Enemas are used to relieve constipation when laxatives and diet are ineffective. Cleansing enemas are also used to clean the colon before colonoscopies and other tests. In traditional Chinese medicine, retention enemas are sometimes used as part of treatment.
Water enemas are safe and effective, but like mineral oil products, they have side effects when used at home or frequently. In some cases, it can lead to serious complications such as intestinal perforation and sepsis, which are life-threatening conditions due to infection.
This article explains when enemas are used, as well as the risks and possible complications of their use. It also provides another way to reduce constipation.
Illustration by Nusha Ashjaee from Verywell Health
Safe use of enemas
Enemas push fluid into the large intestine to soften stool and aid in bowel movements. The fluid is administered through the anus into the rectum and large intestine. Enemas are used for various reasons.
- before test: One or more enemas may be used before undergoing a test, such as a colonoscopy, to remove all stool from the large intestine.
- During imaging of the colon: To see the large intestine more clearly on images, medical professionals use barium enemas. Barium is a metallic substance that lines the lining of the colon. This makes it easier to detect abnormalities such as colon cancer.
- To deliver medicine: Certain drugs can be delivered directly to the rectum or sigmoid colon (lowest part of the large intestine) to treat conditions such as inflammatory bowel disease (IBD).
- To relieve constipation: Enemas can be used to effectively relieve occasional constipation when nothing else works.
Some enemas use plain water, but be sure to use a reputable product rather than making it at home. In some cases, the liquid used in the enema is simply salt water or water mixed with baking soda. Some enemas contain laxatives.
Use of enema kit: water or oil
If your health care provider recommends home enemas, you can purchase a commercial enema kit. Most of them contain water and salt, mineral oil, or a mild laxative. Buy the type recommended by your health care provider. Do not add anything and follow the instructions carefully. Do not try to assemble a “DIY” enema using your own materials or liquids.
water enema side effects
Water enemas can cause side effects, which is a risk associated with all enema products. These side effects include:
- nausea and vomiting
- abdominal pain or swelling
- cold sweat
- palpitations
- dizzy
In a study that used warm water-based enemas (and saline enemas) in children before colonoscopies and then one dose of laxatives before the procedure, children who received more mineral oil laxative products These side effects were found to be fewer than those of
Side effects also depend on other factors such as your underlying health and age. Older adults may need warm water enemas to treat fecal impaction or prepare for a procedure.
Generally, water-based enemas are safer than soap enemas, which can damage the lining of the colon. It can also limit the effects of electrolyte imbalance.
sodium phosphate enema
In 2014, the Food and Drug Administration (FDA) issued a warning against repeated use of over-the-counter enemas containing sodium phosphate. It is especially dangerous for people over 55 years of age and should never be used on children under 2 years of age. hyperphosphatemia– Electrolyte disturbances with increased phosphate levels and decreased calcium levels in the blood.
Oribase enema side effects
The side effects of enemas containing mineral oil (such as Fleet Brand) are similar to other side effects of enemas. You may experience stomach cramps or pain, and may have nausea or diarrhea. This can also occur with glycerin laxatives.
When using mineral oil enemas, be careful of oil leakage from the rectum and irritation of the entire rectum.
Some people may have a more severe systemic allergic reaction to oil-based enemas. For example, people with latex allergies should choose latex-free products.
Call your health care provider or call 911 if you experience any of the following symptoms:
- skin rash
- Itching and hives (hives)
- swelling of the face, lips, and tongue
- difficulty breathing
If you do not have a bowel movement within 15 minutes, stop using mineral oil enemas and consult your doctor. However, keep in mind that the speed at which enemas and laxatives work depends on the specific product, such as 60 minutes for glycerin products (commonly used in children).
Mineral oil is considered a safer enema option than phosphate enemas for older adults. Some products are sodium-free.
If you have hemorrhoids, enemas may make them more painful. Avoid using enemas if you have rectal prolapse (a condition in which the lower end of the intestine protrudes from the rectum). Excessive use of laxatives is one of the causes of rectal prolapse.
interaction
Enema products have several known drug interactions, often interacting with drugs that regulate fluids and electrolytes in the body or that affect the kidneys (because enema products help with stool evacuation) (to move body fluids).
These drugs include nonsteroidal anti-inflammatory drugs (NSAIDs) and Lasix (furosemide). The following blood pressure medications may also be included:
- Angiotensin-converting enzyme (ACE) inhibitor
- Angiotensin receptor blockers (ARBs)
Coffee, herbal and other enemas
Never use ingredients in enemas intended for cleansing or improving digestive health that have not been approved by your health care provider. Enemas containing coffee, herbs, minerals such as Epsom salt, soap suds, acidic solutions, etc. are generally not recommended by the medical community and have no proven effectiveness.
Complications and warnings
The use of enemas at home always carries certain risks. Enema-related perforations are rare but can cause serious and fatal injuries, including sepsis (a serious blood infection).
Other risks may include:
- Damage or perforation (perforation) of the rectum or intestines due to stretching
- Disruption of the natural microbiome in the gut
- pain caused by using liquids that are too hot or too cold
- Too much fluid can stay in your body and come out without warning
- Infection caused by non-sterile equipment. This is especially problematic for people with autoimmune diseases or compromised immune systems.
safe alternative
Water-based enemas and mineral oil enemas should be a last resort for treating constipation. In most cases, constipation can be alleviated by making lifestyle changes such as:
- add fiber to your diet
- Exercise
- drink more water
Over-the-counter laxatives may be an option, but they also come with risks. Talk to your health care provider about them, especially if you have regular constipation.
summary
Enemas work by releasing fluid into the colon and large intestine through a tube inserted into the anus. Enemas are used before tests such as colonoscopies that require a clear view of the colon. It is also used to relieve constipation when other measures have failed.
Doing enemas at home or repeatedly can pose health risks. It should be used under the supervision of a healthcare provider to avoid complications. Keep in mind that in some cases, constipation can be a sign of a serious illness, such as a neurological problem or colon cancer.
Always consult your health care provider before attempting an enema at home. We can provide information about lifestyle changes, medications, and other interventions to improve digestion.
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