Experts reveal the safest ways to perform an enema at home


Last Updated June 13th, 2021

What is enema?

Bowel evacuation happens naturally for some and for others, an assisting aid needs to be provided. Constipation affects 1 – 8% of the North American people. There are various means you can rectify it. An enema is a common nonsurgical medical method for bowel evacuation. It is available as an over the counter kit. The digestive system has the small and large intestine. The end of the large intestine until the anus is called the rectum. An enema is a method where a drug solution introduced (via a tube or a syringe or a rectal bulb) into the rectum to expel out the fecal contents.

How is it useful?

enema constipationPeople with constipation usually have bowel movements once in 3 to 7 days. Many ways of promoting bowel evacuation are utilized such as drinking water and consumption of fiber-based In some cases, even laxatives are consumed. If none of these options work, the final option would be an enema. Consult a doctor for instructions for performing enema to avoid any injuries. Enemas are also performed to clean out the contents in the colon and it enables the doctors to detect any cancers or blockages.

What are the types of enemas?

Cleansing enema is performed to flush out the feces. This is usually suggested before any medical examination or to relieve constipation, fatigue, headaches, and backaches. Here, a mixture of a stool softener in a water-based solution being introduced. This will stimulate the muscle movement of the intestine for bowel evacuation.

A retention enema also stimulates the bowels, but the solution that is used is intended to be “held” in the body for 15 minutes or more. Here either oil or a medication (antibiotic) is used. Oil retention enema is used to lubricate the colon, rectum and the anal areas. Antibiotic retention is used to treat any infections or worms in the colon.

Barium enema; here, a white barium solution is introduced followed by the introduction of air. This is done for an X-ray scan of the abdominal areas. The doctor will ask you to take various positions by holding your breath. The air is used to open the bowels up to enable better clarity of the scanned image.

Probiotic enema; probiotics are consumable substances that contain healthy bacteria. They help replenish the healthy bacteria living inside the gut and the colon. The bad bacteria in the colon can be eliminated with this procedure. This type of enema is useful for digestive disorders such as irritable bowel syndrome (inflammation of the digestive tract), or any ulcers in the intestine and more. The cons associated with probiotic enema are pains, abdominal discomfort, infection, etc.

How do I prepare myself before an enema?

  • Firstly consult a doctor if an enema is to be considered. The doctor may instruct you on your diet a few days before an enema.
  • Sterilize all the types of equipment required to prevent any infection. Apply the lubricant in your hand. Follow the instructions of the kit and mix the enema solutions accordingly.
  • After an enema, when you get up to clear out your bowels, the fluid may leak out on the bathtub or the bathroom floor. Prevent any fluid leakage by placing a towel or cloth in the area.
  • Make sure that you measure 4 inches and mark your enema tube so that you do not insert the tube more than 4 inches into your rectum.

Steps to perform an enema at home

Usually, enema kits contain the enema solution, a small can, rubbers, tubes, and nozzles. Fix them in a certain way as mentioned in the kit. Follow the steps given below:

  • Use warm water and fill the enema container or the bag with the enema solution. Close the clamp and hold the bag with the hose end down. Open the clamp for a moment to evacuate any air bubbles because otherwise you make get air bubbles into your colon and you don’t want that.
  • Hang the bag in a place that gives you access to it when you are lying on your left side.
  • Lubricate the end of the tube and then insert it no more than 4 inches into your rectum.
  • Lie down to your left, pull your knees up to your chest and push the anus out. Then, insert the enema tube.
  • Open the nozzle for the enema solution to drain into the pipe and enter your rectum.
  • Breathe deeply as you wait for the fluid to enter your rectum until the bag is empty.
  • Slowly remove the nozzle from your rectum. You may now feel the urge to pass out your bowels immediately.
  • If you are following cleansing enema, carefully stand up and go to the toilet.
  • If you are following retention enema, follow the instructions given in the kit.

Once all of the solutions enter the colon, you can expect a bowel movement within the hour. The enema procedure is a success if the bowels are expelled from the rectum. After the enema, it is important to stay at home just to avoid any further incidences of bowel evacuation. Drinking electrolytes will help restore the electrolyte balance lost during enema based bowel evacuation.

Potential risks of enema administration

An enema is generally safe when you follow the doctor’s instructions. In a barium enema, you might poop white waste for a few days, but it is not harmful. Here are the few disadvantages that are associated with an enema.

  • It can give rise to irritation if your force the enema solution into the rectum. Never force the tube into the rectum. If you experience discomfort, try again later or consult the doctor.
  • The stool that you excrete out might contain blood. This can be because of rectal damage or any injuries associated while inserting the tube or may be an underlying complication. Consult a physician if you experience rectal bleeding.

The following complications may arise:

  • Nausea
  • Vomiting
  • Sweating and dizziness
  • Diarrhea
  • Fluid overload
  • Bowel irritation
  • It may disrupt the functionality of the muscles of the large intestine to evacuate the bowels.

Enema and serious medical issues

People with a heart condition such as arrhythmia, etc., must not undergo enema. Otherwise, it can stimulate the nerves associated with the heart muscles to give rise to bradycardia.

There are chances of pulmonary embolisms to occur as well. This is a condition where there is a blockage in the arteries of the lungs. Here, the individual might experience chest pain and shortness of breath. There are scenarios where perforation of the rectum occurs if an enema is done repeatedly. The fecal contents from the rectum tend to enter the clean areas of your abdomen where feces are not supposed to enter. This is very harmful.

An excessive enema can also result in a loss of electrolytes. Electrolyte imbalance can cause dehydration, vomiting, seizures, etc. Another disadvantage is that excessive use can increase dependency on it.

There are chances of an anal fistula. An anal fistula is a pathway between the anus and the skin around the anus. This is treated surgically. Sodium phosphate based enemas can lead to kidney failures.

A dietary alternative to enema

Instead of opting for an enema, try your best to make some dietary changes to evacuate your bowels. Include fibers in your diet. An adult must have a dietary intake of about 25 to 30 grams per day.

Consider the following options for a good fiber intake:

  • Whole grains – whole wheat bread, oatmeal, bran flake cereals, etc.
  • Legumes – lentils, black beans, soybeans, chickpeas, etc.
  • Fruits – kiwi fruit, berries, apples with the skin on, oranges, etc.
  • Vegetables – carrots, broccoli, green peas, etc.
  • Nuts and seeds – flaxseeds, almonds, peanuts, etc.
  • Prunes are good as well. You should know that prunes not just help soften the stool, but also improves the stool consistency and frequency as well.
  • Drink lots of water and exercise regularly.
  • If you have constipation, refrain from eating fried or spicy foods, meat, frozen foods or fast foods.

Coffee enema – a work in progress

Coffee enemas are enemas where the coffee liquid is introduced to soften the tool. It does offer good health benefits but can be harmful if performed often. Coffee helps in stimulating the liver to break the food down to improve digestion. There are reports that claim improved blood circulation, immunity, cell growth, removal of toxins. Disadvantages include inflammation, significant electrolyte loss, prolonged diarrhea, and rectal bleeding.

To sum it up all…

An enema is a procedure involving stool softening and bowel evacuation. There are many kits available and follow the instructions given. First, it is important to try bowel evacuation via the consuming probiotics or including dietary fibers (via apples, oats, etc.). You can also try using laxatives (psyllium husk) that absorb water and bulk the stool to enhance the pressure on the muscles for bowel evacuation. Don’t overdo enema as it increases the dependency for bowel evacuation. Talk to your doctor about considering enema as a bowel evacuation option.


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