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Keeping Things Moving: The Risks and Safe Use of Enemas

Constipation can be a real pain in the…well, you know where. Sometimes, when things get backed up, you may consider an enema to relieve constipation. But what exactly are enemas and are they safe?

We dive into the world of enemas with some advice from Misty Shearer, a family nurse practitioner with Banner Health, on the risks and benefits of enemas, how to safely use one and when it’s better to call your health care provider.

What’s the scoop on enemas?

An enema is a liquid solution that goes into your bum (anus) to help cleanse the colon. Most over-the-counter (OTC) enema kits contain water and salt, mineral oil or a mild laxative.

“At-home enema solutions are often used to soften stool and help your bowel movement along when you are occasionally constipated. But they have other medical purposes as well,” Shearer said. 

In addition to constipation, enemas are used to:

  • Prepare for medical procedures or exams like a colonoscopy or X-ray
  • Give medicine when you aren’t able to take medicine by mouth
  • Provide fluids and electrolytes when you are dehydrated and can’t drink

Why does constipation need attention?

Occasional constipation may sound harmless, but if it is ignored it can lead to problems like hemorrhoids, anal fissures (tears in the bottom) and even serious issues like a bowel obstruction that needs medical attention.

“Constipation can also cause behavioral and developmental changes in children, such as avoiding toilet training, urinary tract infections and soiling (encopresis) or having accidents in their underwear,” said Shearer.

It’s essential to treat constipation before it becomes a problem. We’ll share tips on that below.

Are there any risks in using enemas?

While enemas can be helpful in treatment for constipation, using them too much or not following the instructions may cause problems. Some risks may include:

  • Irritation: Enemas may make your bottom feel uncomfortable or sore.
  • Dehydration: Too many enemas can mess with the balance of important gut bacteria and chemicals and make your body lose too much water.
  • Infection: If your enema isn’t clean, you could get sick.
  • Damage to the rectum and anus: In rare cases, if an enema is pushed in too hard or if you have medical issues, the walls of the colon or rectum can tear.  
  • Dependence: Using enemas too often may make your body rely on them too much. It can become a habit, and your body may forget how to poop on its own.

“Enemas may also not pair well with certain medications you are taking and certain health conditions,” Shearer said.

Talk to your health care provider before using an enema if you:

  • Are pregnant
  • Have a heart or kidney condition
  • Are allergic to latex
  • Have inflammatory bowel disease, rectal or colon problems or recent abdominal surgery

How to safely use an enema

If you find yourself in the enema aisle at the store, Shearer has some tips:

  • Ask a pro: Check with your provider first to ensure it’s the right move.
  • Read the instructions: Every enema kit comes with a guide. Be sure to read it carefully.
  • Get your gear: Collect everything you need: an enema kit, clean towel, gloves and lubricant to help the enema slide in smoothly.
  • Stay clean: Wash your hands and wear gloves for a clean process.
  • Find a good spot: Choose a comfy and private place for the enema.
  • Lube it up: Make the tip of the enema (nozzle) slippery with lubricant.
  • Insert gently: Slowly insert the enema nozzle into your bottom, following the instructions.
  • Wait it out: Squeeze the enema liquid and keep it inside for the suggested time.
  • Get ready to go: Be ready for a poop, which should happen soon after.
  • Clean up: After you’re done, clean up well and throw away used items.
  • Ask for help: Call your provider if anything feels wrong or you’re worried.

[Also read “How to Give an Enema (or Suppository) to Your Child”]

Safe enema alternatives

“Enemas should typically be considered as a last resort or when other methods are not effective or feasible,” Shearer said.

Before you jump into enema territory, she shared some other ways to help move things along:

  • Eat right: Load up on fiber with fruits, veggies and whole grains. Drink lots of water, too!
  • Get moving: Exercise helps keep your digestive system on track.
  • Laxatives: There are many types of OTC laxatives, such as bulk-forming or stool softeners, or prescription medications that may be a gentler option.
  • Establish a regular bathroom routine: Recognize and respond to the urge to go #2. Don’t wait to go and hold it.
  • Probiotics: Supplements may help regulate gut health and help with going poop.
  • Biofeedback therapy: This therapy teaches you how to control your pooping process better.
  • Manual removal: If your constipation is really bad, your health care provider may need to step in and manually remove the stuck poop.

[Check out “Is Squatting the Answer? How to Deal with Constipation”]

Discuss your symptoms and concerns with your provider, who can determine the possible causes of your constipation and recommend the most appropriate treatment and lifestyle changes.

When should you call for backup?

If you notice any of these signs, it’s time to call your health care provider right away:

  • Bad stomach pains that don’t get better
  • Blood in your poop
  • Non-stop vomiting
  • Fever
  • Chronic (ongoing) constipation
  • If you’re super thirsty, dizzy or your pee is a dark color
  • If you notice side effects from enema use, like rectal pain, rectal bleeding or allergic reactions

Bottom line (no pun intended)

Enemas are helpful tools when you are sometimes backed up or before a big medical test (like a colonoscopy), but here’s the catch: Enemas can still be risky. 

To stay safe, talk to your health care provider or a Banner Health specialist before purchasing an enema. They can tell you whether or not an enema is a good idea. They can also help suggest other ways to help you feel better if you are constipated.

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