Enema

What is an enema?

An enema is the insertion of a liquid into the rectum or colon by way of the anus. The colon, also called the large intestine or large bowel, is a long, hollow organ in your abdomen. It plays an important role in digestion by removing water from digested material and forming feces (stool). Your doctor may recommend an enema for therapeutic or diagnostic purposes.

An enema is only one method your doctor can use to diagnose or treat certain diseases and conditions of your colon and rectum. You should discuss different diagnostic and treatment options with your doctor to best understand which option is right for you.

Types of enema

The types of enema include:

• Therapeutic enema is an enema that cleans out the colon or rectum, relieves constipation, or treats diseases, such as inflammatory bowel disease (Crohn’s and ulcerative colitis).
• Diagnostic enema is an enema that helps diagnose certain conditions of the colon or rectum, including abdominal pain, bleeding symptoms, and ulcerative colitis. A barium enema is a diagnostic enema. Barium shows up well on X-rays and allows your doctor to see the colon in detail.

Why is an enema performed?

A therapeutic enema is a procedure that your doctor may recommend to treat diseases and conditions of your colon or rectum including:

• Constipation: hard, dry, infrequent stools that are difficult to pass
• Excessive gas: belching, bloating, distended abdomen
• Fecal impaction: a large amount of hard stool that is stuck in the rectum
• Ulcerative colitis: inflammation and bleeding in the colon. Your doctor may order an enema that contains corticosteroids dissolved in water. Corticosteroids reduce inflammation.

Your doctor may also order an enema before medical procedures. This type of enema (cleansing enema) makes it easier for your doctor to examine your colon in detail in certain tests, such as colonoscopy. A cleansing enema can also lower the amount of bacteria in your colon and reduce the risk of infection for certain surgeries.

How is an enema performed?                       

You may administer your therapeutic enema at home. Sometimes, a nurse will administer a therapeutic enema while you are a hospital inpatient. Your diagnostic enema, such as a barium enema, is performed in a hospital radiology department or outpatient setting. Administering a typical therapeutic enema generally includes these steps:

1. Wash your hands.
2. Remove the tip cover from the enema. Often, enema tips are lubricated for easier insertion.
3. Position yourself to insert the enema. There a few positions you can try. You can lie on your left side and pull your knees up to your chest in a fetal position. You can lie on your back and pull your knees up to your chest. Or you can kneel with your head lowered and your chest forward until your face nears or rests on the ground.
4. Relax as much as possible. Relaxing your muscles will ease insertion.
5. With steady and even pressure, gently insert the enema tip into your anus with side-to-side motions. Stop if it is hard to insert, as forcing an enema can cause damage.
6. Squeeze the bottle until the liquid is instilled into your rectum or colon. Remove the enema tip. Follow the directions about how long to retain or keep in the enema liquid.

Will I feel pain?

When administered properly, an enema should not be painful. You may feel fullness, mild pressure, or brief, minimal cramping during the procedure. You may also feel like you need to have a bowel movement. Take a few long, deep breaths to help yourself relax. If any discomfort does not pass quickly, tell a member of your hospital care team. If you experience pain while self-inserting an enema, stop and contact your doctor.

What are the risks and potential complications of an enema? 

Risks and potential complications of any enema include:

• Dehydration
• Puncture of the colon

Complications after a barium enema are uncommon. However, any procedure involves risks and the possibility of complications that may become serious in some cases. Complications can develop during the procedure or throughout your recovery. Risks and potential complications of a barium enema include: