The term enema is used to refer to the process of instilling fluid through the anal sphincter into the rectum and lower intestine for a therapeutic purpose. An enema administration is performed using a flexible plastic rectal tube with several large holes in the tip. This is connected to the tubing from a solution bag or container. An enema can also be performed using a prepackaged solution that comes in a soft plastic bottle with a pre-lubricated rectal tip attached. Enema solutions are prepared using plain tap water or saline, soapsuds solutions, oil solutions, or various medication solutions.
The most common purpose for administering an enema is to stimulate peristalsis (involuntary contraction) and to evacuate stool from the rectum. A tap water or soapsuds enema dilates the bowel, stimulates peristalsis, and lubricates the stool to encourge a bowel movement. These types of enemas are instilled and held for five to 10 minutes, as tolerated. They are used to treat constipation, to cleanse the bowel before a bowel exam, and to cleanse the bowel before bowel surgery. Another type of enema, the oil retention enema, is prepared in a smaller volume and is retained in the bowel for 30–60 minutes. The purpose of the oil retention enema is to soften the hardened stool and allow normal elimination. Enemas are also used to deliver medication directly onto the rectal mucous membranes to be absorbed into the bloodstream. Steroid enema solutions can be administered to alleviate bowel inflammation in patients with ulcerative colitis. Antibiotic enema solutions can be administered to treat localized bacterial infections. Medicated hypertonic enema solutions can be used to pull excessive potassium or ammonia from the bloodstream through the rectal wall. These substances are then eliminated with the stool.
Mary Elizabeth Martelli R.N., B.S., The Gale Group Inc., Gale, Detroit,