Definition
Enema is the introduction of fluid through the anus into the intestine. The terms anal rinsing or enema are used synonymously, which is derived from the Greek word for cleaning. Enema is prescribed by a doctor and different types of enema are used depending on the requirements.
Preparation
In preparation for an enema, one should find a suitable place to administer it, depending on whether one is administering it oneself or is being treated in a hospital/practice. Most often enemas are administered in bed, on the bathroom floor or in the bathtub. A suitable carpet pad should be placed underneath you for possible fluid leaks and overflows. Most enemas are performed at body temperature or at 37 – 40.5°C. The solution and accessories should be prepared according to the product and package insert.
Procedure
The enema can be done by a doctor, a nurse or by yourself. If you do the enema yourself, you must be careful never to insert the tube into the anus by force, otherwise the intestine could be injured. It is best to lie down during the procedure, as the intervention can put a strain on the circulation.
If you perform the enema on yourself, you often use the knee-elbow position: you squat on the floor and support yourself on your knees and with one elbow. The second hand inserts the intestinal tube into the anus. If an enema is used for enema, the tip of the enema is inserted into the rectum with a little lubricant and finally the whole enema is inserted into the rectum with twisting movements.
The sphincter muscle must be relaxed. From the bag, the liquid is then slowly pressed into the tube and introduced into the intestine. Then the patient should tense the sphincter muscle and the nurse or person performing the procedure removes the tube.
After about 10 minutes, the patient may empty the bowel in the toilet as normal. During an enema, the nurse warms water to body temperature. A bowel enema is usually used to empty the bowel or remove stubborn constipation, so the fluid must be introduced further up the digestive tract.
For this reason, an intestinal tube of the desired length is used, lubricant is applied to it, and it is inserted 10 to 20 centimeters deep into the intestine with a juicy twisting motion. Via a hose in the tube, liquid is given into the intestine. It is important that the patient breathes with an open mouth and does not tense the abdominal muscles.
Once the fluid has been introduced, the patient should tense the sphincter muscle and the tube is removed. A liquid at body temperature is also used for the colonic irrigation, for example 5,000 milliliters for adults. The nurse prepares an intestinal tube coated with lubricant, which in this case has an inflowing and an outgoing tube.
The patient relaxes the sphincter muscle and the nurse inserts the tube into the intestine by rotating it and allows fluid to enter. The process is repeated until clear fluid finally flows through the outflow tube. The tube is then disconnected and the bowel tube is carefully removed while the sphincter muscle is tensed.
For pre-birth enemas, mini enema tubes are often used, the contents of which are injected into the rectum. Meanwhile, one sits on the toilet and quickly feels the pressure to empty it. The enema can also be performed in bed by a nurse or midwife using warm water.
