An enema is a procedure in which liquid is inserted into the rectum through a bottle, bulb, or bag device. Its purpose is to cleanse the large intestine, stimulate bowel movements, or deliver medication directly to the colon. Enemas can be self-administered at home or given in a medical setting.

Depending on the type and liquid solution, enemas may relieve constipation, prepare the bowel for medical procedures, or deliver treatment for digestive conditions.

Types of Enemas

Cleansing Enema

This type is designed to work quickly. It flushes stool and waste material out of the colon, often within minutes. Cleansing enemas are commonly used for:

  • Relieving occasional constipation

  • Preparing for medical procedures such as colonoscopy, sigmoidoscopy, or surgery

Retention Enema

Unlike cleansing enemas, a retention enema is meant to stay in the body longer so that the medication or solution has time to work. Retention enemas are often prescribed for conditions such as inflammatory bowel disease (IBD), where medication like mesalamine needs to reach and soothe inflamed tissues.

What’s Inside an Enema?

The effectiveness of an enema depends on its liquid ingredients. Some common types include:

  • Barium: Used for X-ray imaging of the colon, though less common now due to colonoscopy.

  • Bisacodyl: A stimulant laxative that triggers bowel contractions.

  • Glycerin: Helps draw water into the colon, softening stool and encouraging bowel movements.

  • Mineral Oil: Lubricates the lower bowel, making stool easier to pass.

  • Sodium Phosphate: Pulls water into the colon to soften stool, often used for short-term constipation relief.

  • Medication-Based Solutions: Such as mesalamine enemas for ulcerative colitis or antibiotic-based enemas for certain infections.

⚠️ Avoid homemade enemas with soapsuds, detergents, or hydrogen peroxide, as these can irritate or damage the intestines.

Common Uses of Enemas

Relieving Constipation

Enemas can provide fast relief from constipation when dietary changes or oral laxatives aren’t effective. Sodium phosphate, bisacodyl, glycerin, and mineral oil enemas are all available over the counter.

Treating Fecal Impaction

In more severe cases of constipation, stool may harden into a large lump (fecal impaction). A warm mineral oil enema can soften and lubricate stool so it can pass more easily.

Delivering Medications

Retention enemas are sometimes prescribed to treat conditions such as ulcerative colitis. Mesalamine enemas, for example, coat the intestinal lining and reduce inflammation. These are usually administered at night so the medication can stay in place for several hours.

Preparing for Medical Procedures

Before procedures like colonoscopy, enemas help clear the bowel so doctors can get a clear view of the colon and rectum.

How to Use a Cleansing Enema

Here’s a step-by-step guide for a typical sodium phosphate enema:

  1. Lay a towel or waterproof pad over your surface.

  2. Remove the protective cap from the enema tip.

  3. Apply lubricant to the tip for comfort.

  4. Position your body on your left side with knees bent, or kneel with your chest slightly forward.

  5. Insert the applicator tip gently at an angle toward the navel. Stop if you feel pain.

  6. Slowly squeeze the bottle to release the solution.

  7. Remove the tip and remain lying down until you feel the urge to have a bowel movement (usually within 1–5 minutes).

  8. Go to the toilet and empty your bowels.

How to Use a Retention Enema

Retention enemas differ in one key way: you hold the liquid longer.

  • Perform the enema at bedtime so medication stays in place overnight.

  • Stay lying down for at least 15–30 minutes to help the solution coat the intestines.

  • Empty your bowel naturally the next morning unless instructed otherwise.

Are Enemas Safe?

Enemas are generally safe when used occasionally and according to instructions. However, overuse or improper administration can lead to:

  • Cramping or bloating

  • Dehydration or electrolyte imbalance

  • Rectal irritation or infection

  • Bowel perforation (rare but serious)

Seek medical attention if you notice:

  • Dizziness or fainting

  • Rectal bleeding

  • Severe abdominal pain

  • Vomiting

  • Swelling of feet or legs

Prevention Tips Before Relying on Enemas

Since enemas are not meant for everyday use, try these alternatives to prevent constipation:

  • Eat a high-fiber diet (fruits, vegetables, legumes, whole grains).

  • Drink plenty of water daily.

  • Stay physically active to keep digestion moving.

  • Use oral stool softeners or fiber supplements if recommended.

A Quick Review

Enemas are a useful short-term solution for constipation, bowel cleansing, or delivering medication. They can be purchased over the counter or prescribed by a doctor. While safe for occasional use, enemas should not replace long-term lifestyle and dietary habits that promote digestive health.