Enema: How It Works & When to Use It

An enema is a procedure used to empty the bowels by inserting a liquid solution into the rectum. It usually works within 2 to 5 minutes and can help relieve temporary constipation.

An enema is commonly used to reduce discomfort and make bowel movements easier when stool is difficult to pass. It may also be recommended before certain medical tests that require the intestines to be cleared.

Although an enema can be effective, it should not be used frequently unless recommended by a doctor. Overuse can affect normal bowel function and intestinal flora, increasing the risk of ongoing constipation or chronic diarrhea.

How to perform an enema correctly

To perform a cleansing enema at home, you should:

1. Assemble the enema kit by connecting the tube to the water container and plastic tip
2. Fill the enema kit container with 1 liter of filtered water at 98.6°F (37°C)
3. Open the clamp on the enema kit and let a small amount of water flow to remove air from the tube
4. Hang the container about 12 to 18 inches above the body
5. Lubricate the plastic tip with petroleum jelly or water-based lubricant
6. Lie on your side with your knees bent, or lie on your back with your knees bent toward your chest
7. Gently insert the tip into the anus, pointing it toward the navel, without forcing it to avoid injury
8. Open the clamp to allow water to enter the rectum slowly
9. Stay in this position and wait until you feel a strong urge to have a bowel movement, usually within 2 to 5 minutes

If needed, over-the-counter enemas, such as Fleet enema, can be used as directed on the label. These products are pre-measured and should not be mixed with other substances. According to the FDA-approved label for sodium phosphate enemas, using more than one enema in 24 hours can be harmful.

When to perform an enema at home

A cleansing enema can be done at home for constipation to help stimulate bowel movements, or in other cases when recommended by a healthcare provider.

In some situations, such as during pregnancy, an enema may be used if recommended by a healthcare provider, since constipation during pregnancy is common. However, it should not be used routinely without medical guidance.

In addition, bowel cleansing with an enema may be indicated before certain tests, such as a barium enema, which is used to evaluate the shape and function of the large intestine and rectum.

Important precautions

Some precautions are important when performing an enema at home, such as:

• Using the correct amount of water in the enema kit container

• Not using very hot water, as it can cause irritation or burns

• Not using very cold water, as it can cause intestinal contractions and make the water come out before the enema works

• Being careful when inserting the enema tip into the anus to avoid intestinal perforation

• Not using coffee, alcohol, or other substances to perform the enema

• Drinking plenty of water to keep the body hydrated after performing the enema

In addition, if you still do not feel the urge to have a bowel movement after using an enema, or if you feel pain or discomfort, you should consult a your primary care provider or a gastroenterologist to identify the problem and start the right treatment.

Is it healthy to use an enema?

Using an enema can be safe when it is done with medical guidance, after the cause of constipation has been evaluated, and when the correct technique is used.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, a doctor may recommend short-term laxative use and can help determine which type is best for constipation. However, enemas should not be used frequently, as they can alter the intestinal microbiota.

To help relieve constipation, it’s important to follow a high-fiber diet to support regular bowel movements.

When to see a doctor

It is recommended to consult a primary care provider or a gastroenterologist, or go to the emergency room when:

• There has been no bowel movement for several days, especially if this is unusual for you
• There is no relief after using an over-the-counter enema
• Signs of severe constipation appear, such as a very swollen abdomen, severe abdominal pain, vomiting, or inability to pass gas

In these cases, the doctor may order diagnostic tests, such as imaging exams like an abdominal X-ray or CT scan, to look for possible causes of persistent constipation, including bowel obstruction, intestinal twisting, or hernias.