Digestive Health Constipation Are Enemas Safe? What About Repeated Use? Regular enema use can make constipation worse and harm your health By Amber J. Tresca facebook twitter linkedin Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16. Learn about our editorial process Amber J. Tresca Medically reviewed by Medically reviewed by Priyanka Chugh, MD on January 08, 2020 linkedin Priyanka Chugh, MD, is board-certified gastroenterologist with a background in internal medicine. She practices with Trinity Health of New England in Waterbury, Connecticut. Learn about our Medical Review Board Priyanka Chugh, MD on January 08, 2020 Print Table of Contents View All Safe Use Unsafe Use Fad Enemas Constipation Treatments Enemas are a common treatment for constipation, and while they can be safe and effective, they do have risks when performed at home, or if they're used too frequently. When over-used for constipation, they can even make your health problems worse. They can lead to life-threatening complications, as well. Enemas work by getting fluid into your intestines so it can soften up your stool and help it pass. However, this is a last resort for constipation. Before you opt for an enema, and especially repeated enemas, you need to understand the risks and how often they can be safely used. Verywell / Nusha Ashjaee Safe Use of Enemas An enema, broadly speaking, is the introduction of a fluid into the rectum and large intestine through the anus. Enemas are used for a variety of reasons: Before tests: One or more enemas might be used before having a test such as a colonoscopy, to clear the large intestine of all stool.Colon X-rays: To get the large intestine to show up better on an X-ray, doctors use barium enemas, which contain a metallic substance that coats the lining of your colon. This allows them to better detect abnormalities, such as colon cancer.To deliver medication: Inflammatory medications can be delivered directly to the rectum or the sigmoid colon (the lowest part of the large intestine) as a treatment for conditions such as inflammatory bowel disease (IBD).Constipation: While enemas can effectively relieve constipation, you should only use them on the direct advice of a doctor, and you shouldn't use them frequently. Enema Kits If your doctor recommends an at-home enema, you can buy an over-the-counter enema kit. Most of them contain water and salt, mineral oil, or a mild laxative. Get the kind your doctor recommends. Don't add anything to it, and make sure you follow the directions carefully. Don't try to put together an enema kit from things you have around the house. Simple Instructions on How to Use an Enema Unsafe Use of Enemas Using an enema at home always comes with certain risks. Risks of a single enema include: Damage to or perforation (puncturing) of rectum or intestines due to stretchingDisruption of the natural microflora in your gutPain caused by using liquid that is too hot or coldIntroducing too much liquid, which may stay in the body and come out without warningInfection introduced by equipment that's not sterile; this is especially a problem for people with autoimmune diseases or an otherwise compromised immune system An enema-related perforation can result in sepsis (blood poisoning), which one study found is fatal about 4% of the time. Repeated Use The repeated use of enemas can, over time, cause serious problems, such as: Weakening the muscles of the intestine so you're dependent on enemas to have a bowel movementA condition called hyponatremia or water intoxication, which is an imbalance of electrolytes that occurs when the body does not have enough sodium; in severe cases, it can cause confusion, seizures, and coma One type of enema is called a high colonic or colon hydrotherapy. They're invasive and can lead to harmful effects if you use them to clear out stool on a regular basis. Contraindications If you have hemorrhoids, enemas may cause extra pain. If you have a rectal prolapse (the end of the lower intestine protruding from your rectum), you should avoid using an enema. In 2014, the U.S. Food and Drug Administration (FDA) issued a warning against the repeated use of enemas containing sodium phosphate, such as the brand Fleet Enema and multiple store brands with the same ingredients. The sodium phosphate enema is especially dangerous for elderly people. It can lead to hyperphosphatemia—an electrolyte disorder that involves high phosphate levels and low calcium levels in the blood. This can lead to pain, rash, muscle cramps, intermittent spasms, kidney and liver damage, and (rarely) death. Fad Enemas A lot of people tout at-home enemas, often with "special" ingredients, for cleansing your bowel, improving digestive health, or other supposed benefits. These uses of enemas are not recommended by the medical community. This includes enemas containing coffee, herbs, minerals such as Epsom salt, soap suds, acidic solutions, and basically anything your doctor hasn't told you to use. In addition to the regular risks of enemas, these fad enemas can cause: Disruption of gut bacteriaElectrolyte disturbancesSevere dehydration that can be fatalRectal burns, inflammation, and infection that can be fatalInternal bleeding that leads to blood transfusion and possibly removal of your colon Safe Treatments for Constipation Again, an enema should be a last resort for treating constipation. In most cases, constipation can be relieved with lifestyle changes, such as: Adding fiber to your dietExercisingDrinking more water Over-the-counter laxatives may be an option for you, but they also come with risks. Talk to your doctor about them, especially if you have regular constipation. Constipation can be caused by a serious conditions, such as neurological problems or colon cancer. If you have constipation that it's hard to relieve, talk to your doctor. How Constipation Is Treated A Word From Verywell Constipation isn't pleasant and you probably want quick relief. If safe and recommended treatments don't offer that, seek medical help instead of trying home remedies that may do more harm than good. Was this page helpful? Thanks for your feedback! Gas pain? Stool issues? Sign up for the best tips to take care of your stomach. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Portalatin M, Winstead N. Medical management of constipation. Clin Colon Rectal Surg. 2012;25(1):12–19. doi:10.1055/s-0032-1301754 Horiuchi A, Nakayama Y, Kajiyama M, et al. Colonoscopic enema as rescue for inadequate bowel preparation before colonoscopy: a prospective, observational study. Colorectal Dis. 2012;14(10):e735-9. Seow-choen F. The physiology of colonic hydrotherapy. Colorectal Dis. 2009;11(7):686-8. Additional Reading National Digestive Diseases Information Clearinghouse, NIH Publication No. 04–2673 2004. Facts and Fallacies About Digestive Diseases. Niv G, Grinberg T, Dickman R, Wasserberg N, Niv Y. Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable. Int J Gen Med. 2013 Apr 26;6:323-8. doi:10.2147/IJGM.S44417 Ori Y, Rozen-Zvi B, Chagnac A, et al. Fatalities and severe metabolic disorders associated with the use of sodium phosphate enemas: a single center's experience. Arch Intern Med. 2012 Feb 13;172(3):263-5. doi:10.1001/archinternmed.2011.694 United States Food and Drug Administration (FDA) 2014. FDA Drug Safety Communication: FDA warns of possible harm from exceeding recommended dose of over-the counter sodium phosphate products to treat constipation. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-possible-harm-exceeding-recommended-dose-over-counter-sodium