How to Use an Enema at Home, and Is It Safe?

Published

17 June 2020

Fact Checked

Reviewed by Tanya Tantry, MD, Obstetrician & Gynecologist, Medical Consultant at Flo

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If you’ve been experiencing constipation, you may turn to an enema to ease the discomfort. At-home enemas should always be carefully prepared and administered. Keep reading for a complete breakdown on at-home enemas, including their risks and some alternative ways to relieve constipation. 

Why use an enema?

Enemas are often used to combat constipation, when bowel movements are infrequent or difficult to pass for several weeks or longer. Generally, if you have fewer than three bowel movements a week, you are likely suffering from constipation.  

Occasional constipation is quite common, but some people experience chronic constipation, which can interfere with their quality of life and ability to function throughout the day.

The treatment for chronic constipation will depend on the underlying cause. However, there are cases where a reason for the condition is never found. 

Elderly people are five times more prone to constipation than young people due to immobility, medication side effects, and the blunted urge to defecate. 

Many people use over-the-counter drugs to help with constipation, but sometimes urgent intervention is required, and a hospital visit may be necessary. A cleansing enema is a popular treatment method for constipation. 

Enemas are also used to clean the bowels before a medical procedure or examination, such as a colonoscopy. 

Fleet enemas use forms of phosphorus, a naturally occurring substance that is important in every cell in the body. This type of enema has two purposes:

• Treating constipation
• Cleaning the bowels before X-rays, colon surgery, or endoscopy examinations

Someone may have an enema to clean their lower bowel, receive medication, or help get gas or stool out of the body.  

Are enemas safe?

Different kinds of enemas work differently. All enemas distend the rectum, which stimulates the colon to contract and eliminate stool. A phosphate enema directly stimulates the muscles of the colon. 

Enemas can be quite effective, but there is a risk of severe adverse effects such as metabolic derangement or perforation. 

A hypertonic sodium phosphate enema can cause serious phosphate nephropathy. Elderly people with a history of chronic renal failure or patients treated with ACE inhibitors are especially prone to phosphate nephropathy from enemas. 

Although rarely reported in medical literature, a cleansing enema can have life-threatening side effects. For example, the most frequent side effect from an enema is perforation from the device tip. 

Enema kits are sold at most drug stores. It’s important to follow the instructions exactly as outlined, and you should never have more than one enema in 24 hours. For most people, enemas are a safe practice. However, there are rare cases when too many enemas can have life-threatening side effects on the heart and kidneys. 

Call your health care provider immediately if you experience any of the following after an enema:

• Little or no ability to urinate
• Drowsiness
• Swelling in the legs, ankles, or feet

Do not use an enema (unless otherwise directed by a health care provider) if you have any of the following conditions:

• Congestive heart failure
• Severe kidney disease
• A perforated bowel
• Megacolon
• Paralytic ileus
• Active inflammatory disease
• A blockage in the digestive tract
• Rectal obstruction
• Dehydration
• Other intestinal disorders

How to prepare an enema at home

Follow these steps to prepare an at-home enema:

1. Warm the enema in a bowl and pull off the nozzle. Make sure to keep the bottle upright so the contents don’t spill.  
2. Lubricate the nozzle. 
3. Lie on your left side on a towel, with your knees bent toward your chest as high as possible.
4. Gently push the nozzle approximately three inches into your anus.
5. Slowly squirt the contents in. Remove the nozzle when you have finished all the liquid and remain lying down.
6. Try to hold the liquid in for (ideally) five minutes. 
7. When you can no longer hold the liquid in and have a strong urge to empty your bowels, go to the bathroom. 
8. It’s best to stay near the toilet over the next hour.
9. Some people experience stomach cramps for a short time after their enema. If you feel dizzy or light-headed, make sure to lie down until you feel better.

An enema should take an hour or less to work. 

Enema solutions

There are a few different options for the liquid solution inside enemas. You can also choose to purchase an at-home enema kit that includes an enema bag. The bag contains the water or solution that will be injected into the rectum. The liquid might be a saline solution or baking soda mixture.

Potential risks of using an at-home enema kit

An at-home enema kit can increase your risks because you probably aren’t as experienced as a medical professional at inserting the device tip. The possible health risks associated with enemas are:

• Perforation
• Metabolic derangement
• Severe phosphate nephropathy (for hypertonic sodium phosphate enemas)
• Harmful side effects to the kidneys or heart from too many enemas
• Injury to the bowels
• An improper fluid in the enema mixture can have adverse effects on your electrolyte balance, bowels, or overall health
• Risk of infection from a nonsterile enema kit
• Enemas with acidic ingredients, such as lemon juice, carry a risk of causing burns, irritation, or inflammation 
• According to one report, children who received a hydrogen peroxide enema reported developing inflammation of the colon, vomiting, bloody diarrhea, and other long-term complications 

Always talk with your health care provider before attempting an enema at home. Most health care providers discourage the use of homemade or DIY enemas.

Enema alternatives

Health care providers will typically recommend diet and lifestyle changes to treat chronic constipation. If that doesn’t work, your health care provider may prescribe medications or surgery. 

Diet and lifestyle changes

Your health care provider may recommend that you add more fiber to your diet, which can increase the weight of your stools and help them work their way through the intestines faster. Foods high in fiber include fruits, vegetables, and whole-grain products. 

Some people see an improvement in their chronic constipation with an increase in physical activity. Regular exercise can increase muscle activity in the intestines. 

Some people with chronic constipation need to learn to give themselves time in the bathroom without feeling distracted or rushed. 

Medication

Many types of laxatives can help make bowel movements easier. Some over-the-counter options include:

• A fiber supplement can add bulk to the stool, which makes it softer and more comfortable to pass. 
• Stimulants can help your intestines contract and pass a bowel movement. 
• Osmotic laxatives help improve bowel movements by increasing the secretion of fluid from the intestines, which allows the stool to move through the colon quickly.
• Lubricants use mineral oil to move stool through the colon. 
• Stool softeners draw water from the intestines to soften the stool.
• Suppositories help move stool through the body by providing stimulation and lubrication.  

If over-the-counter medications don’t work for you, consult with your health care provider about a stronger prescription. Some possible medications include: 

• Medicines that draw water into your intestines to speed up the movement of the stool. Examples include lubiprostone, linaclotide, and plecanatide. 
• Prucalopride is a type of serotonin 5-hydroxytryptamine 4 receptor that helps move stool through the colon.  
• If the constipation is caused by opioid use, peripherally acting mu-opioid receptor antagonists can reverse the effect of opioids on the intestines and keep the bowels moving.

The takeaway

Living with chronic constipation can significantly affect your quality of life and ability to get through the day. An enema is a popular choice for people struggling with constipation. However, there are risks associated with this procedure. Before attempting an enema at home, check with your health care provider to make sure it’s a safe choice for you. 

References

https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641812/
https://www.drugs.com/mtm/fleet-enema-rectal.html
https://journals.lww.com/nursing/fulltext/2003/11000/administering_an_enema_to_an_adult.25.aspx
https://www.kch.nhs.uk/Doc/pl%20-%20579.3%20-%20guidance%20for%20using%20an%20enema.pdf
https://www. medicalnewstoday.com/articles/327006.php#risks

History of updates

Current version
(17 June 2020)

Reviewed by Tanya Tantry, MD, Obstetrician & Gynecologist, Medical Consultant at Flo

14 June 2020

How long they take to work and more

During an enema, people insert fluid into the rectum to soften stool and flush out the contents of their bowels. An enema can take a few minutes to begin working, but a person should stay near a toilet for roughly 1 hour.

A person uses an enema to inject fluid through the anus into the sigmoid colon. An enema can involve different fluids, depending on the purpose.

Enemas can begin to work after a few minutes, but people may need to use the bathroom more than once for the next hour.

In this article, we discuss how long it takes for an enema to work and how to use one.

People use an enema, or clyster, to treat various conditions. Depending on the reason for the enema, a person may vary:

• the fluid injected
• the volume of the contents
• the retention period

Doctors may prescribe an enema to clear the lower half of the large bowel before a diagnostic test or for other medical purposes.

Some people will use an enema regularly because they believe it enables general health benefits through detoxification.

It is best to check with a doctor before using an enema, as people have varying needs, and not all products suit everyone.

Uses

According to the Canadian Society of Intestinal Research, medicinal uses include:

• administering medication for conditions such as ulcerative colitis
• treating chronic constipation or other bowel conditions
• preparing for surgery or diagnostic examination, such as a colonoscopy

Using an enema at home can be dangerous if someone does not do it correctly.

People can speak with a doctor to discuss the uses, what to expect, and how to administer it.

Regardless of how quickly the enema works, a person should stay near the bathroom to pass the contents of their bowels for the remainder of the hour.

Usually, once a person stops passing stool of any consistency, the solution has worked through their body, and they would have cleared out all the remaining bowel contents.

If a person chooses to use an enema at home, they should set aside enough time so they do not rush the process.

It is best not to eat for at least 30 minutes before using an enema.

Most enemas will show results within an hour of use. After injecting the fluid, the individual should lie on their back and hold it in for as long as possible. They will usually be unable to keep their bowels closed for more than 5 minutes.

A person may find that they cannot have a bowel movement after using an enema. If this happens, they should seek medical attention. A doctor can examine the bowels, and they may suggest using a second enema.

A person may need to try lying on their back again to see if the fluid works its way to the bowels.

Doctors may also recommend using an alternative type of enema, as discussed below.

Different fluids can go into an enema. Some types of enema include:

Barium

A doctor may perform a barium enema if they want to see the outline of the large intestine.

This enema uses a solution that contains barium, which coats the intestinal wall and helps show the shape of the digestive tract on an X-ray.

Salt solution

If a person uses an enema for constipation, they will typically use salt solutions.

Sodium phosphate laxatives draw water into the bowels, softening the stool and making it easier to pass.

However, according to the Food and Drug Administration (FDA), using more than one dose in 24 hours of sodium phosphate drugs may cause rare but serious complications, such as kidney and heart damage. This is because they can cause dehydration or abnormal levels of electrolytes in the blood.

Learn more about making a saline enema at home.

Soap sud

These types of enemas can also treat constipation. They typically include a mixture of water and castile soap, a vegetable oil-based soap.

According to a 2017 study, a soap sud enema is typically safe and effective for use.

Mineral oil

Mineral oil enemas can treat constipation. People can purchase oil enemas without a prescription from a local drugstore or pharmacy.

When using a mineral oil enema, a person should try to hold it in for 5 minutes.

Coffee

There is little scientific evidence to support the use of coffee enemas.

Some people use this enema as detoxification therapy to treat constipation, obesity, and pain relief.

However, a 2020 systematic review does not recommend people self-administer coffee enemas as a complementary or alternative treatment.

Warm water

Warm water alone can also work as an enema for impacted fecal matter.

A 2015 study on the management of constipation in older adults suggests warm water enemas are safe. Warm water enemas may be useful for people who cannot tolerate oral preparations for constipation.

An enema can be available at a doctor’s office or clinic, but many people use them at home.

There are a series of steps to follow for home use. A person should:

1. Warm the enema in a bowl of warm water before starting.
2. Remove the lid from the enema nozzle, holding the bottle vertically to prevent spillage.
3. Add lubricating jelly to the nozzle if this is a preference.
4. Lie down sideways on a towel with knees pulled to the chest.
5. Insert the nozzle roughly 7 centimeters into the anus and slowly squeeze the bottle to inject the contents.
6. Remove the nozzle from the anus and lie down flat, with the back on the ground.
7. Keep the bowels closed for as long as possible to retain the fluid.
8. Go to the bathroom when the bowels begin to open. A person should should not worry if they are unable to produce a bowel movement at first.
9. Stay near the bathroom for 1 hour if there is a need to pass feces again.
10. Lie down if feeling faint or dizzy. After 1 hour, the effects of the enema should have worn off.

If complications arise, a person should seek medical attention.

Enemas are typically safe and easy to use, providing a person administers them correctly and uses sterile equipment.

However, if a person administers an enema incorrectly, there may be a risk of:

• electrolyte imbalances
• bowel perforation
• inflammation
• infections
• bloating
• cramping

Before a person uses enemas at home, they should consult a doctor and follow any written instructions carefully.

If no liquid comes out after 30 minutes, they should call a doctor promptly due to the risk of dehydration.

Who should not use one?

Advice varies according to the contents of an enema, but most people should avoid using an enema if they have kidney or heart conditions.

Older adults tend to have greater risks of adverse effects and should avoid using enemas unless necessary.

There are some risks with the use of enemas at home.

If issues arise, it is important to see a doctor promptly before the complications worsen.

Side effects can include:

• dizziness
• feeling faint
• stomach cramps
• bloating

Some of these complications can be life threatening. If a person is experiencing rectal bleeding, they should seek help at once.

An enema is a device people use to clear the lower half of the large bowel. It contains fluid that goes into the colon and expels feces after a short retention period.

An enema will take up to an hour to work but will typically take effect after 5 minutes. If adverse effects occur, it is important to see a doctor before they worsen.

People considering using an enema at home should speak to their doctor to ensure it is safe.

Normacol Enema: instruction, price, analogues | rectal solution Norgine

• Pharmacological properties
• Indications Normacol Enema
• Application Normacol Enema
• Contraindications
• Side effects
• Special instructions
• Interactions
• Overdose
• Storage conditions
• Diagnosis
• Recommended alternatives
• Trade names

when mono- and disodium phosphates are combined with a small amount of sterculia (vegetable) glue, a solution is formed, the pH of which does not irritate the intestinal mucosa. The use of a hypertonic enema promotes the influx of water into the intestinal lumen. Moistened and softened feces increase in volume, stretching the walls of the large intestine, which leads to defecation in 5–20 minutes.

The components of the drug are not absorbed, not broken down. The drug is almost not absorbed, thus retaining a large amount of water in the intestine.

preparation for X-ray and endoscopic examinations of the rectosigmoid colon.

Symptomatic treatment of constipation in the lower intestines, especially due to difficult defecation.

is used rectally.

Remove the protective cap, insert the tip into the anus and carefully squeeze out the contents of the vial.

After the administration of the enema, the patient should remain in the supine or side lying position until the urge to defecate occurs.

Symptomatic treatment of constipation: 1 enema 5-20 minutes before the selected bowel time.

Preparation for x-ray and endoscopic examinations: 1 enema the night before and 1 enema in the morning on the day of the examination.

The maximum dose is 1 enema per day.

hypersensitivity to the drug or any of its components.

Electrolyte imbalance with sodium retention, congestive heart failure.

Intestinal obstruction.

OPN.

Megacolon (congenital or acquired significant enlargement of part or all of the colon).

Children under 15 years old (enema 130 ml).

Children up to 3 years (enema 60 ml).

very rarely (<1/10 000) such cases were noted:

• water and electrolyte disorders, including hyperphosphatemia, hypocalcemia, acidosis and hypernatremia dehydration, which leads to the development of seizures. This may be due to an overdose, the early age of the child, or the presence of Hirschsprung’s disease (aganglionosis of the colon) in the child and the presence of renal failure in the patient;
• rectal administration of sodium phosphate solutions may cause local irritation, rectal necrosis;
• allergic reaction with or without rash.

the drug should be used with caution in the elderly and debilitated patients with impaired renal function, while observing a strict salt-free diet, since there is a risk of hyperphosphatemia, hypocalcemia, hypernatraemic dehydration and acidosis.

Patients are advised to maintain an appropriate fluid balance.

Do not use the drug during an exacerbation of hemorrhoids, in the presence of anal fissures or ulcerative colitis.

The drug should be used with caution in the treatment of drugs that can affect the level of electrolytes (eg diuretics, lithium, etc.), as a result of which there is a risk of increasing their effect.

Overdose in children may cause life-threatening fluid and electrolyte disturbances.

Do not recommend long-term use: if there is no effect when using the drug for 3 days, it is necessary to reconsider the tactics of treatment.

This product contains methyl parahydroxybenzoate (E219) and may cause allergic reactions (possibly delayed).

This product contains sorbic acid and may cause local skin reactions (dermatitis).

Normacol enema is a solution for rectal use.

The period of pregnancy and lactation. Treatment of constipation during pregnancy is possible only under the condition of limited use of laxatives in enemas. For safety reasons, it is better not to use phosphate enemas.

During pregnancy and lactation, the drug is used only on prescription.

Children. Do not use in children under 3 years of age.

Do not use the 130 ml enema in children aged 3–15 years.

The ability to influence the reaction rate when driving vehicles and working with other mechanisms. Unknown.

is used with caution in patients taking calcium channel blockers, diuretics, lithium, and other drugs that can affect electrolyte levels and cause hyperphosphatemia, hypocalcemia, hypokalemia, hypernatraemic dehydration, acidosis.

given that the drug is almost not absorbed, an overdose can only be accidental.

In case of accidental overdose, phosphate elimination and measures to improve general condition, acidosis and serum electrolyte levels, especially calcium, are necessary.

at a temperature not exceeding 25 °C.

instructions for use, dosage, composition, analogs, side effects / Pillintrip

WARNINGS

ROWASA® (mesalamine) rectal suspension enema contains potassium metabisulphite
sulfite, which can cause allergic reactions, including anaphylactic symptoms
and life-threatening or less severe asthmatic episodes in certain cases
People. Overall prevalence of sulfite sensitivity in the general population
unknown, but probably low. Sulfite sensitivity is more common in
asthmatic or atopic non-asthmatic people.

Adrenaline is the preferred treatment for severe allergic or emergency situations
although epinephrine contains sodium or potassium metabisulfite
with the potential liabilities mentioned above. Alternatives to using adrenaline
in a life-threatening situation may not be satisfactory. Presence of sulfite(s)
with the introduction of adrenaline, the administration of the drug should not restrain
Treatment of severe allergic or other emergencies.

PRECAUTIONS

Mesalamine has been implicated in the development of acute intolerance syndrome
characterized by cramps, severe abdominal pain, and bloody diarrhea, sometimes
fever, headache and rash; in such cases, immediate withdrawal is required.
the medical history of sulfasalazine intolerance, if any, should be reassessed.
If a retest is performed later to confirm hypersensitivity
this should be done under strict control and only when there is a clear need
Consideration of reduced dosage. Patient in Literature in Advance
sulfasalazine-sensitive was again taken with 400 mg oral mesalamine; inside
You have experienced headache, fever, intense abdominal colic for eight hours
Diarrhea and was resumed as an emergency. She reacted badly to the steroid
Therapy and two weeks later a pancolectomy was required.

Although kidney abnormalities have not been identified in clinical trials with ROWASA®
(mesalamine) rectal suspension intake capacity, the possibility of increasing absorption
mesalamine and associated renal tubular injury as in preclinical
Research must be kept in mind. Patients on ROWASA® rectal suspension (mesalamine)
Admission, especially with concurrent oral products that release mesalamine
and those who already have kidney disease should be closely monitored
Urinalysis, BUN (blood urea nitrogen) and creatinine.

In a clinical study, most patients were hypersensitive to sulfasalazine
can take mesalamine enemas without any signs of an allergic reaction.
However, caution should be exercised when using mesalamine initially.
in patients known to be allergic to sulfasalazine. These patients should be
instructed to discontinue therapy if there are signs of rash or fever.

Some patients have developed pancolitis while using ROWASA® Rectal Suspension Enema (mesalamine). However, extension of the upper limit of the disease and/or exacerbation occurred less frequently in the VON® (mesalamine) series rectal suspension group than in the placebo group.

Worsening of colitis or symptoms of inflammatory bowel disease, including melena
and hematocheechia, mesalamine may occur after onset.

Rare cases of pericarditis have been reported with mesalamine, which contains
Products, including sulfasalazine. Cases of pericarditis have also been reported
as manifestations of inflammatory bowel disease. In registered cases with
ROWASA® (mesalamine) rectal suspension enema, were positive anti-allergic
with mesalazine or mesalamine-containing products. However, in one of these cases
the second repeat of sulfasalazine was negative during the 2-month follow-up period.
Chest pain or shortness of breath in patients treated with ROWASA® (mesalamine) rectal
Suspension enema should be examined with this information in mind. deposit
ROWASA® (mesalamine) rectal suspension enema may be warranted in some
cases, but re-call with mesalamine can be done with careful clinical
Surveillance must have an ongoing therapeutic need for mesalamine.

Carcinogenesis, mutagenesis, impairment of fertility

Mesalamine did not increase the incidence of tumor lesions with control
in a 2-year study, Wistar rats were fed up to 320 mg/kg/day of mesalamine
with a diet. Mesalamine is not mutagenic for Salmonella typhimurium most expensive strains
TA98, TA100, TA1535, TA1537, TA1538. There were no backmutations in the analysis
with E. coli strain WP2UVRA. One had no effects in vivo Mouse
Micronucleus analysis at a dose of 600 mg / kg and in one in vivo sister chromatid exchange
at doses up to 610 mg/kg. No effect on fertility was observed in rats
up to 320 mg/kg/day. Oligospermia and male infertility associated with
Sulfasalazine has been reported very rarely in patients treated with mesalamine.

Pregnancy (Category B)

Teratological studies have been in rats and rabbits at oral doses up to
up to five – or. Eight times the recommended maximum dose for humans and
showed no evidence of damage to the embryo or fetus.