Using an enema involves sending fluid through the anus into the bowels. It may be uncomfortable, but it should not be painful.

In this article, we look at when and why an enema might be painful, how to use one safely, and more.

An x-ray view of a barium enema, and although enemas do not feel pleasant and may hurt, they should not cause pain.Share on Pinterest
Having an enema, such as a barium enema (pictured), may be uncomfortable but should not be painful.

As researchers behind a 2020 analysis confirm, a person can expect possible discomfort, not pain, from an enema.

Also, for a short time after an enema, a person may experience stomach cramps, the United Kingdom’s National Health Service (NHS) note.

A person should seek medical care if they experience any of the following during or after an enema:

  • severe pain
  • persistent pain
  • any other symptoms, such as bleeding

Some people experience discomfort or mild pain when using an enema. If pain persists or other issues, such as rectal bleeding, arise, seek medical advice.

Discomfort due to an enema is typically mild and harmless, and it should resolve within 1 hour. For example, some people experience:

  • dizziness
  • nausea
  • faintness
  • stomach cramps
  • anal irritation

Anyone who starts to feel faint or dizzy should lie down.

Not all enema products are safe for everyone. Before using any type of enema, check with a doctor.

A water enema is safe for most people, provided that the person:

  • uses a product that a doctor recommends
  • ensures that the product is from a reliable manufacturer
  • follows the instructions carefully

A person may experience adverse effects if they administer the product incorrectly or use a liquid or device that is unsafe.

When a person uses an enema incorrectly, it can cause internal tissue damage and infection.

Other complications can include:

There are various medical uses of an enema. For example:

  • A person may need to use an enema before a doctor can examine their bowels.
  • Barium enemas can help the bowels show clearly on an X-ray.
  • Enemas can also help with chronic constipation.
  • A doctor may perform an enema before a procedure, such as a colonoscopy.
  • A doctor may also use an enema to administer medication.

Also, some people regularly use enemas to purify their bodies, because they believe that toxins build up in the lower part of the bowel.

However, as the Canadian Society of Intestinal Research point out, this buildup only occurs in people who are severely constipated.

Pregnant women sometimes use enemas when they go into labor, believing that an enema reduces the duration of childbirth.

However, the World Health Organisation (WHO) do not recommend this, due to a lack of evidence and because having an enema may contribute to discomfort during labor.

In addition, some people use enemas for sexual stimulation, which is called klismaphilia.

The liquid that an enema contains can vary, depending on the purpose. The fluid may be:

  • Barium sulfate: This coats the lining of the lower gastrointestinal tract, helping the area to be clearly visible on an X-ray.
  • Castile soap and water: Some research, such as this 2017 study, has found soap sud enemas to be safe.
  • Sodium phosphate: While this type of enema can help ease constipation, using it incorrectly may cause dehydration and harm the kidneys and heart.
  • Mineral oil: This type of enema can also help relieve constipation.

Enemas containing coffee are popular in some countries, such as Thailand, where they play a role in treatment programs for various conditions.

For example, some people use enemas to help treat:

However, the evidence for these uses is limited or lacking.

When self-administering an enema, a person should:

  1. Prepare the area. Lay a towel on the floor in or near the bathroom, and warm the enema bottle in a bowl or sink filled with warm water.
  2. Hold the bottle upright so that no liquid spills, and remove the lid from the nozzle.
  3. Many enemas come with a lubricated nozzle, but a person can add lubricating jelly at this point.
  4. Lie down sideways on the towel and bring the knees up toward the chest in a position that feels comfortable.
  5. Slowly push the nozzle into the anus.
  6. When the nozzle is inserted about 7 centimeters, gently squeeze the bottle so that the fluid enters the anus.
  7. After all of the fluid has entered the body, remove the enema and turn over onto the back, still lying on the towel.
  8. Keep the fluid inside until it is no longer possible. When the fluid is water, this is usually around 5 minutes, but the wait may be longer when using other liquids.
  9. When it becomes too difficult to hold the fluid in, use the toilet. On the first try, nothing may happen, and this is normal.
  10. After passing stool, stay near the bathroom for the remainder of the hour, until any effects wear off completely. If a person feels light-headed, they should lie down on the towel.
  11. Do not try to use the same enema a second time.

Call a doctor if complications arise.

After using the enema and passing stool, it is best to remain near the bathroom for the remainder of the hour, as multiple bowel movements may be necessary, and the feeling may be urgent.

The effects of the enema should wear off after 1 hour, though some discomfort may last longer.

Some people may mistake an enema for a colonic. Other names for a colonic include colon hydrotherapy and colon irrigation.

A person can use an enema at home, but a colonic takes place at a clinic.

Also, an enema can contain various fluids, but a colonic only uses warm water. During a colonic, roughly 60 liters of water circulates through the bowel.

There appears to be no scientific evidence to show that a colonic has any health benefits.

As with enemas, some adverse effects of a colonic can include:

  • stomach pain and cramping
  • bloating
  • diarrhea
  • dizziness
  • anal irritation

More severe side effects can include:

A person with any of the following health issues should not have a colonic:

A person can expect that they may feel some discomfort due to an enema. Adverse effects, such as stomach cramping and anal irritation, should go away on their own.

However, if any adverse effect is severe or persistent, see a doctor.

The complications of an enema can be severe and include serious rectal bleeding or a condition called hemorrhagic colitis. Some people require blood transfusions or surgery to remove their colons, as a result.

After an enema, it is a good idea to check the stool for any bleeding.

An enema can serve many medical purposes, and some people use them as part of a regular cleansing routine.

The process involves sending fluid up into the colon via the anus to induce a bowel movement.

Beyond a handful of specific medical uses, there is very little evidence that enemas support health, though they have been administered as treatments for centuries throughout the world.

An enema is generally painless and simple to use, as long as the person carefully follows the instructions on the package.

However, enemas can cause discomfort, adverse effects, and complications. A person should consult a doctor before using one at home.

Q:

What does having an enema feel like? What sort of sensations can a person expect?

A:

You can expect to feel an uncomfortable sensation at the onset of the enema, and you will feel a full sensation after the enema is underway. It is normal to feel fullness, then a sense of pressure to release your bowels, which means that the enema is working.

An enema should not feel painful, but it may feel uncomfortable and uneasy. It is important to try and relax, as this will ease the process.

Harshil Matta, DO

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.