From the Guidelines
An enema can be a helpful treatment for constipation, particularly for quick relief of severe cases, as it introduces fluid into the rectum and lower colon, softening stool and stimulating bowel movements. According to the most recent and highest quality study 1, enemas are effective in treating constipation, especially when other laxatives have failed to provide adequate relief. The study suggests that enemas can be used to soften and lubricate impacted feces, promoting a bowel movement.
Some key points to consider when using enemas for constipation include:
- The type of enema used, such as saline, soap solution, or osmotic micro-enema, as each has its own rationale for use and potential adverse effects 1
- The importance of using enemas sparingly and with awareness of possible electrolyte abnormalities, as well as avoiding their use in patients with certain conditions, such as neutropenia or thrombocytopenia 1
- The need to address underlying causes of constipation, such as diet, hydration, and physical activity, for long-term management 1
In terms of administration, a single Fleet enema or 4-8 ounces of warm water is typically sufficient for home use, and the enema should be administered while lying on the left side with knees bent, gently inserting the lubricated nozzle into the rectum, slowly squeezing the contents, and holding the liquid inside for a few minutes before evacuating on the toilet.
Overall, while enemas can provide fast relief for constipation, they should be used judiciously and in conjunction with other treatments to address the underlying causes of constipation.
From the Research
Enema Effectiveness for Constipation
- Enemas can be effective in treating constipation, but they may cause serious adverse events, such as perforation or metabolic derangement 2.
- The use of enemas in adult patients with chronic constipation is considered useful by many physicians as an adjunctive support, but this practice is not substantiated by rigorous scientific data 3.
- Enemas are commonly used to relieve severe acute or chronic constipation, and their administration is deemed a relatively low-risk and safe intervention if undertaken appropriately 4.
Types of Enemas and Administration
- There are three main types of enemas commonly used in nursing practice: retention, evacuant, and softener enemas 4.
- Administration of an enema is invasive and highly personal, and nurses undertaking this procedure must have the knowledge and skills required to do so safely and work within their level of competence 4.
Safety and Efficacy in Specific Populations
- In children, the use of bisacodyl together with fleet enema and a half day of clear fluid diet has been shown to be safe and effective for bowel preparation for colonoscopy 5.
- Soap suds enemas have been found to be efficacious and safe for treating fecal impaction in children with abdominal pain, with a success rate of 82% and minimal adverse events 6.