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Rectum and Anus

Alternative Names 
fleets enema, soap suds enema, sodium phosphate enema, saline enema, Definition
An enema is a way of cleaning out the bowel or large intestine. Various solutions are inserted into the rectum to soften the faeces. This causes the bowel and rectum to stretch and expand, and helps the bowel to empty.

Who is a candidate for the procedure? 
Enemas may be given:
  • to relieve constipation. Sometimes a person may need enemas for an extended time. Enemas may be given at home by the person, a family member, or a visiting nurse.
  • to prepare for an examination of the rectum or bowel, such as a sigmoidoscopy or colonoscopy
  • prior to surgery on the bowel
  • prior to certain x-ray procedures, such as a barium enema. A barium enema is a series of x-ray films that visualise the bowel after a contrast agent is inserted in the rectum.
Enemas used to be given to anyone having surgery, and to women who were in labour. This is usually not done anymore.

How is the procedure performed? 
The person will be asked to lie on his or her left side. The right leg should be bent up toward the chest. This positon helps the solution flow easily into the colon. The solution most commonly used is a mixture of mild soap and warm water, known as a soap and water enema. It is not commonly used much now a days. The solution is placed into a small plastic container with a flexible tube. The tube is rubbed with lubricating jelly. The tube is gently inserted in the rectum about 4 to 6". The solution is then slowly released.

A microlax enema is a small, prefilled enema. It is a faecal softener which liberates the water that is present even in hard faeces making it softer and easier to pass. An oil retention enema is useful for hard stool, because the stool absorbs the oil and is softened.

What happens right after the procedure? 
After an enema, the person is asked to hold the contents inserted into the rectum anywhere from 3 to 15 minutes depending on the type of enema given. After this time he or she can expel the enema while sitting on a toilet. The results should be evaluated to be sure that the enema was successful.

What happens later at home? 
If the enema was given for constipation, the person should monitor his or her bowel movements for further constipation.

If the enema was given to prepare for surgery or for an examination, it may need to be repeated. The goal of this type of enema is to cleanse the bowel. It needs to be repeated until there is no faecal matter expelled after the enema.

After a barium enema, the person will have white coloured stool for a short time as the body expels the barium.

What are the potential complications after the procedure? 
Sometimes a person may feel faint while having an enema. A more serious risk is a perforated bowel, which is very rare. A perforated bowel occurs when the tip of the enema pokes through the bowel and causes damage to the tissue.

Author: Gail Hendrickson, RN, BS
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.

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