4 Reasons to Do an Enema

Medically Reviewed By William C. Lloyd III, MD, FACS
  • An enema involves instilling liquid into the colon—or large intestine. The liquid flows through a nozzle you insert through the anus. There are two basic types of enemas—diagnostic and therapeutic. Diagnostic enemas help doctors screen and diagnose conditions of the colon and rectum. Therapeutic enemas treat certain diseases, disorders and conditions affecting the large intestine and rectum. Here’s a look at common enema uses and enema benefits.

  • 1

    One of the main reasons for enema treatment is to relieve constipation. Generally, doctors recommend other treatments, such as stool softeners or suppositories, first. But for very hard or dry stool that doesn’t pass with other approaches, enemas are beneficial. Frequent use of laxative enemas can cause problems, such as dehydration and electrolyte imbalances. So, talk with your doctor about using an enema for constipation.

    There are several types of laxative enemas to treat constipation including:

    • Bisacodyl and docusate
    • Mineral oil and glycerin
    • Saline
    • Sodium phosphates
  • 2
    Colon Cleansing
    Colonoscopy review

    Doctors often include enemas as part of bowel preparation before exams and procedures. Sodium phosphates enemas are a common choice. This use of enemas will clean out the colon so it is free of stool material. For bowel surgery, this ensures stool won’t contaminate the surgery. It’s also important to have a clean colon for exams, such as colonoscopy. This allows your doctor a clear view of the wall of the colon to check for polyps and other abnormalities.

  • 3
    Lower GI X-ray
    barium enema X-ray of a man shows the normal rectum and cecum

    A lower GI (gastrointestinal) X-ray or scan uses a form of imaging called fluoroscopy. It makes real-time moving pictures of an organ or tissue. A contrast agent like barium, a chalky powder mixed with water, helps make these images. In a lower GI scan, doctors use a barium enema to highlight the structure of the colon. This can help diagnose the cause of symptoms, such as pain, chronic constipation, and blood in the stool. Doctors are often looking for polyps, diverticula, cancer, ulcers and inflammation in the large intestine.

  • 4
    Inflammatory Bowel Disease
    Middle age Caucasian man sitting on couch with stomach on hand in pain or discomfort

    Enemas can be useful for treating inflammatory bowel disease—or IBD. IBD includes ulcerative colitis (UC) and Crohn’s disease. The colon is the site of inflammation in UC and it can sometimes be in Crohn’s as well. The goal of using enemas in IBD is to treat inflammation locally inside the colon. The main type of enema for treating IBD is mesalamine (Rowasa). Doctors may also prescribe corticosteroid enemas, such as hydrocortisone or prednisolone, in some cases.

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  1. Bowel Preparation for Rectal Surgery. Kaiser Permanente. https://mydoctor.kaiserpermanente.org/ncal/Images/Bowel%20Prep%20with%20Fleet%20Enema%2008-12_tcm75-618912.pdf
  2. Corticosteroid (Rectal Route). Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/drugs-supplements/corticosteroid-rectal-route/description/drg-20070430
  3. Inflammatory Bowel Disease (IBD). Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/diagnosis-treatment/drc-20353320
  4. Laxative (Rectal Route). Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/drugs-supplements/laxative-rectal-route/proper-use/drg-20070715
  5. Mesalamine (Rectal Route). Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/drugs-supplements/mesalamine-rectal-route/description/drg-20068210
  6. Rectal Drug Administration in Adults: How, When, Why. Nursing Times. https://www.nursingtimes.net/clinical-archive/neurology/rectal-drug-administration-in-adults-how-when-why-22-02-2016/
  7. Sodium Phosphate Dibasic And Sodium Phosphate Monobasic (Rectal Route). Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/drugs-supplements/sodium-phosphate-dibasic-and-sodium-phosphate-monobasic-rectal-route/description/drg-20137951
  8. Understanding Bowel Preparation. American Society for Gastrointestinal Endoscopy. https://www.asge.org/home/for-patients/patient-information/understanding-bowel-preparation
  9. X-ray (Radiography) – Lower GI Tract. Radiological Society of North America. https://www.radiologyinfo.org/en/info.cfm?pg=lowergi
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Apr 16
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