Pro Guide on How to Use an Enema

Getting an enema is not a pleasant experience. However, it is a necessary tool in a few medical situations. It can clear the lower colon of feces in preparation for surgery, sigmoidoscopy, or colonoscopy.

An enema is also an effective treatment for severe cases of constipation and fecal impaction. It is given by a nurse or other medical professionals, but an enema can be used at home as well.

Although it may seem simple enough, this procedure shouldn’t be taken lightly because it’s invasive and may lead to certain complications. This is why it’s important to know how to use an enema without risking injury.

Things to Consider

Using an enema requires the ability to reach behind to the anal region. Those who struggle with the range of motion or use of hand should seek some assistance.

The right amount of enema fluid is one of the most important factors. Excess fluid can go deep inside the colon and stay there for more than half an hour.

More importantly, too much fluid can cause abnormal widening of the rectum or colon and cause bowel perforation. To make matters worse, this condition might only become apparent when serious symptoms occur.

It is also recommended to introduce fluids of proper temperatures. The intestines don’t respond well to anything that’s above regular body temperature. On the other hand, overly cold fluids cause intestinal contraction and might be immediately expelled.

An enema shouldn’t be used as an ongoing constipation treatment because it can allow dangerous bacteria to enter the intestine. In addition, solid fecal stones might be pushed by fecal matter and fluid and create rectal tears.

Proper Usage

To properly use an enema, one needs a place to lie down, some towels, and an enema kit. The ordeal may take a few hours so it’s best to get a day off and avoid leaving the house.

Enema kits are widely available OTC and lubrication might be required for some. To get started, put the towels on the bathroom floor and roll up one of them to create a cushion. Leave extra washcloths and towels in easy reach.

Get a timer to make sure the enema is used for the appropriate period of time. Take off the cap and apply some lubrication to the anus for smoother insertion. Lie down with the left side on the floor. The right knee needs to be bent with the towel cushion underneath for support.

Gently push the enema nozzle inside the rectum with your right hand. This may feel odd but it should be painless, so stop at the first sign of pain. Once the nozzle is inside the rectum, squeeze the enema container to release the liquid.

The container should be squeezed from the bottom up and emptied completely. Take the nozzle out slowly and throw it away.

All that’s left is to wait. Here are the general times sorted by enema fluids:

  • Glycerin: 15 – 60 minutes
  • Docusate: 2 – 15 minutes
  • Mineral oil: 2 – 15 minutes
  • Sodium: 2 – 5 minutes
  • Bisacodyl: 15 – 60 minutes
  • Senna: 30 – 120 minutes

You’ll know when you have to go. After that, you might want to be near a toilet for another hour just in case.

Different Types of Enema

Barium

Barium enemas are given by medical professionals for intestinal imaging purposes. A solution that contains barium sulfate is inserted into the rectum to create a coating on the distal colon. Afterward, a radiologist takes x-rays.

The barium sulfate coating lends a bright contrast to the X-ray, allowing the doctor to have a better view of the intestine.

Cleansing Enema

Unlike barium enemas, regular cleansing enemas can be obtained over the counter at any drugstore. As said, the usual fluids/solutions are bisacodyl, sodium, mineral oil, or phosphate. Your doctor may recommend a particular type, but any of them should work for the average adult.

What are the Alternatives?

Unfortunately, there is no replacement for an enema in patient preparation. However, it may not be the automatic solution to constipation. There are a few simple lifestyle changes that can promote bowel movement.

For example, one should take up physical activity and keep hydrated. Eating more fiber and being mindful when eating also helps. Constipation can also occur as a result of poor sleep, so make sure to get enough of it.

If this fails, there are always less invasive medication that can help. Finally, consult a doctor before resorting to an enema as frequent constipation might be a sign of an underlying condition.

Are There Any Dangers?

If one knows how to use an enema properly, it’s completely safe.

Remember that the nozzle should never be forced into the rectum because it can cause irritation or injury. It’s best to relax and try again. Talk to a doctor if you have to.

The sight of bloody stool after an enema indicates rectal injury if the blood is bright red, or a more serious condition if the blood is dark or black, which indicates bleeding higher up in the digestive tract.

To avoid complications, an enema should be administered only once a day around the same time. This minimizes the chances of side effects and allows the body to adjust.

Those with a compromised immune system might experience more serious contraindications such as acute coronary syndrome, rectal obstruction (caused by a tumor), or rectal prolapse.

Although rare, the wrong application can create an embolism or a blocked blood vessel. Or rectal perforation in the case of barium enema.

Older patients should avoid sodium phosphate enemas. A limited study indicated a potential connection to certain life-threatening complications like kidney failure.

The Necessary Relief

When all is said and done, an enema can be safely used at home. But it’s important not to overuse it for treating constipation. Make some lifestyle changes and improve your diet to promote bowel movement.

On the other hand, an enema is often a necessary tool to get a patient ready for surgery. In this case, it is given by a trained professional at the hospital.

May the force be with you whenever you need an enema.

 

References:

https://www.kch.nhs.uk/Doc/pl%20-%20579.2%20-%20guidance%20for%20using%20an%20enema.pdf
https://www.ncbi.nlm.nih.gov/pubmed/16328608
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1108682
https://www.medicines.org.uk/emc/product/3772/smpc
https://www.mayoclinic.org/tests-procedures/barium-enema/about/pac-20393008
https://clinicaltrials.gov/ct2/show/NCT00696618
https://www.ncbi.nlm.nih.gov/pubmed/24299100
https://www.ncbi.nlm.nih.gov/pubmed/26133063

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