How to Use an Enema Safely

Precautions, Procedures, and Contraindications

An enema is a helpful tool that can be used in a variety of situations, including in preparation for a colonoscopy, sigmoidoscopy, surgery, or to treat constipation or fecal impaction. An enema could be given by a healthcare professional, such as a nurse, or it could be done at home.

When preparing for a colonoscopy, a doctor may prescribe an enema to make sure the rectum and lower end of the colon are clear of debris prior to the test.

Considerations

To use an enema, it's necessary to be able to reach behind oneself, so for those who have limited range of motion in the shoulders or the arms or have a loss of feeling in the fingers or hands, assistance may be needed.

You should also pay attention to how much fluid is introduced into the rectum. If too much is added, it can pass beyond the rectum and go further up into the colon than anticipated. In some cases, the water may only be released 30 minutes or more after you have already dressed and are in public.

Moreover, the abnormal distention of the colon or rectum can lead to a bowel perforation, a condition which may not be immediately noticed until more serious symptoms appear.

Also, avoid placing overly warm fluids into the rectum. While some people find this soothing, your intestines are unaccustomed to anything other than the normal body temperature. The same applies to icy cold liquids to which the intestines may respond by contracting and expelling the fluid immediately.

An enema is not intended for the ongoing treatment of constipation. Doing so can introduce harmful bacteria into the intestines. If there are hard fecal stones, the sudden rush of fluid and fecal matter from the bowels can cause rectal tears.

How to Use an Enema

To use an enema, things needed includes the enema kit, towels, and a place to lie down. It's also good to have a clear schedule for several hours after the enema to ensure there isn't any stress about having to leave the house for work or school.

  1. Purchase the enema kit from a drugstore. Your doctor may have a recommendation for a particular brand or type. Also, buy some petroleum jelly if you think you'll need lubrication.
  2. Lay some towels on the floor, preferably in the bathroom. Roll up one of the towels to use as a bolster. Keep some other towels and washcloths within arms reach.
  3. Keep a clock or timer within sight to ensure the enema is being used for the recommended period of time.
  4. Remove the cap from the tip of the enema nozzle.
  5. If needed, apply some petroleum jelly to the anus to ease insertion of the enema.
  6. Lie on the floor on your left side with the right knee bent, placing the rolled-up towel under the right knee to support it.
  7. Using the right hand, gently insert the tip of the enema nozzle into the rectum. This may be uncomfortable but should not cause pain. Stop if there is pain and call your doctor.
  8. After insertion, start squeezing the enema container to push the liquid into the rectum. Try to empty all of the contents by squeezing from the bottom of the container to the top.
  1. Slowly withdraw the nozzle.
  2. Wait the recommended period of time before going to the bathroom. Typical waiting times include:
    1. Bisacodyl: 15 minutes to 1 hour
    2. Docusate: 2 to 15 minutes
    3. Glycerin: 15 minutes to 1 hour
    4. Mineral oil: 2 to 15 minutes
    5. Senna: 30 minutes up to 2 hours
    6. Sodium: 2 to 5 minutes
  3. After the allotted time, evacuate the bowels into the toilet.
  4. Stay close to a toilet for the next 30 to 60 minutes as it may be necessary to go to the bathroom several more times. 

Contraindications for an enema include a rectal obstruction by a tumor, rectal prolapse, acute coronary syndrome, or any condition in which the immune system is compromised (such as advanced HIV or cancer chemotherapy).

A Word From Verywell

Always use an enema kit that was recommended by a doctor, and call your doctor if you cannot complete an enema or there is severe discomfort or pain. Home preparations or enemas that include substances like coffee or alcohol are not safe and should be avoided.

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