An enema involves inserting liquid or gas into the rectum, which is the lower part of the large intestine. The aim is to empty the bowels, allow for an examination, or administer medication.
An enema can be effective in treating certain medical conditions, but regular enema use can cause serious health problems.
Because of the risks involved, a person should only use an enema for medical reasons.
In this article, we find out more about enemas and how to use them safely.
A medical professional may give an enema, or a person can use one at home.
Many pharmacies sell enema kits, and these are also available online. Choose one that a healthcare provider has recommended.
A kit usually includes a bag or another type of container attached to a tube or nozzle. This container holds a liquid, which may contain an oil or laxative.
Anyone with sufficient flexibility in their arms and shoulders to reach behind them should be able to use an enema at home.
There are some risks when using an enema:
- Using too much liquid: In this case, the body may hold some liquid in and release it without warning.
- Stretching the bowel: This increases the chance of perforation, which is a risk when the lining of the colon is torn. It can cause the colon's contents to leak into the body.
- Using liquid that is too hot or cold: This can cause discomfort or pain. The liquid in an enema should be at room temperature.
Use the recommended amount of room temperature liquid, and do not use an enema too frequently.
Things to remember
Each enema kit is slightly different and should come with clear instructions. Reading these instructions carefully can help make sure enema use is safe and effective.
Make sure to plan enough time for the enema to work and to take a rest afterward, if needed. Doctors generally recommend having access to a bathroom for 1 hour after using an enema.
An enema can be uncomfortable, but it should not be painful. If there is a pain, stop and seek medical advice. Using petroleum jelly can ease discomfort during insertion.
Instructions for every enema kit are different, but most follow these general steps:
- Choose a quiet place with space to lie down, ideally a bathroom, and have towels, a timer, and the enema kit ready.
- Remove all clothing from the lower half of the body.
- Wash the hands with soap and hot water and dry them thoroughly.
- Lay a towel on the floor and lie on the left side of the body if right-handed or on the right side of the body if left-handed.
- Bend the knee of the topmost leg, and place a rolled towel underneath the knee to support it.
- Remove the cap from the nozzle of the enema.
- Gently insert the tip of the nozzle into the anus, and continue inserting it 10 centimeters (3–4 inches) into the rectum.
- Slowly squeeze the liquid from the container until it is empty, then gently remove the nozzle from the rectum.
- Wait for the enema to take effect. This can take anywhere from 2 minutes to 1 hour, and the kit's instructions should give a more specific estimate.
- Go to the toilet as usual to empty the bowels.
An enema is an invasive procedure, and a person should only use one for medical reasons. Buy an enema kit from a reputable pharmacy — avoid homemade kits.
Using an enema as a regular treatment for constipation can cause health problems. The body can become reliant on enemas to pass stool, and the muscles in the gut may weaken over time. It may become difficult to pass stool naturally, and in some cases, enema overuse could cause incontinence.
Frequent constipation can indicate a medical condition. If a person has concerns about constipation, a doctor can advise about possible causes and recommend diet and lifestyle changes.
Anyone with a compromised immune system — because of a disease such as leukemia, for example — should not use an enema, because of the risk that bacteria may enter the body. A person with a weakened immune system may not be fully able to fight an infection.
Anyone with rectal prolapse, in which the very end of the lower intestine comes out of the body, should avoid using an enema. If a person has hemorrhoids, they should take extra care to avoid further discomfort.
If a person has had a bowel obstruction or colon surgery, they have an increased risk of bowel perforation and should avoid using an enema.
The use of an enema before giving birth is no longer the standard recommendation. The procedure is invasive and does not benefit a woman in labor.
Enemas can help treat some medical conditions. They can also prepare a person for certain medical procedures.
There is no scientific evidence that an enema benefits general health, and using an enema to detox can be harmful. Inserting substances such as coffee or oil into the body can also introduce harmful bacteria.
Some common uses of an enema include:
Preparation for surgery
It is usually necessary to have an empty bowel before surgery on the rectum, colon, or gut. A person may need to use an enema at home before surgery, or a medical professional may give an enema in the hospital.
A colonoscopy is the use of a small camera to check the health of the rectum or bowel. The bowel will need to be empty before this procedure.
A person may need to limit their diet for a few days before the procedure. The doctor may also prescribe an enema to ensure that the bowel is empty.
A barium enema can help check for bowel or colon cancer. One enema empties the bowel, and another puts liquid barium into the rectum. This shows up on an X-ray to give clear images of the bowels. After the procedure, the barium passes from the body in a bowel movement.
An enema can help treat severe constipation.
There are two main types of enema for constipation. The first lubricates the bowels to help stool pass quickly. The second is a retention enema, which stays in the body for longer. A retention enema is usually oil-based, and it soaks the stool to ease its passage from the body.
Regular use of enemas to treat constipation can cause health problems. A more lasting way to resolve constipation is with diet and lifestyle changes. Drinking enough water and including plenty of fiber in the diet can keep bowel movements healthy and regular.
People can administer medication using an enema. This can especially help with treating health problems affecting the colon, such as inflammatory bowel disease.
In some cases, an enema can deliver other types of medication. This is because the network of blood vessels in the rectum can transport medicine quickly to other parts of the body.
An enema can help treat certain health issues and they are a necessary step for some medical procedures. However, regular use can cause long-term problems, and a person should always follow professional advice when using an enema.
The bowel is delicate, and a person should take care when using an enema. Bacteria can upset the balance of the gut and cause infection, and it is possible to injure the rectum. Follow the instructions carefully, and make sure to be gentle.