Enema

What is Enema?
ENEMA is a solution introduced into the rectum
and large intestine. The action of an enema is to
distend the intestine and sometimes to irritate the
intestinal mucosa, thereby increasing peristalsis and
the excretion of feces and flatus.

Enemas
Purpose
Stimulate bowel movement
Relieve constipation or fecal impaction
Cleanse bowel of feces before surgery or diagnostic
procedures
Remove flatus

TYPES OF ENEMAS
CLEANSING ENEMAS

COMMERCIAL

TAP WATER

FLEETS (PACKAGED)

SOAPSUDS

OIL RETENTION

ENEMAS TILL CLEAR

CARMINATIVE

DIAGNOSTIC
BARIUM ENEMA

TYPES OF ENEMAS

A. CLEANSING ENEMA = are intended to remove feces. They are

given chiefly to:
1. Prevent the escape of feces during surgery.

2. Prepare the intestine for certain diagnostic tests such as x ray

or visualization tests ( e.g. colonoscopy )
3. Remove feces in instances of constipation or impaction.

Cleansing Enema uses a variety of solution :

SOLUTION

CONSTITUENTS

Hypertonic
/fleet

90-120ml of solution Draws water

e.g. sodium
into the colon
phosphate

5-10 mins.

Retention of sodium

Hypotonic/ tap
water

500-1,000 ml of tap
water

Distends colon,
stimulates
peristalsis and
softens feces

15-20 mins.

Fluid and electrolyte

imbalance, water
intoxication

Isotonic/ normal 500-1,000 ml of

saline
normal saline ( 9 ml
to 1,000 ml water)

Distends colon,
stimulates
peristalsis and
softens feces

15-20 mins.

Possible sodium
retention

Soapsuds

Irritates
mucosa,
distends colon

10 15 mins. Irritates and may

damage mucosa.

500-1,000 ml soap
to 1,000 ml water

ACTION

TIME TO EFFECT

ADVERSE EFFECTS

B. CARMINATIVE ENEMA = is given primarily to expel flatus. The

solution instilled into the rectum releases gas, which in turn distends the
rectum and the colon, thus stimulating peristalsis. For an adult 60 to 80 ml.
of fluid is instilled.

C. RETENTION ENEMA = introduces oil or medication into the rectum

and sigmoid colon. The liquid is retained for a relatively long period. An oil
retention enema acts to soften the feces and to lubricate the rectum and
anal canal, thus facilitating passage of the feces. Antibiotic enemas are
used to treat infections locally, antihelmintic enemas to kill helminths such
as worms and intestinal parasites and nutritive enemas to administer fluids
and nutrients to the rectum.

D. BARIUM ENEMA =is an X-ray exam that can detect changes or

abnormalities in the large intestine (colon). The procedure is also
called a colon X-ray. An enema is the injection of a liquid into your
rectum through a small tube.

Barium Enema
Indications:
Change in bowel habits
Pain
Mass
Melaena / Anemia
Single contrast Obstruction &
Intussusception.

Contraindications:
Rectal biopsy5 days
Toxic megacolon
Pseudomembranous colitis
Preparation: (Two days)
Low residue diet
Bowel prep (Dulcolax 4
Tab)