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What Is an Enema and How Do You Use an Enema Kit?

Constipation is an extremely common problem for people at all ages and stages of life. Research indicates that up to 20 percent of the population is affected by chronic constipation. Many people manage constipation with lifestyle and diet changes, such as adding more exercise, staying hydrated, and increasing fiber intake. In cases when these changes aren’t effective, some people work with their doctors to find medication or other treatments to improve their constipation. This can include laxatives, stool softeners, suppositories, and enemas.

An enema is a tool used to relieve chronic constipation, treat a significant backup, or for diagnosis. An enema involves flushing the rectum or colon with a lot of water via the anus. The colon is a large hollow organ inside the abdomen. The colon is involved in digestion, the movement of water, and the formation of stool.

There are two primary types of enemas: therapeutic enemas and diagnostic enemas. A therapeutic enema cleans out the colon and/or rectum and is used to treat constipation and bowel diseases like Crohn’s disease and ulcerative colitis. A diagnostic enema typically uses a substance called barium. Barium shows up well on X-rays and allows doctors to assess colon or rectal conditions like ulcerative colitis, undiagnosed bleeding, or abdominal pain.

There are three types of therapeutic enemas used to treat different kinds of conditions.

  • Phosphate enemas are available over the counter. This type of enema works by stimulating and irritating the rectal mucosa.
  • Saline, tap water, and soap suds enemas work by distending the rectum, increasing the urge to poop. They are believed to be less irritating for the rectal mucosa.
  • Over-the-counter stimulant suppositories and enemas typically contain glycerin and/or bisacodyl. 

Different types of enema work differently, but they all have a few things in common. Enemas are meant to stimulate the colon or rectum to encourage defecation. The liquids in an enema will lubricate and soften the stool, hopefully decreasing any straining during bowel movement.

The contents of the enema liquid also pull water from the bowels into hardened stool, making it easier to pass more effectively. Depending on the solution used, enemas may also stimulate the rectal muscle, making it easier to pass stool.

Some people use enemas to clean their colon. Two common types of cleansing enemas are water enemas and coffee enemas.

Water-based enemas are often made up of water or saline (salt water that is supposed to mimic the body’s sodium balance). These are believed to be the least irritating solutions. These enemas are supposed to be held in the rectum for a few minutes. When released, the fluid flushes out any loose fecal matter or impacted stool.

Coffee enemas are a mixture of brewed caffeinated coffee and water. This concentration is believed to dilate the bile ducts and allow for bile excretion and removal from the colon. Supporters of coffee enemas believe they can boost immunity, increase energy, treat autoimmune diseases, remove parasites, treat depression, treat cancer, and prevent overgrowth of yeast. However, there isn’t enough evidence to support these claims. Some research shows that coffee enemas could help prepare the bowels before a video capsule endoscopy. 

Yet perspectively helpful, coffee enema kits may have side effects such as nausea, vomiting, cramps, bloating, and diarrhea. Before trying this colon cleansing, consult your doctor.

Though enemas are commonly used to treat constipation, they have a few different indications for use. These include:

  • Bowel evacuation before surgery
  • Bowel evacuation for X-ray
  • Bowel evacuation before endoscopy
  • To administer prednisolone in patients with ulcerative colitis and/or Crohn’s disease

 Enemas are safe for most people, with a few exceptions:

  • Enemas are not appropriate for people with a paralyzed intestine that causes an obstruction, called paralytic ileus.
  • Enemas are not appropriate for treating chronic obstruction.
  • Enemas are not appropriate when someone has known significant electrolyte imbalances.
  • Enemas should be avoided in patients who have a potential for circulatory overload, mucosal damage, necrosis, perforation, or hemorrhage.
  • Enemas should be avoided after gastrointestinal or gynecological surgeries, especially if the person still has sutures.

Enemas can be administered by doctors or used at home. An enema kit usually includes a bag or container to hold the solution, a tube or nozzle to insert into the anus, and a cleansing solution.

You can buy enema kits at drug stores and pharmacies or online.

There are a variety of enema kits available, so it’s important to buy one from a credible source and pay attention to the materials used. There are single-use disposable enema kits as well as ones with reusable materials. If you’re allergic to latex, make sure to check the list of ingredients. Lastly, try to find an enema kit with a release valve so that you can manage the flow of the enema solution.

Disposable enema kits should still be able to work with a large amount of fluid. Make sure the tip and the tube are sterilized plastic. A vinyl bag is also a good choice, because it can work with gravity or you can squeeze it during use. 

Reusable enema kits are usually made of tougher materials. Look for soft rubber, durable plastic, and silicone. Some higher-end enema kits use stainless steel fluid containers. You will also want to pay attention to the applicators. Enema kits with multiple applicator types mean you can find the one that’s most comfortable. Because you need to clean reusable kits, think about how easy or difficult it will be to take apart and sterilize.

Most doctors discourage the use of a homemade enema since herbal or chemical ingredients and their amounts may be too intensive for you and may cause health problems.

There are a few steps you need to take to prepare for an enema.

  • Don’t eat for 30 minutes before using an enema, or follow your doctor’s instructions about fasting.
  • Drink 8–16 ounces of water to avoid dehydration.
  • Be near a toilet.
  • Have a comfortable place to lie down (with a towel).
  • Warm the enema in a bowl of warm water.
  • Wash your hands.

Applicator tips are often pre-lubricated to make them easier to insert. If not, you can lubricate the tip and a few inches of tubing.

The best positioning may be different for different people. Some choose to lie down in the fetal position on their left side. Others choose to lie on their back with their knees pulled to their chest. Lastly, some kneel down on their hands and knees.

Release any excess air from the tubing, and then gently insert the enema into your anus, no more than four inches. Do not force it.

Squeeze the bag or open the release valve until all of the solution is in. Remove the enema tip. If this is a retention enema, hold the liquid in your rectum for the recommended time.

Move to the bathroom and poop when you feel the urge or the time is up.

Some experience cramping, faintness, or dizziness after an enema. Lie down until this sensation passes.

Enemas are a commonly used medical tool, and they can be extremely effective, but also have side effects: nausea, dehydration, and electrolyte imbalances, so it’s important to talk to your doctor before using them. 

Make sure to talk to your doctor before using an enema. There are often lifestyle changes you can try first to alleviate constipation.

https://www.healthline.com/nutrition/enema-benefits

https://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2019.28.3.154?journalCode=bjon

https://www.uhb.nhs.uk/Downloads/pdf/PiHowToMicralax.pdf

https://www.healthgrades.com/right-care/digestive-health/enema

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4135241/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3348737/

https://www.researchgate.net/publication/8154934_Safety_and_effectiveness_of_large-volume_enema_solutions

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