How to Use an Enema Safely

Precautions, Procedures, and Contraindications

An enema is used to clean stool (poop) out of your bowel. It's useful in many medical situations.

Enemas can treat some conditions, like constipation. They're also helpful for diagnostic procedures like colonoscopies and before bowel surgery.

You can give yourself an enema at home. Or it may be done by a nurse or other healthcare professional.

This article looks at the uses of an enema, potential problems, who shouldn't use them, and how to use one.

How to Use an Enema Safely
Verywell / Emily Roberts

Uses

Enema solutions may contain plain water or medication. As a treatment, they can soften hard stool. That allows you to pass it.

They may also deliver medications directly into the bowel. Enemas are used to treat:

The terms bowel, colon, and large intestine are different names for the same organ.

An enema is a common part of bowel preparation. You may need that before some procedures. Those include:

  • Colonoscopy: A flexible scope is used to see inside your rectum and colon. It can show inflammation, bleeding, damage, and abnormal growths. Studies suggest results are better when an enema is used before other bowel preparations.
  • Sigmoidoscopy: Similar to a colonoscopy but only involves the rectum and lower part of the colon, called the sigmoid colon. It can show inflammation, irritation, and growths.
  • Certain surgeries: Surgeries on the bowel or other parts of the lower digestive system often require an enema beforehand.

Recap

Enemas clear stool from your bowel. They can treat some conditions, like fecal impaction. Medicated enemas may be used for IBD.

Some diagnostic imaging and bowel surgeries require enemas as part of the bowel preparation process.

Potential Problems

To use an enema, you need to twist and reach behind yourself. This may be difficult if you have:

  • Limited range of motion in the shoulders or arms
  • Lost feeling in your fingers or hands

Fluid Considerations

Follow directions about how much fluid to use.

If you use too much, it can travel higher up into your colon. Then it takes longer than expected to come out. You may end up with an unpleasant surprise well after you've left the bathroom.

Using too much fluid can also lead to abnormal distention (your belly sticking out). That can lead to bowel perforation. This condition may not be obvious until serious symptoms appear.

Don't use water that's much warmer or cooler than your body temperature. Hotter water can be irritating. Cold water may cause contractions that force the water out too fast for it to work.

What To Use (And Not Use)

Use an enema kit that's recommended by a healthcare provider.

Call your provider if you can't give yourself a prescribed enema. Get medical help if it causes pain or severe discomfort.

Don't use home preparations. Avoid trendy enema solutions that contain coffee or alcohol. They aren't safe.

Don't use enemas to treat ongoing constipation. That can introduce harmful bacteria into the intestines. If you have hard fecal stones, the sudden outward rush of fluid and fecal matter can cause rectal tears.

Contraindications

Something is contraindicated if it's unsafe for you for because of some aspect of your medical history. You shouldn't use enemas if you have:

Recap

If you have physical limitations it may be hard to give yourself an enema. Follow directions and don't use too much fluid. Contact your healthcare provider if you have problems.

Don't use an enema if you have conditions that are contraindicated.

Instructions

To use an enema, you'll need:

  • An enema kit (available from grocery or drug stores)
  • Petroleum jelly or other lubrication
  • Towels
  • Space to lie down

Clear your schedule for several hours afterward so you're not in a hurry.

  1. Lay some towels on the floor, preferably in the bathroom. Roll up one to use as a bolster. Keep other towels and washcloths within arms reach.
  2. Have a clock or timer close by (possibly on your phone) so you can properly time the enema.
  3. Remove the cap from the tip of the enema nozzle.
  4. Apply some petroleum jelly or lubricant to your anus to make insertion easier.
  5. Lie on the floor on your left side. Bend your right knee and place the rolled-up towel under it. (If you're left-handed, reverse these instructions.)
  6. With your dominant hand, gently insert the tip of the enema nozzle into your rectum. This may be uncomfortable but not painful. If there's pain, stop and call your healthcare provider.
  7. After insertion, squeeze the enema container to push the liquid into the rectum. Squeeze from the bottom to the top and empty the container.
  8. Slowly withdraw the nozzle.
  9. Set an alarm for the recommended amount of time before going to the bathroom. (See chart below.)
  10. When the alarm goes off, use the toilet.
  11. Stay close to a toilet for the next 30 to 60 minutes. You may need to go several more times. 
Solution Minimum Time Maximum Time
Docusate
Mineral oil
Sodium
2 minutes 15 minutes
Bisacodyl
Glycerin
15 minutes 60 minutes
Senna 30 minutes 120 minutes

Summary

Enemas clean out your bowel. This is helpful for treating constipation or fecal impaction. It can also deliver medication to the bowel.

You may need an enema before colonoscopy, sigmoidoscopy, or bowel surgery.

Tell your healthcare provider if you have problems with an enema or can't use one as prescribed. Don't use one if you have an enema if you have tumors obstructing your rectum, rectal prolapse, acute coronary syndrome, or a compromised immune system.

Follow the instructions carefully and observe the weight times for your kit's ingredients.

A Word From Verywell

An enema can be uncomfortable, embarrassing, and fairly gross. Try to put that aside. Understand that it's necessary and discuss any concerns with your healthcare provider.

Enemas shouldn't be used regularly. If you find yourself needing them for something like chronic constipation, talk to your provider about other treatments.

Frequently Asked Questions

  • What is an enema?

    An enema is a handheld device used to push liquid (often mineral oil) through the anus into the large intestine. It is used to treat constipation and in preparation for certain types of procedures, such as a colonoscopy.

  • Can an enema be used to treat constipation?

    Yes, an enema can be used to treat constipation. But it's considered a last resort and shouldn't be used regularly.

    Safer ways of treating constipation include:

    • Adding fiber to your diet
    • Drinking more water
    • Getting regular exercise
  • How often can you use an enema?

    Repeated use of an enema comes with certain risks. That includes weakened intestinal muscles and hyponatremia (water intoxication). Talk to your healthcare provider before using an enema.

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5 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.
  1. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Colonoscopy. Updated July 2017.

  2. Yıldar M, Yaman İ, Başbuğ M, Çavdar F, Topfedaisi H, Derici H. A new approach in bowel preparation before colonoscopy in patients with constipation: A prospective, randomized, investigator-blinded trialTurk J Surg. 2017;33(1):29-32. Published 2017 Mar 1. doi:10.5152/UCD.2015.3189

  3. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Flexible sigmoidoscopy. Updated July 2016.

  4. Lund JN, Buckley D, Bennett D, et al. A randomised trial of hospital versus home administered enemas for flexible sigmoidoscopy. BMJ. 1998;317(7167):1201. doi:10.1136/bmj.317.7167.1201

  5. 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;6:323-8. doi:10.2147/IJGM.S44417

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