Why do people do an enema

Enema - effect and implementation

With an enema, tempered liquid, usually water, is fed into the anus. This was already common in ancient times to relieve the intestines and to cleanse them. Today enemas have a wide variety of uses and are used, for example, for emptying the bowels before an operation or childbirth, as a preparatory measure for a colonoscopy, as a natural colon cleanse and for constipation or fever.

The intestine consists of the small intestine and the large intestine. Depending on the type of enema, the entire colon or just the rectum will be emptied. Oral ingestion of suitable preparations is necessary for cleaning the small intestine.

Enema overview

  • description: The introduction of a liquid (usually water) through the anus into the intestine is called an "enema".
  • execution: The most common instruments for performing an enema are irrigators, disposable enemas, enema syringes and klyso pumps.
  • effect: The liquid introduced causes the intestine to empty very quickly (usually after a few minutes).
  • application areas: Enemas are used, among other things, for stubborn constipation, sluggishness of the intestine after an operation, for the administration of medication, as preparation for certain operations or a colonoscopy and before a birth.
  • Possible risks and side effects: Irritation of the intestinal mucosa, circulatory problems, diarrhea, nausea and vomiting, anaphylactic shock
  • Contraindications (Selection): Pregnancy and breastfeeding, chronic inflammatory bowel diseases, acute abdominal diseases, heart diseases, bleeding in the gastrointestinal tract, intestinal obstruction, hemorrhoids, colon cancer, after an intestinal operation

Historical review

The enema started with a slightly bizarre story. The ancient Egyptians believed they observed that the sacred ibis (a stork-like bird from the ibis and spoonbills family) kept sticking its beak into its anus. But the truth was different: he took a secretion from his tail gland in order to lubricate his plumage. However, this was the beginning of the enema.

The enema, a tool that is still common today, was already fashionable back then. The current name comes from the Greek, so "klysterion" means purification.

Such enemas were already used in ancient times to empty the intestines, but also to apply drugs or nutrients. They were to serve to nourish the sick who could not eat or keep anything to themselves. So-called nutrient enemas contained broths, wine, milk or pureed meat, for example.

As early as 3000 years before Christ, the view was held that diseases can also arise from constipation, among other things. In addition, there was the widespread opinion that so-called disease demons can leave the body through the intestines. An enema administered should speed this up. An enema at that time consisted of a cut off cattle horn.

According to the teachings of the famous Greek physician Hippocrates, health existed only when the body's humors were balanced. Even then, constipation was called an imbalance. Elimination procedures, such as bloodletting, cupping and also the enema, were among the therapies used and are modern again today in naturopathy.

The heyday of the enema prevailed in the 16th and 17th centuries, a downright enema addiction. And not just to cleanse the colon, but to stay healthy and young and keep your skin youthful. The enema was even used daily.

Enema and other enema devices

An enema can be performed with different instruments. The most common enema devices for performing colon cleansing at home are irrigators, disposable enemas, enema syringes and klyso pumps.

Single-use enemas have a capacity of 100 to 200 milliliters, micro-enemas hold five to ten milliliters and the irrigators can hold one to two liters of fluid. The enema devices are available in pharmacies or online and differ in structure and use.

Irrigator

The irrigator consists of a container, a hose and an intestinal tube. This is very carefully inserted up to 30 centimeters into the anus. With this device a fluid supply of up to two liters is possible. The term “high enema” is often used when it is used, as the entire colon can be cleaned with it.

Single enema

With the single-use enema (or micro-enema) only the rectum is "irritated". Between five and 200 milliliters of liquid are used, which is usually a hypertonic solution. This binds the water in the intestine, so that the stool becomes softer. With a single-use enema, no intestinal tube is necessary. This is the remedy of choice, especially for constipation, and can also be used for babies and toddlers.

Klyso pump

With a so-called Klyso pump, it is possible to introduce a larger amount of flushing liquid, namely up to two liters. The liquid in a separate container is sucked in with the pump and then pumped into the anus with the help of a hose.

Enema - therapeutic

Therapeutic indications for an enema are preparation for childbirth, the presence of persistent constipation (constipation), sluggishness of the bowel after an operation and the administration of medication through the bowel. If a patient is unable to take medication orally, this can happen through the intestinal mucosa. An enema is then carried out for this purpose.

When a patient has too high a level of ammonia in their blood, which usually happens as a result of cirrhosis of the liver, the medicine uses lactulose enema. Lactulose (lactulose is a double sugar that draws water into the large intestine and binds ammonia) can bind excess ammonia, which is then excreted.

Another example is the so-called resonium enema, which is used in connection with chronic kidney failure. If the kidneys are not working properly, this can increase the level of potassium in the blood (hyperkalaemia). Resonium (it exchanges sodium for potassium ions in the intestine) supports the excretion of potassium.

Risks and Side Effects

A careful, properly performed enema usually does not lead to any side effects. This also depends on the person who gets the enema. Some people are sensitive to it. If the enema is done too often, this can lead to damage to the intestinal flora.

The wrong water temperature can lead to cramps or scalds. If any acidic substances are added to the liquid, this can lead to irritation of the intestinal mucosa. In the worst case, anaphylactic shock is possible as a reaction to the irrigation fluid used.

Other possible side effects are circulatory problems, diarrhea, nausea and vomiting. Injury to the intestinal wall or the anus is possible if used improperly.

Contraindications

There are various criteria or circumstances that prohibit an enema:

How often is an enema performed?

Enemas that are performed too frequently can, as already mentioned, damage the intestinal lining. If you suffer from constipation, you should not overdo this measure. However, an enema once a month is not a problem.

If the intestines are cleaned beforehand in connection with therapeutic fasting, this is harmless twice a year. But listen to your stomach - if you feel total discomfort just at the thought of an enema, then don't do it.

Enema at home

If you want, you can do an enema yourself at home. It is best to start with a small amount of liquid to familiarize yourself with the process. Be sure to find a place near a toilet to do it. You should have enough time and rest. Get an enema kit, such as an irrigator, from the pharmacy and read the instructions carefully.

The longer the water remains in the intestine, the better the effect. Ten to fifteen minutes is recommended. But do not despair if this is not possible. Even if you need to go to the bathroom faster, it does not mean that the enema is unsuccessful.

If the application of an irrigator is too complicated for you, an enema can be found. This is much easier, especially for self-application, and is therefore recommended. In the pharmacy or a well-stocked drugstore there are even ready-made "mini enemas", for example with the additives glycerine, olive oil and chamomile.

In general, you should rest after the enema. You may need some warmth. Lie down comfortably on the couch with a blanket and a hot water bottle.

Rinsing liquid

As a rule, lukewarm water at a temperature of around 37 degrees Celsius is used as the rinsing liquid. Chamomile tea has anti-inflammatory effects and calms the intestines somewhat. Additives such as table salt, glycerine, healing earth or oil can be added to the water. In doing so, however, the recommended amount of the additive must be observed and the enema must be stopped immediately if symptoms or discomfort arise.

The enema with coffee is repeatedly touted. This is supposed to detoxify the liver and bile. But this belongs in the hands of a therapist and is not suitable for the unauthorized procedure at home. Side effects such as circulatory problems, massive nervousness or disturbances in the electrolyte balance can occur.

Attention:
Even if enema sets are freely available and self-implementation is touted as simple and recommendable on the Internet, such an enema can still be associated with risks and side effects. Especially when the intestinal flora has already been attacked or changed in a highly inflammatory manner, this procedure should be kept away.

If you are not sure, it is best to ask your doctor beforehand. If you do an enema at home, you shouldn't be alone. In the event of circulatory problems, nausea or vomiting, help is immediately available.

Enema due to recurring constipation is not a permanent solution. The reason for the constipation needs to be found and properly treated. (sw)

Author and source information

This text complies with the requirements of specialist medical literature, medical guidelines and current studies and has been checked by medical professionals.

Susanne Waschke, Barbara Schindewolf-Lensch
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  • Smith, Lee: Coffee: Friend or Enema ?: Coffee Enemas and Detoxification, CreateSpace Independent Publishing Platform, April 2011
  • Schewior-Popp, Susanne; Sitzmann, Franz; Ullrich, Lothar (Ed.): Thiemes Pflege: The textbook for nurses in training, Thieme, 2017
  • Uchiyama-Tanaka, Yoko: Colon irrigation causes lymphocyte movement from gut-associated lymphatic tissues to peripheral blood, in: Biomedical Research, 30/5: 311-314, 2009, Biomedical Research
  • Horiuchi, A .; Nakayama, Y .; Kajiyama, M. et al .: Colonoscopic enema as rescue for inadequate bowel preparation before colonoscopy: a prospective, observational study, in: Colorectal Disease, 14/10: e735-e739, October 2012, Wiley Online Library
  • Hussain, Zilla H. et al .: Fecal Impaction, in: Current Gastroenterology Reports, 16/9: 404, September 2014, Springer Link

Important NOTE:
This article is for general guidance only and is not intended to be used for self-diagnosis or self-treatment. He can not substitute a visit at the doctor.