Enemas
An enema is a medical procedure involving the introduction of liquid into the rectum to achieve specific health outcomes. Primarily, enemas are used for two main purposes: cleansing the bowel and retaining solutions for medicinal purposes. Common cleansing solutions include mild soapsuds mixed with tap water or saline, which help soften fecal material and stimulate bowel movement. The procedure typically requires the patient to lie on their left side, with the solution administered at a controlled temperature and flow to minimize discomfort.
Cleansing enemas can help alleviate constipation, which is sometimes a concern during toilet training in children. However, it's important to note that routine use of enemas is discouraged, as they can lead to bowel dependency, particularly in older adults. Retention enemas, on the other hand, are used to deliver medications or lubricants and require the patient to hold the solution for an extended period before evacuation. Understanding these procedures is essential for making informed decisions about bowel health and managing constipation effectively.
Enemas
Anatomy or system affected: Abdomen, anus, gastrointestinal system, intestines
Definition: A procedure to assist the body in evacuating fecal material from the bowel
Indications and Procedures
Enemas are used primarily for two purposes: cleansing and retention. Many solutions have been used to promote cleansing. The most commonly used is made up of mild soapsuds and tap water. Commercially prepared solutions containing premeasured mild soap and water are also available. Enemas are also produced with a saline solution.
To receive an enema, the patient should lie on the left side of the body with the upper thigh drawn up to the abdomen. The solution should be slightly above body temperature. The source of the enemafluid should be thirty to forty-five centimeters (twelve to eighteen inches) above the anus. All air should be removed from the tubing that connects the enema reservoir and the tip. The tip is warmed in the hands, lubricated with a commercial preparation or a bit of soapy water, and gently inserted into the anus with a combination of soft pressure and a twisting motion. The tip should not be inserted more than ten centimeters (four inches) into the rectum. The solution is allowed to flow slowly into the rectum to prevent cramping.
A towel may be held gently against the rectum to prevent leakage. If cramping does occur, the flow should be interrupted by pinching the tubing. For an adult, approximately one liter (one quart) of solution is probably sufficient. The patient should hold the solution for two to three minutes. The enema tube is tightly clamped and slowly withdrawn, and a towel is again held against the anus to catch any leakage. A bedpan or toilet stool should be readily available so the patient can evacuate the bowel. Depending on the reason for the enema, the procedure may be repeated.
The procedure for administering a retention enema is similar, except that the solution is instilled very slowly to promote retention. Lubricants or medicines are administered in this fashion. The patient holds the instilled solution as long as possible before evacuating the bowel.
Uses and Complications
Cleansing enemas are used to promote bowel evacuation by softening fecal material and stimulating peristalsis, the movement of bowel walls. Retention enemas are used to lubricate or soothe the mucosal lining of the rectum, to apply medication to the bowel wall or for absorption by the colon, and to soften feces. Enemas are sometimes used for constipation in children as a result of toilet training.
There is no physiological need to have a bowel movement every day; normality is defined as between three and ten per week. Enemas should not be used routinely for cleansing because the bowel quickly becomes dependent on them. This problem is especially common among older individuals.
Bibliography
Davis, Mark. “Therapeutic Retention Enemas.” Naturopathic Doctor News & Review, vol. 12, no. 1, 2016, pp. 1–8. Alt HealthWatch, search.ebscohost.com/login.aspx?direct=true&db=awh&AN=112725493&site=eds-live. Accessed 24 Jan. 2017.
“Enema, Saline.” DailyMed, dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=619f934e-ac71-4447-a17b-1a30d1073b36&type=display. Accessed 22 July 2023.
Heuman, Douglas M., A. Scott Mills, and Hunter H. McGuire, Jr. Gastroenterology. Philadelphia: W. B. Saunders, 1997.
Icon Health. Enemas: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. San Diego, Calif.: Author, 2003.
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Peikin, Steven R. Gastrointestinal Health: The Proven Nutritional Program to Prevent, Cure, or Alleviate Irritable Bowel Syndrome (IBS), Ulcers, Gas, Constipation, Heartburn, and Many Other Digestive Disorders. 3d ed. New York: Perennial Currents, 2004.