Enema

Enema

An enema is the procedure of introducing liquids into the rectum and colon via the anus for cleansing, for stimulating evacuation of the bowels or, for other therapeutic or diagnostic purposes.. The increasing volume of the liquid causes rapid expansion of the lower intestinal tract, often resulting in very uncomfortable bloating, cramping, powerful peristalsis, a feeling of extreme urgency and complete evacuation of the lower intestinal tract.

Enemas can be carried out as treatment for medical conditions, such as constipation and encopresis, and as part of some alternative health therapies. They are also used to administer certain medical or recreational drugs. Enemas have been used for rehydration therapy (proctoclysis) in patients for whom IV therapy is not applicable.

Types of enema:

v Dry enema

A dry enema is an alternative technique for cleansing the human rectum either for reasons of health, or for sexual hygiene. It is accomplished by introducing a small amount of sterile lubricant into the rectum, resulting in a bowel movement more quickly and with less violence than can be achieved by an oral laxative.

It is called "dry" by contrast to the more usual wet enema, because no water is used.

A rudimentary form of 'dry' enema is the use of a non-medicated glycerin suppository. However due to the relative hardness of the suppository - necessary for its insertion into the human body - before the glycerin can act, it must be melted by the heat of the body, and hence it does not take effect for up to an hour. Often the hygroscopic glycerin irritates the sensitive membranes of the rectum resulting in forceful expulsion of the suppository without any laxative effects.

v Nutrient enema

A nutrient enema, also known as feeding per rectum, rectal alimentation, or rectal feeding, is an enema administered with the intent of providing nutrition when normal oral feeding is not possible. Although this treatment is ancient, dating back at least to Galen, and commonly used in the Middle Ages, and still a common technique in 19th century medicine, nutrient enemas have been superseded in modern medical care by tube feeding and intravenous feeding.

v Tobacco smoke enema

The tobacco smoke enema, an insufflation of tobacco smoke into the rectum by enema, was a medical treatment employed by European physicians for a range of ailments. Tobacco was recognised as a medicine soon after it was first imported from the New World, and tobacco smoke was used by western medical practitioners as a tool against cold and drowsiness, but applying it by enema was a technique appropriated from the North American Indians. The procedure was used to treat gut pain, and attempts were often made to resuscitate victims of near drowning. Liquid tobacco enemas were often given to ease the symptoms of a hernia, however by the early 19th century the practice fell into decline, when it was found that the principal active agent in tobacco smoke, nicotine, was poisonous.

Medical usage of enema:

The main medical usages of enemas are:

—  To relieve symptoms of constipation or impaction.

—  To cleanse the rectum and lower intestines in preparation for an examination.

—  To remove feces to prevent contamination during a surgical procedure.

—  To administer anesthetic or drugs to a patient.

Precautions

Improper administration of an enema may cause electrolyte imbalance (with repeated enemas) or ruptures to the bowel or rectal tissues resulting in internal bleeding. However, these occurrences are rare in healthy, sober adults. Internal bleeding or rupture may leave the individual exposed to infections from intestinal bacteria. Blood resulting from tears in the colon may not always be visible, but can be distinguished if the feces are unusually dark or have a red hue. If intestinal rupture is suspected, medical assistance should be obtained immediately.

The enema tube and solution may stimulate the vagus nerve, which may trigger an arrhythmia such as bradycardia. Enemas should not be used if there is an undiagnosed abdominal pain since the peristalsis of the bowel can cause an inflamed appendix to rupture.

Colonic irrigation should not be used in people with diverticulitis, ulcerative colitis, Crohn's disease, severe or internal hemorrhoids or tumors in the rectum or colon. It also should not be used soon after bowel surgery (unless directed by one's health care provider). Regular treatments should be avoided by people with heart disease or renal failure. Colonics are inappropriate for people with bowel, rectal or anal pathologies where the pathology contributes to the risk of bowel perforation.

Recent research has shown that ozone water, which is sometimes used in enemas, can immediately cause microscopic colitis.