Definition
An enema is an introduction of fluid into the lower bowel through the rectum for the purpose of cleansing or to introduce medication or nourishment.
Purpose
- To stimulate defecation & to treat constipation ex: simple evacuant enema
- To soften hard faecal matter ex: oil enema
- To administer medication ex: sedative enema
- To protect and soothe the mucus membrane of intestine & to check diarrhoea ex : emollient enema
- To destroy intestinal parasites ex : anthelminitic enema
- To relieve the gaseous distention ex : carminitive enema
- To administer the fluid and nutrients ex: nutritive enema
- To relieve inflammation ex : astringent enema
- To induce peristalsis ex : purgative enema
- To stimulate a person in shock and collapse ex: stimulant enema
- To reduce the temperature ex : cold enema or ice enema
- To clean the bowels prior to x-ray studies , visualization of the bowel , surgery on the bowel or delivery of a baby ex : saline enema
- To make diagnosis ex: barium enema
- To establish regular bowel functions during a bowel training programme
- To induce anesthesia ex : anesthetic enema
Cleansing Enemas
Stimulate peristalsis through irrigation of colon and rectum and by distention
- Soap Suds: Mild soap solutions stimulate and irritate intestinal mucosa. Dilute 5 ml of castile soap in 1000 ml of water
- Tap water: Give caution o infants or to adults with altered cardiac and renal reserve
- Saline: For normal saline enemas, use smaller volume of solution
- Prepackaged disposable enema (Fleet): Approximately 125 cc, tip is pre-lubricate and does not require further preparation
Oil-Retention Enemas
- Lubricates the rectum and colon; the feces absorb the oil and become softer and easier to pass
Carminative Enema
- Provides relief from gaseous distention
Astringent Enema
- Contracts tissue to control bleeding
Key Points: Administering Enema
- Fill water container with 750 to 1000 cc of lukewarm solution, (500 cc or less for children, 250 cc or less fro an infant), 99 degrees F to 102 degrees F. Solutions that are too hot or too cold, or solutions that are instilled too quickly, can cause cramping and damage to rectal tissues
- Allow solution to run through the tubing so that air is removed
- Place client on left side in Sim’s position
- Lubricate the tip of the tubing with water-soluble lubricant
- Gently insert tubing into client’s rectum (3 to 4 inches for adult, 1 inch for infants, 2 to 3 inches for children), past the external and internal sphincters
- Raise the water container no more than 12 to 18 inches above the client
- Allow solution to flow slowly. If the flow is slow, the client will experience fewer cramps. The client will also be able to tolerate and retain a greater volume of solution
- After you have instilled the solution, instruct client to hold solution for about 10 to 15 minutes
- Oil retention: enemas should be retained at least 1 hour. Cleansing enemas are retained 10 to 15 minutes.
