the enema tube for easier insertion.
4. Insert the tube: Gently insert the lubricated tube into your rectum.
5. Administer the solution: Squeeze the enema container to allow the contents to enter your rectum.
6. Wait: Maintain your position until you feel the urge to move your bowels.
7. Hold: Try to retain the enema for at least five minutes to maximize its benefits.

Dr. Curtin emphasizes the importance of holding the enema until the urge to defecate is strong, as this ensures maximum effectiveness.

Potential Risks and Side Effects of Enema Use

While enemas can be effective for treating severe constipation, they come with several risks and are not intended for frequent use. Dr. Curtin warns against the potential for abuse, stating, “Too much enema use can lead to anorectal pain disorders. Generally, you should avoid using enemas regularly unless instructed to by your doctor.”

Some of the potential risks and side effects associated with enema use include:

• Tissue damage in the large intestine
• Bowel perforation
• Infections, including sepsis
• Electrolyte imbalances
• Hyperphosphatemia (excessive phosphate in the blood)

Research, including a case report published in 2020 in SAGE Open, has shown that incorrectly administered enemas can cause bowel perforation. Moreover, non-sterile enemas can lead to infections, including potentially life-threatening sepsis.

Long-term use of enemas may result in electrolyte imbalances, leading to symptoms such as fatigue, headache, muscle cramping, nausea, and vomiting, according to the Cleveland Clinic.

Who Should Avoid Enemas?

Dr. Pothuri advises that certain individuals should avoid using enemas, including:

• People with colorectal cancer
• Individuals with an enlarged, distended colon that may be more prone to perforation
• Those with active inflammatory bowel disease

It’s crucial to consult a healthcare provider before using an enema and to explore all other constipation treatment options first.

Safer Alternatives for Constipation Relief

Given the potential risks associated with enemas, they are typically recommended only as a last resort for constipation treatment. Before considering an enema, it’s advisable to try the following safer alternatives:

High-Fiber Diet

Dr. Curtin suggests that dietary changes are usually the first recommendation for managing constipation. Increasing fiber intake helps add bulk to the stool, facilitating its passage through the digestive system. Patients dealing with constipation should aim for 20 to 30 grams of daily fiber.

Some ways to increase fiber intake include:

• Adding more fruits and vegetables to your diet
• Incorporating whole grains into meals
• Gradually increasing fiber intake to avoid bloating and gas
• Considering over-the-counter fiber supplements like Metamucil (consult with a doctor first)

Proper Hydration

Staying well-hydrated is crucial for maintaining regular bowel movements. Adequate water intake helps soften stool and promotes easier passage through the intestines. The exact amount of water needed varies from person to person, but a general guideline is to drink enough so that your urine is pale yellow to clear.

Regular Exercise

Physical activity can stimulate bowel movements and improve overall digestive health. Aim for at least 30 minutes of moderate exercise most days of the week. This can include activities such as brisk walking, swimming, or cycling.

Over-the-Counter Laxatives

There are several types of over-the-counter laxatives available that can help relieve constipation:

• Bulk-forming laxatives (e.g., psyllium)
• Osmotic laxatives (e.g., polyethylene glycol)
• Stimulant laxatives (e.g., bisacodyl)
• Stool softeners (e.g., docusate sodium)

It’s important to use these products as directed and consult with a healthcare provider if constipation persists or recurs frequently.

When to Consider Enemas as a Treatment Option

Enemas should be considered only when other, less invasive methods have failed to provide relief from constipation. Some situations where a healthcare provider might recommend an enema include:

• Severe, prolonged constipation that hasn’t responded to dietary changes, increased fluid intake, or over-the-counter laxatives
• Preparation for certain medical procedures, such as colonoscopies
• Management of specific medical conditions that affect bowel function

It’s crucial to remember that enemas should only be used under the guidance of a healthcare professional. Self-administering enemas without proper medical advice can lead to complications and health risks.

The Role of Professional Medical Advice in Constipation Management

While constipation is a common issue, it’s important to seek professional medical advice if symptoms persist or worsen. A healthcare provider can help determine the underlying cause of chronic constipation and develop an appropriate treatment plan.

When should you consult a doctor about constipation? Consider seeking medical attention if:

• Constipation lasts for more than three weeks
• You experience severe abdominal pain
• You notice blood in your stool
• You’re losing weight without trying
• You have persistent changes in bowel habits

A healthcare provider can perform a thorough evaluation, which may include a physical examination, medical history review, and potentially diagnostic tests to rule out more serious conditions.

Personalizing Constipation Treatment

Every individual’s digestive system is unique, and what works for one person may not be effective for another. A healthcare provider can help tailor a constipation management plan that takes into account factors such as:

• Overall health and medical history
• Dietary habits and lifestyle
• Medications that may contribute to constipation
• Underlying medical conditions affecting bowel function

By working closely with a healthcare provider, patients can develop a comprehensive approach to managing constipation that minimizes risks and maximizes effectiveness.

The Future of Constipation Treatment: Emerging Therapies and Research

As medical science advances, new approaches to treating constipation are being developed and studied. Some promising areas of research include:

Microbiome-Based Therapies

Scientists are exploring how the gut microbiome affects digestive health and bowel function. This research may lead to probiotic or prebiotic treatments that can help regulate bowel movements more naturally.

Targeted Medications

Researchers are working on developing new medications that specifically target the mechanisms involved in constipation, potentially offering more effective relief with fewer side effects.

Biofeedback and Pelvic Floor Therapy

For some individuals, constipation may be related to pelvic floor dysfunction. Biofeedback techniques and pelvic floor therapy are showing promise in helping patients retrain their muscles for improved bowel function.

Neuromodulation

This emerging therapy involves using electrical stimulation to modulate nerve activity in the digestive system, potentially improving bowel motility and function.

As research in these areas progresses, it’s likely that new, safer, and more effective treatments for constipation will become available, further reducing the need for more invasive interventions like enemas.

Conclusion: Balancing Efficacy and Safety in Constipation Treatment

While enemas have a long history in treating constipation, modern medical practice emphasizes safer and less invasive alternatives. The potential risks associated with enema use, including tissue damage, infections, and electrolyte imbalances, underscore the importance of using them only as a last resort and under medical supervision.

For most cases of constipation, lifestyle modifications such as increasing fiber intake, staying hydrated, and regular exercise should be the first line of defense. Over-the-counter laxatives and stool softeners can provide additional relief when needed. However, persistent or severe constipation warrants professional medical attention to rule out underlying conditions and develop an appropriate treatment plan.

As research continues to uncover new insights into digestive health and bowel function, we can expect to see more targeted and effective treatments for constipation in the future. Until then, a balanced approach that prioritizes safety and efficacy, guided by professional medical advice, remains the best strategy for managing constipation and maintaining overall digestive health.

Gut Check: Should You Use An Enema for Constipation Relief?

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

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

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

The Back Story: How Does an Enema Treat Constipation?

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

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

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

How to Administer an Enema

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

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

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

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

Possible Side Effects of Enemas

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

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

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

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

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

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

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

Safer Options for Constipation Relief

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

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

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

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

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

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

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

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

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Enema Constipation | Everyday Health

Some common steps in administering an enema include:

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

Health Concerns Regarding Enemas

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

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

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

Learn more in the Everyday Health Digestive Health Center.

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what to choose for the treatment of chronic constipation

Laxatives and enemas: what to choose for the treatment of chronic constipation

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• Laxatives and enemas: what to choose for the treatment of chronic constipation

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

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

Laxatives for constipation – types and features of use

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

General principles for the use of laxatives:

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

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

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

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

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

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

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

Stool bulking agents

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

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

The advantages of drugs from this group:

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

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

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

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

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

Osmotic laxatives

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

Benefits of osmotic laxatives include:

● do not irritate the intestinal mucosa;

● are not addictive;

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

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

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

Drugs that cause chemical irritation of intestinal receptors

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

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

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

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

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

● can provoke a specific drug complication – laxative disease.

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

Softeners

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

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

Enemas for constipation – when and why they are prescribed

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

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

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

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

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

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My mother was in the oncological dispensary at the 5th department, her attending physician was Krotov. I would like to express my gratitude to the doctor for the competent medical care of my mother and the moral support he gave her during her long stay in the hospital. Mom believes that she was lucky with the doctor in charge, and I share this opinion, since I personally also talked several times with Kirill Yuryevich, inquired about the mother’s condition. He is a great professional and a great person.

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Ruslan Valentinovich is a very polite and pleasant doctor. At the appointment, the doctor conducted a preliminary examination to make a conclusion whether I can be vaccinated or not. He explained everything clearly, according to the protocol. Then he allowed me to do so. Then he called the nurse who vaccinated. They showed me a bottle with the vaccine, told me what and how, what to prepare for and what to expect. Everything I wanted, I got. There were no problems. The reception left an extremely positive impression.

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I want to say a huge thank you to Tatyana Sergeevna for her professionalism and caring attitude! She was at the reception on January 26 with a suspicion of an active process of toxoplasmosis during pregnancy (there was a positive test for IG M, obtained in one of the well-known hospitals in the city). After analyzing all the data, Tatyana Sergeevna doubted the reliability of the analysis and painted me an action plan for rechecking. And most importantly, she reassured me, gave confidence that everything would be fine, gave useful advice. And indeed, everything turned out as the doctor expected: when rechecking at Botkin, they did not find anything with me. Thank you very much, Doctor!

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Korneeva Tatyana Sergeevna

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My husband and I turned to Korneeva Tatyana with a request for vaccinations against pneumococcal infection. The clinic is taking all precautions due to COVID. The doctor conducted a full examination, consulted in detail about the vaccination, showed attentiveness and care for the patients. After vaccination was observed for 30 minutes. Friendly and attentive all the staff of the clinic.

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They did an express test for COVID-19, everything was very fast and painless, the result was sent very quickly.

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Before turning to Natalya Olegovna, there had already been a year of unsuccessful treatment in the district clinic and in the nephrology / urology department of one of the regional hospitals. Inflammation – antibiotic treatment – recovery … And then everything is in a new circle. She was overcome by despair, but, fortunately, she got an appointment with her. The doctor is very attentive. He studies all the statements and old test results, asks many questions that relate to all health and all medications taken (although they are for diabetes and thyroid). Explains prescribed procedures, tests, and medications. He knows how to listen, explain and set up for the right treatment and recovery. Yes, I am ready to receive and track all my new test results quickly, by e-mail (and I have quite a few of them – and you won’t go with each analysis). She was able to solve my problem: for a year without exacerbations. Thank you very much, dear doctor!

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Krotova Natalya Olegovna

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Enema for constipation – how to do it, contraindications, types

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

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

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

Enema for constipation

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

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

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

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

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

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

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

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

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

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

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

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

• intoxication, poisoning;

• planned operations;

• forthcoming birth;

• upcoming proctological examination;

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

• preparation for endoscopic interventions;

• preparation for the formulation of a medicinal enema.

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

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

Enema contraindications

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

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

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

There are other contraindications to enema:

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

• inflammation of the large intestine;

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

• hemorrhoids, anal fissure, proctitis, proctosigmoiditis;

• intestinal tumors.

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

How to make an enema

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

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

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

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

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

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

• collect Esmarch’s mug according to the instructions;

• fill it with a solution;

• bleed some fluid to bleed air;

• treat the tip with vaseline oil or baby cream;

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

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

• pour in the solution;

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

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

Types of enemas for constipation

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

The following solutions are used for cleansing and therapeutic measures:

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

By volume, enemas are classified as follows:

Oil

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

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

Hypertonic enema

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

Cleansing enema

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

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

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

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

Cleansing enema algorithm:

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

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

Siphon enema

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

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

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

Medicinal

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

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

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

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

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

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

References

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

• Subbotin AM Ideal preparation for colonoscopy — reality or goal on the horizon? Stages of improving its quality // Regular issues of “RMZH”.