What is an enema and how to use it safely?

The enema is the most common way to cleanse the large intestine to diagnose and treat various conditions. Its application is simple and only requires a few minutes.

Last update: 19 January, 2022

The term enema usually causes confusion. It is a simple procedure that purports to cleanse the rectum, colon, and part of the small intestine for regulatory, therapeutic and diagnostic purposes. If you are interested in knowing what an enema is and how to use it safely, then we will tell you.

Enemas are also known as washed or enemas. They consist of the introduction of a medicinal solution or other aqueous medium through the anal sphincter. In this sense, the objective is to promote the evacuation of the intestinal content and the cleaning of the colon and rectum.

As usual, this procedure is useful in the treatment of constipation or constipation. Similarly, it is usually used prior to radiological, endoscopic tests and some surgical approaches.

Uses of the enema

Enemas are substances administered rectally made from water, medicines or natural remedies. These can be classified as evacuation or retention.

Some of the more common uses include the following:

  • Treatment of constipation.
  • Approach to retention or fecal impaction.
  • Elimination of fecalomas.

On the other hand, an enema is a critical step in certain endoscopic procedures, such as sigmoidoscopy and colonoscopy. Both have the purpose of exploring the intestinal lumen with a small camera.

Studies affirm that intestinal cleansing by enema is a useful strategy to reduce postoperative complications of intestinal surgeries, as well as hospitalization days and costs. In addition, the practice of this procedure for hygienic purposes is now becoming more and more common.

Similarly, enemas are useful for administering radiopaque contrast substances, such as barium sulfate, prior to an X-ray examination. This facilitates the visualization of intestinal loops and the identification of conditions.

Cleaning the end of the digestive tract improves visualization when studies such as colonoscopy are to be performed.


Adverse effects and contraindications

The application of an enema under medical indication it is usually a safe procedure with few adverse effects. Nausea, colic and anal burning are some of the secondary symptoms.

Similarly, excessive fluid administration can lead to distention of the abdomen. Some research suggests that ischemic colitis and intestinal perforation are the main complications of evacuation enemas.

On the other hand, they can be harmful in the presence of certain health conditions. Among the contraindications are the following:

  • Colitis and appendicitis.
  • Peritonitis.
  • Rectal prolapse.
  • Abdominal trauma.
  • Gastrointestinal bleeding.
  • Hemorrhoids.

What’s more, its use can be of high risk in people with acute coronary disease, severe dehydration and kidney failure. For this reason, it is vital to inform the treating physician about any pathological condition.

Steps to perform an enema properly

The administration of an enema is usually a simple procedure that only takes a few minutes. In the case of one for medicinal purposes, it is vital to consult the doctor about the frequency and time of use.

Also, keep your enema kit, Vaseline, towels, and a timer handy, as well as a comfortable space to lie down. For the application, the following steps must be followed:

  1. Prepare the surface where you will perform the procedure, spreading some towels on the bed or the floor.
  2. Lie on your left side, bending the right knee against the chest and placing a rolled towel under it. Another position consists of kneeling, bringing the chest to the ground and leaning on the left side of the face.
  3. Using a finger, apply petroleum jelly or lubricant around the anus to make it easier to insert the enema.
  4. Remove the plastic cap from the enema nozzle and with your dominant hand slowly insert it through the anal hole. It is recommended to make small movements from side to side with the nozzle to facilitate insertion. This step usually causes discomfort; pain may indicate the presence of anal fissures or external hemorrhoids.
  5. Once the nozzle is inserted, squeeze the container to get the solution into the rectum. The pressure must be from bottom to top to ensure the entry of the solution. When finished, carefully remove the nozzle from the rectum.
  6. You must maintain the same position for the time recommended by the treating doctor or what the product instructions say. Enemas take between 5 and 20 minutes to stimulate a bowel movement.

In most cases, this procedure can promote several continuous bowel movements, so you should be near a bathroom for the first hour. Do not use another enema until all of the administered solution has been expelled.

Chronic constipation is one of the indications for enema use. However, it cannot be used frequently.


When to seek medical attention?

An enema is one of the most common ways to cleanse the large intestine and rectum. Nevertheless, this procedure is not indicated for all people and can promote various health complications. In this sense, consult a trusted doctor if you have any doubts about its use and care.

On the other hand, it is vital to seek professional attention as soon as possible if the product is not evacuated after 30 to 60 minutes. Similarly, rectal bleeding, severe abdominal pain, and signs of dehydration are situations that require emergency medical management.

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