Enemas: Types, Uses, and Precautions PDF

Krupali Makwana Assistant Professor School of Pharmacy RK University Definition  An enema involves fluids that are inserted into the rectum and colon to stimulate peristalsis, thereby causing elimination of stool and flatus. An enema may also be given to introduce medications or othe...

Krupali Makwana Assistant Professor School of Pharmacy RK University Definition  An enema involves fluids that are inserted into the rectum and colon to stimulate peristalsis, thereby causing elimination of stool and flatus. An enema may also be given to introduce medications or other therapeutic agents.  USES  To stimulate defecation & to treat constipation  To soften hard faecal matter  To relieve the gaseous distention  To relieve inflammation  To clean the bowels prior to surgeries KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 2  Types of enemas 1) Cleansing enema 2) Oil retention enema 3) Carminative enema 4) Return flow enema KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 3  Cleansing enema  Cleansing enemas are used to evacuate the colon and rectum before a surgery. The solution is instilled in the rectum for a short time to flush the colon thoroughly. Your body then releases the stool within a few minutes.  These enemas typically contain a solution of saline or tap water, and they work by increasing the volume of fluid in the colon, which triggers the natural urge to defecate. KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 4  Oil retention enema  This enema is for people whose stool has hardened. It softens the stool. They contain 90-120 ml solution which is retained for 15 minutes to an hour to get effective results. These relieve constipation by lubricating the colon and rectum, making it easier to pass stools.  These are used to treat inflammatory bowel disease (IBD). These enemas contain a solution of medication, such as mesalamine. KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 5  Examples  Mineral oil  Probiotic enemas  Herbal enemas KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 6  Carminative enema  This is given to expel flatus. The solution instilled into the rectum releases gas, which in turn cause the rectum and the colon to swell, thus stimulating peristalsis.  60-80 ml of the solution is introduced.  They are used to help relieve gas and bloating in the colon. These enemas contain a solution of warm water and a mild soap or other agent, such as chamomile or peppermint oil, that helps to break up gas bubbles. KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 7  Return flow enema  Used to expel flatus.  Done on people with trouble pooping due to intestinal gas. A large fluid volume is used. The fluid is then drawn out along with the flatus (intestinal gas). This process is repeated three to five times until the gas is entirely out.  This involves the alternating flow of fluid in and out of the large intestine to stimulate peristalsis and the expulsion of feces.  If the return solution becomes thick with feces it is replaced by fresh solution. KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 8  ADVANTAGES  Can soften the fecal matter and help in easier excretion.  Relieve gaseous bloating.  Acts as an investigatory tool for the detection of tumors, colitis, etc. by introducing barium sulphate into rectum or colon and taking an X-ray after.  Enemas are done before colonoscopy – where a specialized camera is used to see inside the rectum and colon. KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 9  DISADVANTAGES  Gastric and intestinal bleeding  Inflammation in colon, anus.  Stretching during enema delivery can lead to intestinal perforation.  Cramping  Discomfort KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 10  STORAGE  Enema should be stored at room temperature and away from direct sunlight or humid places.  Do not keep or reuse any unfinished enema. KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 11  AUXILIARY LABEL FOR RECTAL USE ONLY STORE IN COOL PLACE (AT TEMPERATURE NOT MORE THAN 25°C) KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 12  Sodium Phosphate Monobasic, Sodium Phosphate Dibasic Enema (60 ml) Rx  Monobasic Sodium Phosphate.................. 9.5 g  Dibasic Sodium Phosphate........................ 3.5 g  Water q.s..........................................……60 ml KRUPALI MAKWANA School of Pharmacy, RK University, Rajkot 13 THANK YOU!