The Enema Procedure
Basically the most common purpose for an enema procedure is to stimulate digestive track or peristalsis to create an involuntary contraction and to evacuate stool from the rectum. If you are a candidate for an enema and this is your first time, you may want to be educated on the procedure just to be prepared and be comfortable, because an enema for constipation can be a little embarrassing for some people.
What will be needed
- Enema Bag. Enema Bag kit is consist of the bag, long hose, clamp on the hose and the nozzle.
- Bulb Syringe. Prepare a disposable container for the bulb syringe it should be wide enough on top so it will be easy to access with the syringe.
- Lubricant like Petroleum jelly. This will be applied at the tip of the nozzle and on the anus opening.
- Distilled Water. The water should be at room temperature: not too hot because it might burn you or too cold that it might trigger your bowel to empty quickly.
- Old Towel. Select an old towel so you can throw it after the procedure.
- Large Plastic Bag. To be used as protection on the floor.
- Funnel or Pitcher. For transferring the water solution on the Enema Bag.
- Close the room's door to ensure the patient's privacy.
- Patient must empty both bladder and bowels before the procedure.
- Undress the patient completely from the waist down.
- Position the patient in a comfortable way on the bed with his/her left side and the knees drawn upward to abdomen.
- Thoroughly explain the procedure to the patient and to emphasize the breathing through the mouth technique to relax the rectal sphincter.
- Inform the patients that during the procedure when he/she might feel the urge to exudates try to hold it for at least 5 - 10 minutes after instilment of the enema solution.
- Lubricate the anal area of the patient with Vaseline or Super Salve to easily insert the nozzle.
- Use a gloved finger for this step. Apply enough lubricant to your finger tip to the outside part of the patient's anus then with the remaining lubricant on your finger tip press the center of the anus with enough pressure for 5 seconds. This will allow the anus to relax then work the lubricated finger in and out and around the inside of the anus and then into the rectum.
- Hang the Enema Bag. Suspend the bag at about 1 foot or 18 inches above the anus. Do not exceed than 18 inches or it will yield a faster flow and might cause cramping. Hanging the bag lower than the level of the anus will result to back-flow of the stool into the Enema bag.
- Insert the Nozzle or Rectal tube. Based from the experienced while lubricating the anus, you already know which direction the nozzle should be pointed and the pressure required. Gently insert the nozzle while informing the patient to breathe from the mouth. Never force the Enema nozzle into the rectum.
- Slowly open the clamp. Administer the solution very slowly by 1/2 to 1 cup per minute or (4 to 8 oz). Usually a large volume of Enema solution can take up to 15 minutes to finish. Do not give the entire amount solution at once.
- Carefully watch the signs for cramping. When you see signs of cramping on the patient you should slow or stop the flow then have the patient relax. You can also massage the patient's abdomen to assist the solution further into the colon and makes the fecal material on the colon to loosen.
- In a counter-clockwise direction, massage the patient's abdomen to help the solution travel faster into the colon.
- From lower left side then slowly while applying a little pressure massage up below the ribs then down to the right side.
- Patient must retain the enema for 10-15 minutes. Assist the patient in the toilet after 10-15 minutes when its time and release the rectal tube from the anus but wait until he/she is in the right position to evacuate before removing the nozzle. Some uses a Welles Step to position your body in the toilet in a squatting position to apply pressure to your abdomen with your thighs making it easier to expel enema.
An enema procedure is administered by a physician or a licensed nurse in a clinic, although unlicensed staff can be trained to conduct a non-medicated enema, which is of course with a supervision of a registered nurse. If the patient is cooperative enough he/she can be allowed to self-administer a non-medicated enema with a nurse's direction in the home setting.