Enema

What is an enema?

An enema is an injection of fluid directly into your rectum that helps you poop. You may get an enema at your healthcare provider’s office. Most people buy enema kits they use at home. They’re available without a prescription at most pharmacies.

People have used enemas for centuries to flush out poop (stool) in their colon (large intestine).

You may hear people use “enema” to refer to the actual procedure or the fluid or product they use to flush out their colon. Products you’ve likely heard of before, like Fleet® Saline Enema and Pedia Lax®, are commonly used enemas.

When should you have an enema?

You may need an enema to:

• Relieve constipation: Usually, an enema is a last-ditch effort to relieve constipation. You may need an enema if you can’t poop and lifestyle changes haven’t helped you have a bowel movement. Usually, increasing your water and fiber intake can get things moving. If not, stool softeners you take by mouth may help. If that’s a no-go, it may be time to go directly to the source by trying an enema.
• Treat fecal impaction: Severe constipation can cause poop to get stuck inside your colon, so it’s impossible to pass on your own. An enema is an invasive treatment option, but it’s much less invasive than other options, like removing the stool with surgery.
• Prepare for surgery: You may need an enema to flush out poop before surgery on your colon or rectum. Getting rid of the poop reduces your risk of infection during surgery.
• Prepare for a colonoscopy: During a colonoscopy, a provider inserts a scope into your anus (butthole) and through your rectum to check for abnormal growths inside your colon. Part of your preparation instructions may involve doing an enema the day before so your provider can get a clear view of your colon.
• Have an imaging procedure: During a barium enema, a provider inserts liquid that contains a chalky white powder called barium into your rectum. The barium solution makes problem areas easier to spot on an X-ray.
• Receive medicine: A healthcare provider may insert medicine directly into your colon using an enema. For example, some medicines administered via enema reduce inflammation associated with gastrointestinal diseases, like ulcerative colitis.

Some people use enemas to rid their bodies of toxins or lose weight, but there’s no evidence that enemas help with this.

What are the types of enemas?

Enemas come in varieties based on solution type, the enema’s purpose and the solution amount.

Solution type

• Sodium phosphate enemas are the most common and fastest-acting type. A sodium phosphate enema is a mix of water and salt (saline). These enemas pull water from your colon and into your stool, so it’s easier to pass.
• Glycerin enemas also pull water into your colon to soften stools.
• Bisacodyl enemas stimulate your colon to move, so it pushes the poop out.
• Mineral oil enemas lubricate your colon so that poop can slide through easily.
• Barium enemas are only used during a special X-ray procedure.
• Tap water enemas soften poop so it can pass more easily.

Some people mix homemade solutions that consist of ingredients like soap, vinegar, milk or even coffee. Not all homemade ingredients have been tested for safety, though. They can potentially irritate or injure your colon. If you need an enema, it’s worth it to purchase one that’s safe.

Purpose of the enema

• Cleansing enemas clean you out fast — within a matter of minutes. You insert the liquid, and then you poop. Most enemas are cleansing enemas.
• Retention enemas require you to “hold it” or retain the fluid for a bit so the enema has time to work inside your colon. For example, holding a mineral oil enema gives it time to lubricate your colon so you can poop easier.

Amount of solution

• Large-volume enemas (from 500 to 1,000 milliliters of fluid) push fluid higher into your colon, cleansing it completely.
• Small-volume enemas (less than 500 milliliters of fluid) clean the lower part of your colon, which may be all you need.

Regardless of the enema type, you should follow the instructions — to the letter — to ensure you’re inserting the right amount of fluid. Otherwise, you may experience unpleasant side effects. Too much fluid can damage your colon.

How does an enema work?

Inserting any fluid into your rectum creates pressure inside your colon, triggering a reflex that makes you poop. This doesn’t mean that inserting any fluid is safe, though.

The enemas you buy over the counter are safe (when administered correctly) and provide additional benefits to help you feel relief fast. For example, they can help you retain water to soften your stool, stimulate your colon to move or lubricate your colon to grease the passageway.

How is an enema performed?

No two enema kits are the same. For example, the container that holds the fluid may be a bottle or a bag. The part that administers the solution may be a tube, a nozzle or a syringe. Follow the instructions on the kit or from your healthcare provider closely.

In general, here are the steps you should follow.

1. Lay a towel on the floor and have a timer nearby so you know when you should feel the urge to poop. The towel can catch any accidents if you can’t get to the toilet in time.
2. Wash your hands and prepare the solution as needed. You may need to mix and measure the solution and transfer it to a container. Make sure the solution is at room temperature. Liquid that’s too hot or cold will hurt.
3. Get in a position that makes it easy to insert the enema. If you’re doing an enema alone, lie on your side with the knee of your other leg pulled to your chest. It’s a good idea to lie on your nondominant side so that your dominant hand can insert the tube or syringe. If someone’s helping you, you can kneel (as if the bottom half of your body were in the child’s pose in yoga) and lean forward, resting the side of your face on the towel.
4. Lubricate the tube (petroleum jelly or K-Y Jelly® are good options) and gently insert it into your butthole. The kit will tell you how far it should go. Don’t force the tube. If it won’t go in, contact your provider.
5. Squeeze the solution until you’ve administered the correct amount of fluid, then slowly remove the tube. If you’re doing a retention enema, wait until the designated time described on the kit before pooping. Otherwise, once you feel the urge to poop, go.

What are the risks or complications of an enema?

An enema is a safe procedure when done correctly, but errors can happen.

Risks include:

• Pain or discomfort. An enema may hurt if you use fluid that’s too hot or cold or if you force the tube and damage tissue. You should take extra care to be gentle when inserting if you have hemorrhoids.
• Puncturing your rectum. You can tear your rectum if you’re not careful. Contact your provider if you have a bloody stool. Bright red blood may signal a tear.
• Puncturing your colon. The tissue can tear if you overwhelm your colon with too much fluid. Your risk is higher if you’ve had previous colon surgery that’s weakened the tissue.
• Infection. You can introduce bacteria into your body with the enema if the materials aren’t clean. You may need to avoid enemas if you have a compromised immune system.
• Chronic constipation. Overusing enemas can cause your colon to lose the “muscle memory” it uses to help you poop. This can lead to long-term constipation issues.
• Electrolyte imbalance. You should avoid sodium phosphate enemas if you have chronic kidney disease (CKD). They may disrupt your electrolyte balance to dangerous levels.
• A missed diagnosis. Relying on frequent enemas to relieve constipation can prevent you from learning if you have an underlying condition causing your constipation. Instead of reaching for immediate relief, contact your healthcare provider. Constipation may be a symptom of a condition your provider needs to diagnose and treat.

As with any treatment, enemas aren’t for everyone. Check with your healthcare provider to ensure an enema is safe based on your health.

How long will it take for me to feel better?

Most enemas provide relief within minutes up to an hour. Read the instructions on the enema kit so you know the timeframe. Contact your healthcare provider if it’s past the window when you should’ve pooped, and nothing’s moving.

How long after an enema do you poop?

With most enemas, you poop within 15 minutes, but it depends on the type of enema you’re using. Some may take up to an hour to clean you out completely. A key benefit of an enema is that it provides instant relief.

It’s a good idea to stay close to the toilet for the first hour after having an enema, just in case.

Can I do anything to make the experience of an enema easier on me?

There’s nothing pleasant about hiding out in the bathroom and waiting to poop (finally). Still, the experience doesn’t have to be agony. You can get a comfortable footstool to rest on while you wait to go. It’s especially helpful for children, whose feet may not be able to reach the floor.

Books, tablets, cell phones and handheld video games are also a good idea. An enema is mostly about pooping, but that doesn’t mean you can’t distract yourself with the news, a good book or even cute cat videos.

When should I call my healthcare provider?

Call your healthcare provider if you’re considering using an enema to relieve constipation. There may be simpler solutions that can help.

Don’t hesitate to ask your provider for help if you have any questions about performing the procedure correctly. It’s better to ask than risk an injury.

If you’ve performed an enema and nothing’s moved within the timeframe, contact your provider. Some enemas can lead to dehydration if they stay in your body too long.

A note from Cleveland Clinic

The thought of an enema may make you squeamish, but the benefits can outweigh the “ick” factor of the actual process. It’s not a first-line treatment for constipation. Still, an enema can provide relief fast — at that moment when you’re feeling most desperate. Just make sure you’re not relying too much on enemas. That can make your constipation worse in the long run. And follow the instructions on your enema kit down to the last detail. An enema is safe when it’s performed correctly and only as needed.