While, oftentimes, associated with the filthy functions of the human bowel system, the role of the enema is invaluable in a health care setting. Even though some patients or clients may cringe at the word, enemas are typically given when most other interventions have failed to accomplish relief in constipation. From being used as a treatment to aid in constipation relief, to serving a more preventative function by helping to assist the human body in evacuation of harmful colonic toxins, follow the steps in this Info Barrel article and you can learn how to best self-administer an enema or give one to a patient.

With water generally being one part of the bowel stimulating enema, enemas do not have to exclusively consist of just a water component. In fact, additional components such as baking soda, mild hand soap, buffered sodium phosphate solution, and mineral oil can each aid in greater overall effectiveness of the enema. Unfortunately, while each additional component can help to make an enema more effective, mineral oil, in particular, can lead to unwelcome seepage as a result of its stool softening and lubricating properties. While this Info Barrel article will focus specifically on giving a simple water enema with mild soap, do bear in mind that other types of enemas (that do not include water, like a milk and molasses enema) also exist, may be used in special situations, and may also carry with them special considerations for usage and administration.

Things You Will Need

  • Warm Water
  • Enema Bags/ Tubing
  • Water-Based Personal Lubricants
  • Mild Soap
  • a Towel

Step 1

Whether you will be self-administering your own enema, or you will administering one to your patient, it is important to remember that what you will be doing is an invasive nursing procedure and can carry with it complications. Knowing a patient's medical history, current physical state, and tolerance of past enemas, will be critical in anticipating any potential complications of the enema that you will be administering. In patients with existing electrolyte imbalances, the administration of any enema may do more harm than good as it may further intensify the imbalance resulting in specific physical manifestations.

Alterations in heart functionality (arrhythmias), such as bradycardia, can occur if an enema is not administered properly to yourself or your patient. Stimulation of the vagus nerve, by the enema tube and solution, could always occur and lead to this bradycardia. Before actually administering an enema to a patient, it is absolutely imperative that you be continually conscious of the potential adverse outcomes so that you can respond quickly if they do occur.

Step 2

As with any bedside nursing procedure, gathering and quickly taking an inventory of your supplies/equipment is of utmost importance. Rather than have to run back to the supply room (or store) to retrieve something you may have forgotten, ensuring that you have all the right equipment can save you time, as well as, not cause any undue inconvenience to your patient. In this article step, not only should you ensure that you have the right equipment, but you should also ensure that your equipment is operational and functional. What good does tubing do if there are ample kinks, and how well do you think an enema bag would work if it had a giant tear in it? Prior to administering an enema, be sure that you have all your equipment and that it is also completely functional.

Privacy should also be adhered to, especially if you will be administering an enema to a patient. While having a door closed or a drape pulled may not particularly bother some patients, doing this should become second nature regardless of who the patient is. Providing privacy shows general interest and care for the patient's comfort and dignity.

Step 3

While pre-made enema solutions can be purchased at your local Rite-Aid, Walmart, or Walgreens Stores, you can also make your own effective enema solutions. Because of its ability to dilate (widen, and increase blood flow) of your blood vessels, warm water is generally used and is preferable to cold water or scolding hot water. Rarely will you ever see those two temperature extremes of water being used for an enema administration. Even though you can use just a plain warm water solution as an enema, you can certainly increase the mechanical bowel stimulating effects of your enema by including baking soda or mild hand soap.

Dependent upon how much volume your enema bag actually holds will determine just how much of the water part of your enema you will include. Generally 1 to 2 liters of water, with enough mild hand soap included to form a soft bowel stimulating lather, will be sufficient in making your own pre-made solution.

Step 4

Now, your patient must lay on their left side, with their right leg lifted (bent) in order to aid in greater exposure of the rectal area and unimpeded flow of the solution. Unfortunately, immobile or physically compromised patients may find it particularly difficult to achieve this position on their own. In this case, it may be necessary to help them into this enema administration position.

Step 5

Grasp your enema tubing and your water-based personal lubricant, and proceed to apply the lubricant liberally to the top of the enema tubing. Do not apply the lubricant directly to the patient's rectum prior to insertion of the enema tubing. The lubricant should be in direct contact with the enema tubing prior to being administered. You may apply lubricant to both the enema tubing, as well as, the patient's rectum, if you deem it necessary.

Step 6

Excessive insertion of the enema tubing, beyond 4-6 inches, may cause discomfort to your patient and may actually cause them to experience great irritation, and/or stimulation of the vagus nerve. Too little advancement of the enema tubing tip will prove to not be beneficial as the solution seeps out because it is not instilled far enough into the patient's rectum. Generally, an approximation can be made regarding the distance of enema tip advancement, or you can mark the 4-6 inch mark on the tubing with a piece of tape.

Step 7

Prior to allowing the enema solution to flow, be sure to provide proper instruction before (and during) the procedure. In order to minimize discomfort and cramping, the patient should be instructed to breath deeply and slowly through the mouth. Nose breathing should be minimized.

Step 8

Dependent upon how you hold the enema bag will determine how quickly or slowly the solution flows because of the natural effect of gravity. If you hold the enema bag high, the enema solution will flow quickly, and the inverse is true: the enema solution may not flow at all if held very low. If a patient complains of discomfort or cramps, be sure to lower the enema bag (in order to decrease the flow of the solution). If the patient still complains of discomfort or cramps, discontinue (stop) the enema immediately.

Step 9

Upon completion of all the solution being exhausted in the enema bag, be sure to gently withdraw the tubing from the patient's rectum. While an intense urge to evacuate the bowels may exist, the nurse or caregiver should encourage the patient to try to hold the solution in for at least 3-5 minutes in order to maximize their benefit from the enema. When withdrawing the enema tubing, gradual seepage may occur either subtly or sporadically, especially if accompanied by flatulence. Delicate clenching and closure of the patient's butt cheeks may help to minimize seepage while you are proceeding to withdraw the enema.

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