Enema After Laxatives: Safe Or Not?

Enemas are used to relieve constipation and cleanse the colon. They are typically used as a last resort when other methods, such as laxatives, suppositories, or a high-fibre diet, have failed to work. Enemas can be administered by a medical professional or self-administered at home, but it is important to consult a doctor before use due to possible side effects and health risks. These include abdominal pain, swelling, and in rare cases, bowel perforation or sepsis.

When should you use an enema?

Enemas are used to relieve constipation and cleanse the colon. They are usually recommended as a last resort for treating constipation, after other methods such as dietary changes, laxatives, suppositories, and exercise have been tried. Enemas are also used to clear the colon before certain medical tests and surgeries, such as a colonoscopy or X-ray of the colon.

There are two main types of enemas: cleansing enemas and retention enemas. Cleansing enemas are water-based and meant to be held in the rectum for a short time to flush the colon. Retention enemas are designed to be held in the bowel for an extended period, usually a minimum of 15 minutes, before being released.

Enemas can be administered by a medical professional or self-administered at home. However, it is important to follow instructions carefully and use sterile equipment to avoid side effects and complications. Some possible side effects of enemas include disturbing gut bacteria, affecting electrolyte balance, and dehydration. More serious complications may include bowel perforation, sepsis, and electrolyte imbalances.

Before using an enema, it is recommended to consult a healthcare provider and try other methods of treating constipation first.

What are the side effects of an enema?

Enemas are injections of fluids used to treat constipation and similar issues, such as cleansing the colon before a medical procedure. They can be administered by a medical professional or self-administered at home. While they can be safe and effective, there are several side effects and risks associated with their use.

Firstly, enemas can cause abdominal pain, discomfort, and swelling. They may also lead to more serious complications, such as bowel perforation or sepsis, a life-threatening condition due to infection. Enemas can also affect the balance of gut bacteria, disturbing the natural microflora and causing digestive symptoms. In addition, enemas have been linked to electrolyte imbalances, which can be dangerous, especially in older adults.

Another potential side effect is rectal irritation and burning or stinging around the bottom. This is usually mild and resolves within a few days. However, it is important to use a cream if it persists and consult a doctor if it does not improve. Enemas can also cause rectal bleeding, which should be reported to a doctor immediately.

Furthermore, enemas have been associated with allergic reactions, including itching, hives, swelling of the face, lips, or tongue, and difficulty breathing. In rare cases, a serious allergic reaction (anaphylaxis) may occur, requiring immediate medical attention.

Additionally, enemas can increase the risk of dehydration, especially in children and older adults, and can lead to kidney problems if fluids are not replenished adequately.

Some specific types of enemas have their own unique side effects. For example, sodium phosphate enemas can lead to hyperphosphatemia, an electrolyte disorder with high phosphate and low calcium levels in the blood. This type of enema is especially dangerous for people over 55 and should never be used in children under two. Oil-based enemas may cause oily leakage from the rectum, nausea, and diarrhoea.

Overall, while enemas can be a useful treatment for constipation and other conditions, they should be used with caution due to the potential side effects and risks involved. It is important to follow the instructions carefully and consult a healthcare provider if you have any concerns.

How do you administer an enema?

Administering an enema involves inserting fluid into the rectum to clear out stool or waste matter. This is usually done to stimulate the elimination of faeces from the rectum, often to treat constipation or a faecal impaction. Enemas can also be used to clean the rectum and lower colon before a diagnostic or surgical procedure, such as a colonoscopy.

• Gather your supplies: a clean enema bag with tubing (available at pharmacies), a water-soluble lubricant, a small measuring container, and any other ingredients as ordered by your healthcare provider.
• Prepare the enema solution: fill the enema bag with warm water and add any additional ingredients as instructed. Mix gently without shaking vigorously.
• Clamp the tubing and release a small amount of water to remove air from the tube. Reclamp the tubing and hang it from a secure place, such as an IV pole.
• Prepare the recipient: advise them to empty their bladder beforehand to reduce discomfort. Ensure their privacy and dignity, and provide anticipatory guidance about what to expect.
• Position the recipient: ask them to lie on their left side with their knees drawn up towards their abdomen. This position eases the passage and flow of fluid into the rectum.
• Lubricate the enema tube and gently insert it into the rectum at a depth of 2-4 inches for adults and 1-1.5 inches for infants. Stop if you feel resistance or the recipient reports discomfort.
• Administer the enema: hold the enema bag about 12-15 inches above the recipient's hips and unclamp the tubing. Allow the solution to flow slowly into the rectum.
• Inform the recipient that they may experience cramping or distension. If they report pain or nausea, stop the procedure and seek medical advice.
• Remove the tube: after the solution has been administered, gently remove the tube and assist the recipient with peri-care and repositioning.
• Observe and monitor: stay by the recipient's side and inform them about how long they should retain the enema. Assist them to the bathroom when needed and observe the content and quantity of the stool.
• Clean up: dispose of any waste, and return or clean the equipment for storage.

It is important to follow specific instructions provided by a healthcare professional and to seek medical advice if you are unfamiliar with the procedure. Enemas should not be used regularly and may carry certain risks, especially if administered incorrectly.

What are the alternatives to an enema?

Enemas are used to relieve constipation and cleanse the colon. However, they should be used as a last resort to treat severe constipation, as they can have side effects such as disturbing your gut bacteria and affecting your body's electrolyte balance.

• Drink caffeinated coffee: Coffee is known to stimulate defecation.
• Stay well hydrated with water: Drinking enough water is important for overall health, including digestion.
• Get regular exercise: Activities such as walking, running, biking, or aerobics can help get things moving in your digestive tract.
• Try an over-the-counter oral laxative: Laxatives, or stool softeners, are available over the counter and can help with constipation.
• Increase your fibre intake: Adding more fibre to your diet increases the bulk of your stool, speeding up its passage through the digestive system. Aim for 20 to 30 grams of daily fibre by eating more fruits, vegetables, whole grains, nuts, and seeds.
• Rectal suppositories: In some cases, rectal suppositories may be a better option than enemas, especially when time is limited or when dealing with constipation in children.

What are the different types of enema?

Enemas are injections of fluids used to cleanse or stimulate the emptying of the bowel. They are used to treat constipation and similar issues, such as fecal incontinence. They can also be used to clean the bowel before medical tests or surgery.

There are two main types of enema: cleansing and retention.

Cleansing Enemas

Cleansing enemas are water-based and are meant to be held in the rectum for a short time to flush the colon. They are usually retained for a few minutes until the body releases the fluid, along with loose matter and impacted stool.

Cleansing enemas include:

• Large volume enema: This treats constipation by cleaning a large part of the colon with 500-1,000 ml of fluid.
• Small volume enema: This cleans the lower part of the colon with less than 500 ml of fluid and is recommended for people who are not constipated in the upper part of the colon.
• Water or saline: The least irritating option, water or saline is used to expand the colon and promote defecation.
• Epsom salt: Similar to a water or saline enema, but with added magnesium to relax bowel muscles.
• Sodium phosphate: An over-the-counter enema that works by irritating the rectum, causing it to expand and release waste.
• Lemon juice: Lemon juice mixed with warm water is said to balance the body's pH while cleansing the colon.
• Apple cider vinegar: Mixing apple cider vinegar with warm water is said to clear the bowel and provide other healing effects on the digestive system.
• Soap suds: Adding a mild soap to water irritates the bowel and encourages rapid excretion of stool.

Retention Enemas

Retention enemas are designed to be held in the bowel for an extended period, usually a minimum of 15 minutes, before being released. They may be water- or oil-based and soften the stool to make it easier to expel.

Retention enemas include:

• Coffee: Coffee enemas are a mixture of brewed coffee and water, thought to promote bile removal from the colon.
• Mineral oil: This type of enema lubricates waste inside the colon and promotes its removal.
• Probiotic: Mixing probiotics with water may help cleanse the bowel and promote good gut bacteria.
• Herbal: Herbs like garlic, catnip tea, or red raspberry leaf are mixed with water to make enemas with purported nutritional and anti-inflammatory benefits.
• Oil-retention enema: An oil-based solution used for people with hardened stool.

Frequently asked questions