Enema - Uses , Risk Factors and Myths

Introduction:

The enema process allows one to push waste out of the rectum when one cannot do so alone. Enemas are unrestricted for purchase at pharmacies for use at home, but one should ask a doctor or nurse for detailed instructions to prevent injury. An enema is a method used to evoke stool evacuation, generally to ameliorate constipation. The way it is done depends on the type of enema and whether one can do it at home or at a more professional setup like a hospital. An enema administration is most typically used to cleanse the lower bowel. Nevertheless, this is usually the last alternative for the treatment of constipation. If diet and exercise are not enough to keep the excretion of wastes regular, the doctor might suggest a laxative before opting out for an enema. In some cases, laxatives are used the night prior to an enema administration to encourage the flow of waste. There are many types of enemas like barium enemas, oil enemas, coffee enemas, etc.

What Is An Enema?

Enema is a helpful procedure that is performed in many medical situations. It mainly helps in clearing the bowel in the case of constipation or for some diagnostic procedures like colonoscopies or before bowel surgery. It is also helpful in delivering medication and also to reduce body temperature. One can administer an enema at home, or it can be done with professional help. A liquid or gas is injected into the rectum through the anus in this procedure.

There are different types of enemas available. They are;

• Cleansing Enema – It is mainly used for cleaning the colon. A normal saline solution is used in this type of enema.

• Oil-Retention Enema– It is mainly used to soften the stool. The solution should be retained for one hour.

• Cooling Enema – It can be used for reducing body temperature.

• Return-Flow enema – It is used to remove intestinal gas.

How to Use an Enema?

Enema administration can be done at home or by a medical professional. If one is not familiar with enemas, they can seek professional help. A barium enema is exclusively administered in a medical office. One has to prepare the gut before going for an enema. Special dietary instructions will be given by doctors. This may vary in individuals. If the enema is administered at home, all the equipment used for the enema must be well-sanitized. Empty the bladder before the procedure. Place a towel or cloth on the floor and lie on that while administering an enema. The self-administration of an enema includes the following steps:

1. The enema bag is filled with a solution containing laxatives or oil.

2. The end of the tube that has to be inserted into the anus is lubricated to make the insertion comfortable.

3. The tube is then inserted into the rectum. Not more than four inches of the tube should be inserted into the rectum.

4. Wait for the solution to enter the rectum. Wait till the bag is empty.

5. Remove the tube slowly from the rectum.

Fleet enema is used as follows:

• Take off the orange protective shield from the enema before inserting.
• With steady pressure, gently insert the enema tip into the rectum with a slight side-to-side movement, with the tip indicating toward the navel. Insertion may be easier if the person acquiring the enema reaches down as if experiencing a bowel movement. This aids to relax the muscles around the anus.
• The enema tip should not be forced into the rectum as this can cause harm.
• Squeeze the bottle until almost all the liquid is gone. It is not required to empty the bottle, as it holds more liquid than needed.
• Remove the enema from the rectum and hold the position until the desire to evacuate is strong.

What Is the Purpose of Enemas?

The main purposes of an enema are as follows:

Treating Constipation:

It is a condition in which there are less than three bowel movements a week. It can cause discomfort in the affected individual. There will be a feeling that not all stool has passed, and the passing of stools will be painful too. Generally, doctors will recommend making changes in diet, drinking more water, exercising, and even laxatives. If all these options are not effective, the doctor may suggest enema administration. Enemas containing salt solutions are recommended in this case. However, its frequent use is not recommended. The enema treatments have more health risks. So it should be taken only under professional guidance.

Bowel Emptying:

Colonoscopy is a procedure used to detect any abnormalities in the rectum or colon. A thin, flexible tube will be inserted into the rectum via the anus in this procedure. So it is mandatory to empty the colon before the procedure. Hence enemas are recommended in such cases. It is also recommended before surgery that requires an empty bowel.

Administration of Medicines:

This is one of the common uses of enemas. If there is some disease condition in the large intestine or rectum, the medications can be directly applied to this area. If the medications are given orally, they may get degraded in the stomach or small intestine and may not reach the large intestine. In such cases, enema administration can deliver medications directly to the large intestine or rectum.

Diagnostic Purpose:

Barium enema plays a vital role in diagnosing any abnormalities in the large intestine. Using barium enema, an outline of the intestine can be seen. After the administration of the barium enema, a series of x-rays are taken.

How Do Enemas Work?

Enemas introduce a large volume of fluid into the large intestine. This will help the stool soften. The stool can then be easily flushed out of the rectum. This is how enemas work in case of constipation and for bowel emptying. In a barium enema, which is an x-ray examination, a liquid containing barium is injected into the rectum. The barium forms a thin layer around the colon, and then the x-ray is taken. It can give a clear outline of the colon. In the case of ulcerative colitis or any inflammatory bowel disease, enemas help deliver medications directly to the rectum and large intestine. The network of blood vessels present in this area easily absorbs the medication when administered through enemas.

Why Enema Is Given Before Surgery?

The purpose of giving an enema to the patient as a part of bowel preparation is to clean the patient’s bowel so that stool will be absent which can compromise the scheduled surgery. This will make the surgery safer and lessens the chances of infection and harm to the bowel.

What Are the Dangers of Enema?

The complications associated with enema include:

1. Perforations in the rectum if the procedure is not done correctly.
2. Presence of blood in stools due to rectal damage.
3. Risk of cancer in case of barium enema due to radiation exposure.
4. Dehydration.
5. Dependence on enema for passing stools, if used regularly.
6. In severe cases, it can cause embolism (obstruction caused due to a clot).

What Are the Contraindications of Enema?

Some of the contraindications for having an enema are given below:

• The high amount of phosphate in the blood.
• Low levels of calcium in the blood.
• A raised sodium level in the blood.
• Dehydration(loss of water or reduction of water level in the body).
• The patients who are undergoing the method of removing waste or poison from blood with dialysis.
• Sudden and serious symptoms of heart failure.
• Appendicitis (Inflammation of an appendix).

Conclusion:

Enemas are usually recommended if no other options other than surgery can give a significant result. There are many benefits of an enema like it relieves the patient from constipation or irritable bowel syndrome. It is advisable to administer an enema only if recommended by the physician. It is also recommended to follow the time of administration of enema as guided. The instructions should be followed carefully to prevent complications in the future.