Table of ContentsView AllTable of ContentsWhat Is an Enema?How Do Enemas Work?When Are Enemas Used?TypesHow to Use an EnemaBenefitsRisksPrognosis
Table of ContentsView All
View All
Table of Contents
What Is an Enema?
How Do Enemas Work?
When Are Enemas Used?
Types
How to Use an Enema
Benefits
Risks
Prognosis
Anenemais a liquid inserted through theanusinto the large intestine. It may be given to help you pass stool as a treatment forconstipation. It may be used as part of the procedure to empty the contents of the bowel before a test, as with acolonoscopyprep.In some cases, it may be used to administer medication.
Some practitioners offer enemas using liquids (like coffee) that healthcare providers do not recommend. There is no evidence that using an enema for “detoxing,” or for reasons other than removing impacted stool or cleaning the bowel before a test or procedure, has any health benefits whatsoever.
This article explains how enemas work, their benefits, and what to expect when using one.
Liudmila Chernetska / Getty Images
An enema purchased from a pharmacy has a nozzle on the end of a small bag or bottle. This container is filled with liquid—sometimes salt and water, sometimes mineral oil—injected into the body. The nozzle is inserted into the anus, and the container is squeezed, sending the liquid out of the nozzle and into the last part of the colon, called therectum.
The liquid is usually held in the rectum for the time specified in the product instructions. It could be held until the urge to move the bowels comes on. In some cases, it might be suggested that the enema liquid stays inside the body for a few minutes or longer.
Tips for Safe UseRead and following the directions on the “drug facts” label.Use the correct dose and dosing frequency.Refrain from using more than one dose of the product in 24 hours.Do not give an enema to a child younger than 2.
Tips for Safe Use
Read and following the directions on the “drug facts” label.Use the correct dose and dosing frequency.Refrain from using more than one dose of the product in 24 hours.Do not give an enema to a child younger than 2.
Enemas work to clear fecal matter from the bowels in several ways. First, the water often softens the stool and makes it easier to pass. Depending on the enema solution used, it could also attract water to the rectal tissues, which also helps soften the stool.
The liquid itself also makes the rectum feel fuller, which triggers a reflex to have a bowel movement.
There are a few scenarios that call for the use of an enema. They include:
Types of Enemas
Sometimes, the liquid used in an enema is salt water or water mixed with baking soda. Some enemas contain a laxative.The type of liquid may vary, depending on why the enema is used.
The volume of liquid used in an enema is classified into high-volume and low-volume. Low-volume enemas use 500 mL or less, while high-volume enemas use 500-1,000 mL. High-volume enemas can reach higher into the colon, which could be better for pre-procedural enemas. However, low-volume enemas might be sufficient to help relieve constipation.
Check with your healthcare provider if you are unsure about which enema to use, and be sure they are aware of your enema use. Some common enema liquids include:
Medications
Some conditions, includinginflammatory bowel disease (IBD), require medication to be given with an enema. Asacol and Rowasa (mesalamine) are used to treatulcerative colitisin this way.
This treatment usually addresses inflammation in the last section of the colon, where the enema liquid will reach. It’s often recommended that these enemas be used at night to give the medication time to work.
Other Substances
Some practitioners offer enemas with substances that might surprise you, like coffee, lemon juice, and milk. The idea is to remove toxins from the body and fortify the liver and gallbladder.
People with IBD should be especially wary of these types of enemas. There is the potential to introduce harmful materials into the body using a nonmedical enema.In addition, the colon contains various forms of beneficial bacteria, and using an enema may disrupt the bacterial flora and harm the delicate lining of the colon.
How to Use an Enema Safely
In most cases, using an enema is straightforward. People typically give enemas to themselves, although some may need help if they have mobility or cognition issues.
Remember that an enema takes time to work and keeps you in the bathroom for a bit. You’ll want to ensure you’ve set enough time aside for your enema.
Preparation
First, be sure that you have the right enema product and understand the instructions. You’ll also want to ensure that you have space to lie down, typically on the bathroom floor, and some towels.
Administration
The instructions for most anal enema products include the same series of steps. You’ll first apply a lubricant, such as petroleum jelly, to your anus to limit any discomfort and ensure the enema nozzle goes in smoothly. You’ll also take the cap off of the enema nozzle. Other steps include:
Precautions
Most people will not experience any difficulties with the enema procedure, but there are a few things to avoid.
You don’t want to insert the enema nozzle too far up into your anus, causing pain. Be sure to use the enema exactly as instructed because it’s possible for a part to become stuck, causing a foreign body obstruction.
It’s also important to use exactly the amount of fluid called for in the instructions. If you use too little, the enema may not be effective, and if you use too much, it may take longer to work because the fluid has reached higher into your colon.
Complications with enemas are rare, but they can be severe. Among them is the risk of a perforation (puncture) in your intestines or infection that leads to sepsis, a potentially life-threatening condition.Contact your healthcare provider right away if you have pain, fever, or other symptoms that don’t resolve on their own.
Enema Side Effects
Benefits of Enemas
Enemas help relieve discomfort and improve your ability to pass stool (poop). They’re safe for occasional use when treating constipation, IBD or when you’re preparing for a procedure.
Keep in mind, though, that there is little data to support the use of enemas when they’re touted as a method of delivering other health benefits.
People who try coffee, alcohol, hydrogen peroxide, or other fluids in an enema—sometimes after reading “recipes” from the Internet—often cause themselves injury and do more harm than good.
Risks of Enemas
Many people use enemas safely and avoid complications or side effects, but there are a few things to watch out for.
People with certain health conditions should speak to their healthcare providers before using an enema product. They may be at higher risk fordehydrationor relatedelectrolyteimbalances, which can disrupt body functions that rely on these key minerals.
This is true of people with IBD but also those with heart, kidney, and other health conditions. Some patients receiving cancer treatment that requires an enema ahead of surgery also may be at higher risk of complications.In other cases, frequent use of enemas to relieve constipation in people receiving chemotherapy may lead to concerns.
Keep in mind that even if you don’t have a known health condition, your use of enemas may be masking a more serious health issue that’s the cause of your constipation and related symptoms. Among them iscolorectal cancer, which often causes constipation and other bowel habit changes.
Other possible risks include:
It’s worth trying other lifestyle changes, such as diet and exercise, instead of relying too much on enemas to improve your digestive health. Enemas are generally safe products, but there are more health risks from using enemas than there are with other constipation treatment options.
There are few side effects from the enema procedure itself. Most people report only some cramping and bloating, while others experience nausea, vomiting, dizziness, and other symptoms. These symptoms may be more of a concern in children who need enemas for treatment or before a colonoscopy.
How long it takes to work will depend on what type of enema product you use. Some enemas will promote a bowel movement in just 15 minutes or less. Others, such as the bowel prep kits that contain bisacodyl, may take up to an hour before they begin to work. The specific instructions will give you an idea of what to expect.
Summary
An enema delivers liquid through a nozzle and into the anus and rectum. It’s often used to treat constipation, and the ingredients may include salt water, mineral oil, and laxative elements.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Yang HJ, Park DI, Park SK, et al.A randomized controlled trial comparing colonoscopic enema with additional oral preparation as a salvage for inadequate bowel cleansing before colonoscopy.J Clin Gastroenterol. 2019 Sep;53(8):e308-e315. doi:10.1097/MCG.0000000000001087U.S. Food and Drug Administration.FDA Drug Safety Communication: FDA warns of possible harm from exceeding recommended dose of over-the-counter sodium phosphateproducts to treat constipation.National Cancer Institute.Glycerin enema.West R, Russel M, Bodelier A, Kuijvenhoven J, Bruin K, Jansen J,et al.Lower risk of recurrence with a higher induction dose of mesalazine and longer duration of treatment in ulcerative colitis: Results from the Dutch, non-interventional, IMPACT Study.J Gastrointestin Liver Dis. 2022 Mar 19;31(1):18-24. doi:10.15403/jgld-3927Seki T, Fukushima H.Self-administered alcohol enema causing chemical proctocolitis.Open Access Emerg Med. 2019 Jun 11;11:129-132. doi:10.2147/OAEM.S208214Patmano M, Cetin D, Gumus T, Yildirim S.A rare foreign body during colonoscopy: Headpiece of enema kit.Ann Med Res. 2018;25(4):493. doi:10.5455/annalsmedres.2018.06.109 2018;25(3)493-4Cirocchi R, Randolph J, Panata L, et al.The tip of the iceberg of colorectal perforation from enema: a systematic review and meta-analysis.Tech Coloproctol. 2020 Nov;24(11):1109-1119. doi:10.1007/s10151-020-02294-7Offenbacher J, Kristol D, Cain D, Kim P, Nguyen V.An emergency department presentation of severe colitis after a home hydrogen peroxide enema.J Emerg Med. 2019 Aug;57(2):173-176. doi:10.1016/j.jemermed.2019.04.015Karaören GY, Bakan N, Yürük CT, Çetinkaya AO.Effects of bowel preparation and fluid restriction in robot-assisted radical prostatectomy patients.Turk J Anaesthesiol Reanim. 2015 Apr;43(2):100-5. doi: 10.5152/TJAR.2014.57704Kimura S, Hosoya K, Ogata K, Furuno T, Sogawa R, Takeuchi K,et al.Severity of constipation related to palonosetron during first-line chemotherapy: a retrospective observational study. Support Care Cancer. 2021 Aug;29(8):4723-4732. doi:10.1007/s00520-021-06023-0GI Society: Canadian Society of Intestinal Research.Enemas.Yang Y, Xiao Y, Zhang L, Lv J, Huang Q.Effects of different intervention methods on intestinal cleanliness in children undergoing colonoscopy.J Healthc Eng. 2022 Apr 16;2022:1898610. doi: 10.1155/2022/1898610Additional ReadingRichter JM, Arshi NK, Oster G.Oral 5-aminosalicylate, mesalamine suppository, and mesalamine enema as initial therapy for ulcerative proctitis in clinical practice with quality of care implications.Can J Gastroenterol Hepatol. 2016;2016:6928710. doi:10.1155/2016/6928710.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Yang HJ, Park DI, Park SK, et al.A randomized controlled trial comparing colonoscopic enema with additional oral preparation as a salvage for inadequate bowel cleansing before colonoscopy.J Clin Gastroenterol. 2019 Sep;53(8):e308-e315. doi:10.1097/MCG.0000000000001087U.S. Food and Drug Administration.FDA Drug Safety Communication: FDA warns of possible harm from exceeding recommended dose of over-the-counter sodium phosphateproducts to treat constipation.National Cancer Institute.Glycerin enema.West R, Russel M, Bodelier A, Kuijvenhoven J, Bruin K, Jansen J,et al.Lower risk of recurrence with a higher induction dose of mesalazine and longer duration of treatment in ulcerative colitis: Results from the Dutch, non-interventional, IMPACT Study.J Gastrointestin Liver Dis. 2022 Mar 19;31(1):18-24. doi:10.15403/jgld-3927Seki T, Fukushima H.Self-administered alcohol enema causing chemical proctocolitis.Open Access Emerg Med. 2019 Jun 11;11:129-132. doi:10.2147/OAEM.S208214Patmano M, Cetin D, Gumus T, Yildirim S.A rare foreign body during colonoscopy: Headpiece of enema kit.Ann Med Res. 2018;25(4):493. doi:10.5455/annalsmedres.2018.06.109 2018;25(3)493-4Cirocchi R, Randolph J, Panata L, et al.The tip of the iceberg of colorectal perforation from enema: a systematic review and meta-analysis.Tech Coloproctol. 2020 Nov;24(11):1109-1119. doi:10.1007/s10151-020-02294-7Offenbacher J, Kristol D, Cain D, Kim P, Nguyen V.An emergency department presentation of severe colitis after a home hydrogen peroxide enema.J Emerg Med. 2019 Aug;57(2):173-176. doi:10.1016/j.jemermed.2019.04.015Karaören GY, Bakan N, Yürük CT, Çetinkaya AO.Effects of bowel preparation and fluid restriction in robot-assisted radical prostatectomy patients.Turk J Anaesthesiol Reanim. 2015 Apr;43(2):100-5. doi: 10.5152/TJAR.2014.57704Kimura S, Hosoya K, Ogata K, Furuno T, Sogawa R, Takeuchi K,et al.Severity of constipation related to palonosetron during first-line chemotherapy: a retrospective observational study. Support Care Cancer. 2021 Aug;29(8):4723-4732. doi:10.1007/s00520-021-06023-0GI Society: Canadian Society of Intestinal Research.Enemas.Yang Y, Xiao Y, Zhang L, Lv J, Huang Q.Effects of different intervention methods on intestinal cleanliness in children undergoing colonoscopy.J Healthc Eng. 2022 Apr 16;2022:1898610. doi: 10.1155/2022/1898610Additional ReadingRichter JM, Arshi NK, Oster G.Oral 5-aminosalicylate, mesalamine suppository, and mesalamine enema as initial therapy for ulcerative proctitis in clinical practice with quality of care implications.Can J Gastroenterol Hepatol. 2016;2016:6928710. doi:10.1155/2016/6928710.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Yang HJ, Park DI, Park SK, et al.A randomized controlled trial comparing colonoscopic enema with additional oral preparation as a salvage for inadequate bowel cleansing before colonoscopy.J Clin Gastroenterol. 2019 Sep;53(8):e308-e315. doi:10.1097/MCG.0000000000001087U.S. Food and Drug Administration.FDA Drug Safety Communication: FDA warns of possible harm from exceeding recommended dose of over-the-counter sodium phosphateproducts to treat constipation.National Cancer Institute.Glycerin enema.West R, Russel M, Bodelier A, Kuijvenhoven J, Bruin K, Jansen J,et al.Lower risk of recurrence with a higher induction dose of mesalazine and longer duration of treatment in ulcerative colitis: Results from the Dutch, non-interventional, IMPACT Study.J Gastrointestin Liver Dis. 2022 Mar 19;31(1):18-24. doi:10.15403/jgld-3927Seki T, Fukushima H.Self-administered alcohol enema causing chemical proctocolitis.Open Access Emerg Med. 2019 Jun 11;11:129-132. doi:10.2147/OAEM.S208214Patmano M, Cetin D, Gumus T, Yildirim S.A rare foreign body during colonoscopy: Headpiece of enema kit.Ann Med Res. 2018;25(4):493. doi:10.5455/annalsmedres.2018.06.109 2018;25(3)493-4Cirocchi R, Randolph J, Panata L, et al.The tip of the iceberg of colorectal perforation from enema: a systematic review and meta-analysis.Tech Coloproctol. 2020 Nov;24(11):1109-1119. doi:10.1007/s10151-020-02294-7Offenbacher J, Kristol D, Cain D, Kim P, Nguyen V.An emergency department presentation of severe colitis after a home hydrogen peroxide enema.J Emerg Med. 2019 Aug;57(2):173-176. doi:10.1016/j.jemermed.2019.04.015Karaören GY, Bakan N, Yürük CT, Çetinkaya AO.Effects of bowel preparation and fluid restriction in robot-assisted radical prostatectomy patients.Turk J Anaesthesiol Reanim. 2015 Apr;43(2):100-5. doi: 10.5152/TJAR.2014.57704Kimura S, Hosoya K, Ogata K, Furuno T, Sogawa R, Takeuchi K,et al.Severity of constipation related to palonosetron during first-line chemotherapy: a retrospective observational study. Support Care Cancer. 2021 Aug;29(8):4723-4732. doi:10.1007/s00520-021-06023-0GI Society: Canadian Society of Intestinal Research.Enemas.Yang Y, Xiao Y, Zhang L, Lv J, Huang Q.Effects of different intervention methods on intestinal cleanliness in children undergoing colonoscopy.J Healthc Eng. 2022 Apr 16;2022:1898610. doi: 10.1155/2022/1898610
Yang HJ, Park DI, Park SK, et al.A randomized controlled trial comparing colonoscopic enema with additional oral preparation as a salvage for inadequate bowel cleansing before colonoscopy.J Clin Gastroenterol. 2019 Sep;53(8):e308-e315. doi:10.1097/MCG.0000000000001087
U.S. Food and Drug Administration.FDA Drug Safety Communication: FDA warns of possible harm from exceeding recommended dose of over-the-counter sodium phosphateproducts to treat constipation.
National Cancer Institute.Glycerin enema.
West R, Russel M, Bodelier A, Kuijvenhoven J, Bruin K, Jansen J,et al.Lower risk of recurrence with a higher induction dose of mesalazine and longer duration of treatment in ulcerative colitis: Results from the Dutch, non-interventional, IMPACT Study.J Gastrointestin Liver Dis. 2022 Mar 19;31(1):18-24. doi:10.15403/jgld-3927
Seki T, Fukushima H.Self-administered alcohol enema causing chemical proctocolitis.Open Access Emerg Med. 2019 Jun 11;11:129-132. doi:10.2147/OAEM.S208214
Patmano M, Cetin D, Gumus T, Yildirim S.A rare foreign body during colonoscopy: Headpiece of enema kit.Ann Med Res. 2018;25(4):493. doi:10.5455/annalsmedres.2018.06.109 2018;25(3)493-4
Cirocchi R, Randolph J, Panata L, et al.The tip of the iceberg of colorectal perforation from enema: a systematic review and meta-analysis.Tech Coloproctol. 2020 Nov;24(11):1109-1119. doi:10.1007/s10151-020-02294-7
Offenbacher J, Kristol D, Cain D, Kim P, Nguyen V.An emergency department presentation of severe colitis after a home hydrogen peroxide enema.J Emerg Med. 2019 Aug;57(2):173-176. doi:10.1016/j.jemermed.2019.04.015
Karaören GY, Bakan N, Yürük CT, Çetinkaya AO.Effects of bowel preparation and fluid restriction in robot-assisted radical prostatectomy patients.Turk J Anaesthesiol Reanim. 2015 Apr;43(2):100-5. doi: 10.5152/TJAR.2014.57704
Kimura S, Hosoya K, Ogata K, Furuno T, Sogawa R, Takeuchi K,et al.Severity of constipation related to palonosetron during first-line chemotherapy: a retrospective observational study. Support Care Cancer. 2021 Aug;29(8):4723-4732. doi:10.1007/s00520-021-06023-0
GI Society: Canadian Society of Intestinal Research.Enemas.
Yang Y, Xiao Y, Zhang L, Lv J, Huang Q.Effects of different intervention methods on intestinal cleanliness in children undergoing colonoscopy.J Healthc Eng. 2022 Apr 16;2022:1898610. doi: 10.1155/2022/1898610
Richter JM, Arshi NK, Oster G.Oral 5-aminosalicylate, mesalamine suppository, and mesalamine enema as initial therapy for ulcerative proctitis in clinical practice with quality of care implications.Can J Gastroenterol Hepatol. 2016;2016:6928710. doi:10.1155/2016/6928710.
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