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Here’s how enemas work — and how to use them!

Here’s how enemas work — and how to use them!

Marc Kaplan |


If you are searching for information on enemas, you may need to know how enemas work and how to use them. This article provides information on what is an enema, how to use enema, types of enemas and research about enema use.

Enema (pronounced EN-un-muh) is used as a verb and noun in English: it is used to denote the enema device and the action of taking an enema. Colonic or high colonic are synonymous with enema.
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What is an Enema?

According to those who advocate the use of them, enemas remove toxins and waste from the colon. Many healthy people can eliminate fecal waste without the use of enemas. However, not everyone has the benefit of eliminating waste this effectively. Proponents say that poor elimination can lead to the development of health issues, including skin conditions (e.g. psoriasis and eczema), allergies, sinus issues, bad breath, indigestion, back pain, hemorrhoids, depression, headaches, and fatigue.

Enema for constipation

Many people buy an enema for an occasional constipation. Constipation is a common problem that many people will experience throughout their lives. A visit to the doctor is likely to result in suggestions like, eat more fiber or exercise more. Once you have tried these alternatives, your doctor may recommend a home enema to relieve temporary symptoms associated with a sluggish colon, such as bloating and discomfort. It is recommended to discuss a constipation problem with your medical provider before using an enema. He or she may have additional suggestions to relieve constipation, but enemas are also a great alternative to helping relieve such pressure in your body.

Before engaging a medical professional, prepare a few questions on how to use enema. Although this article will provide you with this information, it’s also beneficial to ask, "How does an enema work?” This will help you get a well-rounded answer since the topic of enema’s can be senstive. He or she may recommend an OTC enema or Enema fleet to resolve temporary symptoms. If you have a specific medical condition, they may ask your pharmacy to fill a prescription.

How Does an Enema Work?

Most people want to know how to use enema. They may be concerned about the insertion of an OTC enema or Enema fleet nozzle, or have questions about how long it will take for the enema to work. Questions about how to use enema may involve disrupting healthy intestinal bacteria. You may also have concerns about whether an enema will disrupt the intestinal microbiome. If the individual has recently taken an antibiotic or chemotherapy, he or she may need to restore healthy bacteria in the large intestine.

According to the National Institutes of Health (NIH), the average human has trillions of beneficial bacteria in the intestinal microbiome. Although some bacteria will be released with the stool after an enema, it will not affect the bacteria safely nestled in the intestinal mucosal lining.

If your healthcare provider orders a home enema for constipation or to treat your condition, make sure to follow instructions exactly as they are given. He or she may recommend using a little petroleum jelly to lubricate the anus before inserting the enema nozzle. He or she may also recommend that you drink plenty of clear liquids for a period of time before taking an enema.

How to use enema to treat constipation, deliver medicines, or prepare for a medical procedure

An enema introduces liquid, often mineral oil, salt water, or laxative, through the user’s anus to the large intestine. In addition to treating constipation, an enema may be used to administer medicines or barium. An enema may also be used to empty the user’s bowel before a procedure such as a colonoscopy.

In previous decades, enemas were sometimes given to facilitate a woman’s labor in pregnancy or before abdominal surgery. Few patients have questions about how to use enema in modern hospital delivery rooms. 


What type of enema will my doctor prescribe?

With the variety of enema’s available on the market, it’s always good to understand the various types available. It’s also best to ask your doctor if you have questions about the best type of enema for you. Typically, your doctor will recommend one of the following types of enemas: 

  • Mineral oil: A mineral oil enema is considered a laxative and lubricant. This type of enema is often recommended when the user has constipation or if hemorrhoids are present.
  • Saline solution: Salt water enemas are often recommended to relieve constipation. Do not mix your own saline solution enema with tap water. This is not hygienic.
  • Bisacodyl: A bisacodyl enema is made with a laxative. This type of enema is frequently recommended to prepare for a colonoscopy, sigmoidoscopy, or as a remedy for constipation or impacted feces.
Your doctor, nurse, or healthcare professional may deliver the enema or he or she may recommend an enema to be done at home. In either case, you can always ask the professional how to administer the enema for peace of mind and understanding. One thing to note is avoid overuse of enemas. Ask your provider’s advice about the type and frequency of enema use in your situation.


What types of medications are delivered with an enema?

In many cases, the various enemas available deliver different types of medication. Your doctor may recommend the delivery of medicines with an enema:

  • Inflammatory bowel disease (IBD) or ulcerative colitis medicines, such as Rowasa (a 5-aminosalicylic medication) are often administered with an enema at night. These medicines are usually held through the night to provide time for the medicine to work.
  • Probiotics (“good” intestinal bacteria strains) may be delivered through an enema after your doctor recommends a course of antibiotics. 

If your doctor prescribes medicine to be delivered with an enema, follow his or her directions with care.


How Do I Use an Enema?

The burning questions of how to use an enema can be straightforward but the experience will likely be different for everyone. Before jumping directly to use, make sure to have clean towels, a place to lie down, and an enema kit on hand. It’s recommended to clear your schedule for at least several hours after taking the enema:

  • Purchase an Enema fleet or OTC enema kit. If your doctor recommends a certain brand or formula, ask your pharmacy for it.
  • Wash the anal area with a clean, warm cloth. If you have concerns about possible discomfort, apply petroleum jelly to the anal area.
  • Keep extra clean cloths and towels available and within reach.
  • Have a timer if you need to retain the enema for a period of time. 
  • Remove the protective cover from the enema nozzle tip. Avoid touching the tip with your fingers.
  • Lie on your left side, e.g. on the floor. Bend the right knee and place a rolled towel beneath it for support.
  • Use your right hand to gently insert the nozzle tip into the rectum. Follow the OTC enema or Enema fleet instructions. Note: you may experience discomfort, but you should not experience severe pain.
  • Contact your healthcare provider for advice if you experience severe pain.
  • Squeeze the enema bag to send the enema liquid through the nozzle and into the lower colon, also known as the rectum.Completely empty the liquid in the enema bag by squeezing from the bottom to the top of the enema container.
  • Slowly and carefully remove the nozzle from your rectum.
Wait out the specific period of time to void your bowels. There are many different waiting periods depending on the formulas used in your enema. Typical waiting periods of enema formulas include:
  • Docusate: 2 to 15 minutes
  • Sodium (saline, saltwater): 2 to 15 minutes
  • Mineral oil: 2 to 15 minutes
  • Glycerin: 15 to 60 minutes
  • Bisacodyl: 15 to 60 minutes
  • Senna: 30 to 120 minutes

After you have allowed for the appropriate timing to pass, you’ll want to evacuate the bowels. One of the best tips is to remain close to the toilet for at least 30 to 60 minutes after voiding the bowels. This helps in the case of any accidents occurring.

The enema liquid is typically held in the rectum for a period of time. Most often, it is held until the user experiences the need to move his or her bowels. When it is time, the enema liquid and rectal waste are released by passing a bowel movement on the toilet. Call your healthcare provider immediately  if you cannot complete the enema for any reason. It may be necessary to ask your doctor or nurse to administer the enema in his or her office.

Dispose of the Enema fleet or OTC enema materials after use. Never reuse these materials to deliver potentially harmful materials into your body.

What is the Research About Enemas?

There is little scientific proof to support the claims of proponents concerning the promised health benefits of enemas:

  • According to a study published in Colorectal Disease, (2012) researchers studied approximately 500 patients slated to undergo colonoscopy procedures. 
  • Patients were given a bowel prep solution before the procedure. Twenty-six of the patients received an enema as well.
  • Twenty-five out of 26 participants receiving enemas had a successful colonoscopy.
  • Authors of the study concluded that administration of enemas may be a successful solution for those patients who did not properly prepare for a colonoscopy procedure.

What are the Side Effects and Safety Concerns of Enemas?

Enemas are known to trigger side effects, such as diarrhea, dizziness, nausea, fainting, or vomiting. Some enema types are associated with heart attack, electrolyte imbalances, and tachycardia (rapid heart rate). Additional risks associated with enema use include rectal perforation. Improper insertion of the nozzle into the rectum can cause damage to the user’s internal organs. An improperly administered or prepared enema may also result in infection. Overuse of enemas may also result in weakened bowel muscles. This may interfere with the body’s ability to pass normal and regular bowel movements. Please keep this in mind when using enema’s.

Are There Alternatives to Enemas?

There are no direct replacements to enema’s but there are some activities you can perform that could potentially help you. Enema’s should not be looked at as a last resort, but sometimes these activities can help you from using one. Make sure to ask your doctor about alternatives to the use of enemas. Some of these suggestions could include:

  • Staying physically active
  • Drinking enough water
  • Boosting fiber intake
  • Practicing mindful eating
  • Managing physical stress levels
  • Getting enough sleep

Before making the decision to use any alternative medicine, including an enema, to treat a chronic or worrisome health condition, consult your medical provider first.


Understanding Colonoscopy

Medications for Ulcerative Colitis



On to you

Do you have any experience using an enema or have you administered them to someone? Let us know in the comments below if you have any questions and we hope you found this article valuable. Always feel free to call us directly if you have any questions as well at (1) 866-923-1544.


Here’s how enemas work — and how to use them!

-Marc Kaplan

CEO, Save Rite Medical


Marc Kaplan is founder and CEO of Save Rite Medical — the leading provider of wholesale medical supplies. A salesman by day and educator by night, Marc enjoys providing valuable ways and alternatives to living a healthier lifestyle.