Sarah Lewis, PharmD

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 used to diagnose or treat diseases and conditions of the colon and rectum. Discuss all the diagnostic and treatment options with your doctor to understand which options are right for you. 

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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? 

Your doctor may recommend a therapeutic enema to treat diseases and conditions of the 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 to examine your colon during 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. 

Who performs an enema?

You may give yourself a therapeutic enema at home as prescribed by your doctor. Sometimes, a nurse or technician will administer a therapeutic enema in the hospital setting or a barium enema as part of a diagnostic procedure. 

The following specialists often prescribe enemas:

Family medicine doctors provide comprehensive healthcare to adults and children, including acute, chronic and preventive healthcare. 

Gastroenterologists are internists who specialize in diseases of the intestines.

Geriatricians are internists who care for older adults and specialize in conditions specific to aging.

Internists provide comprehensive healthcare to adults, including preventing, diagnosing and treating a variety of diseases and disorders. 

How is an enema performed?

You can give yourself a therapeutic enema at home. Giving yourself a 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. Forcing an enema can cause damage.

  6. Squeeze the bottle until the liquid has flowed 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?

An enema should not be painful when administered properly. 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. Tell your doctor or care team if any discomfort does not pass quickly. If you have pain while self-inserting an enema