Enemas are sometimes used to treat constipation when other measures, such as laxatives or dietary measures, don’t work. They are also used to clear the colon before colonoscopy or other tests.
Enemas work to get fluid into the large intestine so it can soften your stool and help it pass. While they can be safe and effective, there are real risks when enemas are administered at home or used too frequently. Sometimes, they can cause serious and even life-threatening complications.
This article will explain when to use enemas, the risks and possible complications of using them. It will also provide alternatives to reduce constipation.
Safe use of enemas
An enema is the introduction of fluid into the rectum and large intestine through the anus. Enemas are used for a variety of reasons:
- Before the test: Before a test such as a colonoscopy, one or more enemas may be given to remove all stool from the large intestine.
- Colon X-rays: To make the large intestine appear better on X-rays, health care providers use barium enemas. Barium is a metal substance that coats the lining of the colon. This makes it easier to detect abnormalities, such as colon cancer.
- Drug delivery: Certain drugs can be delivered directly to the rectum or sigmoid colon (the lowest part of the large intestine) to treat conditions such as inflammatory bowel disease (IBD).
- Constipation: Enemas can be effective in relieving occasional constipation, other methods are ineffective.
If your healthcare provider recommends an at-home enema, you can purchase an over-the-counter enema kit. Most of them contain water and salt, mineral oil, or mild laxatives.
Get the kind recommended by your healthcare provider. Don’t add anything to it and make sure to follow the instructions carefully. Don’t try to make “DIY” enemas using your own supplies or liquids.
How to Use Enema Safely
Unsafe Use of Enemas
There are always certain risks associated with using enemas at home. Risks of a single enema include:
- Damage or perforation (puncture) of the rectum or bowel due to stretching
- Disrupting the natural microbial community in the gut
- Pain from using liquids that are too hot or too cold
- Introduces too much fluid, which may remain in the body and flow out without warning
- Infections caused by non-sterile equipment. This is especially a problem for people with autoimmune diseases or compromised immune systems.
Perforations associated with enemas can lead to sepsis (blood poisoning) and are fatal in about 4% of cases, one study found.
Over time, repeated use of enemas can cause serious problems, such as:
- Weakens your gut muscles, making you rely on enemas for bowel movements
- a condition called hyponatremia Or water intoxication, which is an electrolyte imbalance that occurs when the body does not have enough sodium. In severe cases, it can cause confusion, seizures, and coma.
One type of enema sometimes used in alternative medicine is called high colon or colon hydrotherapy. These are invasive and can be harmful if you use them regularly to remove stool.
If you have hemorrhoids, an enema may cause additional pain. You should avoid enemas if you have rectal prolapse (the end of your lower bowel protruding from your rectum).
In 2014, the U.S. Food and Drug Administration (FDA) issued a warning against the repeated use of enemas containing sodium phosphate. These can be found in some store brands, including Fleet Enema.
Sodium phosphate enemas are especially dangerous for older adults.it may lead to Hyperphosphatemia— An electrolyte disturbance involving high phosphate levels and low calcium levels in the blood. This can lead to pain, rash, muscle cramps, intermittent cramps, kidney and liver damage, and (rarely) death.
Many people tout home enemas, which often contain “special” ingredients to cleanse the gut, improve digestive health, or other purported benefits. These types of enemas are not recommended by the medical community.
Popular enemas may contain coffee, herbs, minerals such as Epsom salts, soapy water, acidic solutions, and more. In addition to the usual risks of enemas, these popular enemas can also cause:
- destroy gut bacteria
- Electrolyte disturbance
- Severe dehydration that can be fatal
- Rectal burns, inflammation and infection can be fatal
- Internal bleeding leading to blood transfusion and possible removal of the colon
Never give yourself an enema with ingredients not approved by your healthcare provider.
Safe Treatment for Constipation
Likewise, an enema should be the last resort for treating constipation. In most cases, constipation can be relieved with lifestyle changes such as:
- add fiber to your diet
- Drink more water
Over-the-counter laxatives may be an option for you, but they also come with risks. Discuss them with your healthcare provider, especially if you are frequently constipated.
How to Treat Constipation
An enema works by releasing fluid into the colon and large intestine through a tube inserted into the anus. Enemas are used before a test, such as a colonoscopy, which requires a clear view of the colon. They are also sometimes used to relieve constipation when other measures have not been successful. Enemas can be dangerous at home or repeatedly. They must be used under the supervision of a healthcare provider to avoid complications.
If dietary measures or treatments such as laxatives fail to relieve constipation, you may want to consider using an enema. Be sure to talk to your healthcare provider before trying to give yourself an enema at home. They can help you choose the right one and advise you on how to use it correctly and safely. Keep in mind that in some cases, constipation can be a sign of serious medical conditions, such as neurological problems or colon cancer. Consult your healthcare provider if you have recurring constipation that is difficult to relieve, especially after diarrhea.