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Enema Administration

Enema administration

An enema administration is a technique used to stimulate stool evacuation. It is a liquid treatment most commonly used to relieve severe constipation. The process helps push waste out of the rectum when you cannot do so on your own. Enemas are available for purchase at pharmacies for home use, but you should ask a doctor or nurse for specific instructions to avoid injury.

Other types of enemas are administered to clean out the colon and better detect colon cancer and polyps. If you have concerns or worsening symptoms after an enema, ask a doctor right away.

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Uses

What is an enema administration used for?

Constipation is a common gastrointestinal condition. It occurs when the colon is unable to remove waste through the rectum. People with this condition have three or fewer bowel movements over a seven-day period. Mild constipation often occurs when you don’t eat enough fiber or drink enough water on a regular basis. Daily exercise also helps to prevent constipation.

An enema administration is most commonly used to clean the lower bowel. However, this is normally the last resort for constipation treatment. If diet and exercise are not enough to keep you regular, your doctor might recommend a laxative before trying an enema. In some cases, laxatives are used the night before an enema administration to encourage waste flow.

Enemas may also be used before medical examinations of the colon. Your doctor may order an enema prior to an X-ray of the colon to detect polyps so that they can get a clearer picture. This procedure may also be done prior to a colonoscopy.

Learn more: Colonoscopy »

Types

Types of enemas

There are several common types of enemas.

The purpose of a cleansing enema is to gently flush out the colon. It may be recommended prior to a colonoscopy or other medical examination. Constipation, fatigue, headaches, and backaches may be relieved by a cleansing enema. During a cleansing enema, a water-based solution with a small concentration of stool softener, baking soda, or apple cider vinegar is used to stimulate the movement of the large intestine. A cleansing enema should stimulate the bowels to quickly expel both the solution and any impacted fecal matter.

A retention enema also stimulates the bowels, but the solution that is used is intended to be “held” in the body for 15 minutes or more.

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Preparation

Preparing for an enema

You may be asked to fast or follow special dietary instructions in the days prior to having an enema. Instructions may vary, depending on your doctor and your personal health needs.

If you plan to administer an enema at home, make sure that all of the equipment you are using has been sterilized and that you have a lubricant on hand. Pay careful attention to the way that you prepare the enema solution. You may have to mix it yourself with medicinal components.

To lessen the pressure felt in your colon, empty your bladder before you begin the enema. You may also want to place a towel or cloth down in the area between your bathtub and your toilet, in case fluid leaks out of your bowels when you get up to empty your colon. It’s important to measure and mark your enema tube the first time you use it so that you do not insert the tube more than 4 inches into your rectum.

Administration

How an enema is administered

At a medical office

If you are unfamiliar with enemas, you should consider having a medical professional administer one for you. They can also offer instructions for home kits that are available over the counter at pharmacies. Check with your doctor before use.

Some types of enemas are exclusively administered at medical offices. A barium enema, for example, uses a liquid compound that highlights certain areas of the gastrointestinal tract. This increases the amount of the tract that your doctor can see during an exam. Barium enemas are not used to treat constipation.

Read more: Barium enema »

At home

Enemas can be administered in the comfort of your own home. This way can be less expensive, but you should ask your doctor for detailed instructions beforehand. Due to the delicate nature of the procedure, a loved one should help.

Enemas utilize a solution of salt water that is placed into a bag on one side of the tube. The other portion is lubed and placed directly into the rectum. In order for the solution to reach the colon properly, hug your knees to your chest while lying on your stomach or on your side. Here are the standard instructions:

  1. Fill the enema bag with your desired solution, using warm water. Make sure the clamp is shut. Hold the bag with the hose end down and open the clamp for a moment or so to get rid of any air bubbles, which you do not want to introduce into the colon.
  2. Hang the bag alongside the bathtub so that you can access it while lying on your left side.
  3. Lubricate the end of the tube to make insertion more comfortable before inserting the tube, no more than 4 inches into your rectum. Bear down and push the anus out as you insert the tube to make it more comfortable. Lie on your left side and pull your knees to your chest.
  4. Wait for the fluid to enter your rectum, breathing deeply and watching the bag until it is empty.
  5. Remove the nozzle from your rectum slowly.
  6. You will probably feel the urge to use the bathroom (“evacuate”) immediately. If you are doing a cleansing enema, carefully stand up and move to the toilet. If you goal is retention, follow the instructions of your desired enema.
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Results

Enema administration results

Once all of the solution is emptied into the colon, a bowel movement is expected within the hour. If you fail to expel any waste, call your doctor. You may be ordered to perform the procedure at a later time. Successful administrations result in the expulsion of waste from the rectum.

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Research

What the research says about enemas

There are plenty of holistic and nontraditional advocates for enemas as a beneficial method for internal cleansing. For Western medicine at large, the verdict is still out on whether regularly administered home enemas have proven benefits. Not much conclusive research has been done into their long-term health benefits. The occasional use of enemas for “colon irrigation” and relief of constipation will most likely not harm you, as long as your equipment is sterile and you follow directions carefully. But keep in mind that administering enemas has risks.

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Risks

Potential risks of enema administration

When conducted properly following a doctor’s instructions, enema administrations are generally considered safe. A barium enema can cause waste to take on a white color for a few days afterward. This is the normal effect of barium and should clear up on its own. If you can’t produce waste, talk to your doctor about ways to loosen your stool.

Forcing an enema into the rectum can cause irritation and damage to surrounding tissue. Never force the tube into the rectum. If problems persist, try administration at a later time or call your doctor. Blood that is present in the stool after the enema may mean there is rectal damage or an underlying medical problem. Consult with a physician immediately regarding any rectal bleeding.

Your risks for enema-related complications are greater if you administer the tubes multiple times a day. The best course of action is to use the enema once a day, and around the same time every day, as directed by a doctor. This not only reduces side effects, but will also help to train your body to release waste regularly. If constipation continues for more than a few days, call your physician.

In extremely rare cases, the incorrect administration of an enema can cause an embolism (or blockage) to form. Pulmonary embolisms, which occur in the lungs, can be fatal. In other rare cases, an incorrectly administered barium enema can result in perforation of the rectum.

Older adults should avoid the over-the-counter “Fleet” enema, which contains sodium phosphate. A small study in JAMA Internal Medicine linked it to serious complications such as kidney failure.

Takeaway

After an enema

Some people find that they have several additional bowel movements in the hours after an enema. For this reason, many plan to stay home for the rest of the day after an enema is administered. But for the most part, you may carry on with your regular routine after the enema process is complete.

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Q&A

Alternatives: Q&A

  • What are some alternatives to enemas?
  • Enemas are usually used for constipation, which may be caused from not eating a diet rich in fiber (at least 25 grams daily). Including fruits and vegetables regularly in your diet should help with constipation. There are also fiber supplements such as Metamucil. Probiotics and laxatives will also relieve constipation and are good alternatives to enemas.

    - Debra Sullivan, PhD, MSN, CNE, COI
  • Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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