Understanding Enemas: Types and Uses

• Bowel Elimination: Enemas

Cleansing Enemas

• Designed to remove feces from the colon.
• Used to relieve constipation/impaction.
• Help prevent the escape of fecal material during surgical procedures.
• Promote visualization of the intestinal tract, such as in Colonoscopy/Sigmoidoscopy.
• Help establish regular bowel function during a bowel training program.

Large Volume Enemas

• Examples of solutions used include tap water and normal saline solution (isotonic).
• Results in rapid colon emptying.
• May be dangerous for patients with weakened intestinal walls due to bowel infection/inflammation.

Hypertonic Solution Enemas

• Administered in smaller volumes than those commercially available.
• Draws water into the colon, which stimulates the defecation reflex.
• Can be contraindicated in patients with sodium retention problems and those with renal impairment.

Retention Enemas

• Retained in the bowel for a prolonged period.
• Oil retention enemas lubricate stool and intestinal mucosa, making defecation easier.
• Carminative enemas help expel flatus from the rectum and provide relief for gastric distention.
• Medicated enemas provide medication absorbed through the rectal mucosa.
• Anthelmintic enemas destroy intestinal parasites.

Enema Administration

• Tap water, saline solution, and soap solution enemas are administered using a container, rubber, or plastic tubing, a tubing clamp, lubricant, and the solution.
• The solution should be no higher than 18 inches above the level of the anus.
• Enema administration should take 5-10 minutes.
• Lubricate the end of the tube 2-3 inches.
• Have the patient take several deep breaths and insert the tube 3-4 inches for an adult.
• Angle toward the umbilicus, not the bladder.
• If there is resistance, allow a small amount of solution to enter, withdraw, and continue to insert.
• Do not force entry; hold the tube the entire time the enema is instilled.
• Assess for lightheadedness, dizziness, nausea, and diaphoresis; if found, stop and assess B/P and HR.

Small Volume Enemas

• Do not warm; administer at room temperature.
• Tubes should be already lubricated but adding more lubrication is suggested.
• Should take 1-2 minutes to administer.
• Be careful with hemorrhoids, a rigid tip can tear the mucosa, potentially causing bleeding.