A nurses perspective on enemas for IBS Constipation

Written by Bayley Jackson from Canada

The Purpose of Enemas
When used properly an enema can offer relief from severe constipation and fecal impaction. Though as with any kind of treatment the usage of self administered enema's is not without its risk's.

Enema's do not always require a prescription and can be easily obtained 'over the counter' at stores such as Wal-Mart are intended for the treatment of occasional constipation and the directions on the box should be followed carefully as there are cases in which the use of enema's is contraindicated and is certainly not a treatment suitable for everyone. Doctor's may prescribe use of an enema before a test involving the colon or before a bowel surgery or simply as part of a regular treatment for constipation.

Prolonged constipation may be a sign of something else and if you find yourself experience regular bouts of constipation you should first see your doctor before regularly treating yourself with an enema's or laxatives. Enema's also should not be taken when you are experiencing unusual stomach pain's.

Enemas are at times given in a hospital setting by healthcare providers under the direction of Physician as treatment for patients who are suffering from constipation but typically they are only administered after other methods such as stool softeners, laxatives and suppositories have been ineffective. It has been my experience that usually oral laxatives are enough to treat constipation which is why the times I have been asked to administer an enema are virtually next to nil.

Understanding Enemas ( for self-administered usage )
It is not an entirely pleasant experience as enema's must be given per rectum though there are many method's of self administration but care must be taken to do this gently as while the risk is low, it is possible to perforate (create a hole in) the colon which would cause internal bleeding and is an emergency that would require surgical intervention. Though enema bottles come with a blunt lubricated tip and if used with care should pose no real issue, enema bottles are always meant as a one use and then discard item. Though it is my understanding also that multiple use home enema kit's can also be purchased, personally I have no real experience with those and when I am speaking of enema's throughout this article I am writing with the one use 'Fleet' brand enema's in mind.

Any tears caused by the administration of an enema may not be readily seen by active bleeding but bright red blood in the stool should be seen to by a medical professional immediately as this may mean the colon has torn and is a greater risk for serious infection.

Prolonged use of Enema's may also cause change to the colon, stripping away some of the mucous wall over time and weakening the inside of the colon leaving a higher risk of infection and perforation and also flushing out the naturally occurring bacteria which grow in the colon. After a time of prolonged use the colon may also begin to loose its muscular tone. The lowest part of the colon is the sigmoid colon, which is muscular and contracts in order to move stool into the rectum or so is its normal function. If the stool is being constantly flushed out by mean's of using an enema there is no longer need for the sigmoid colon to move along the feces and like any muscle that is not regularly worked it will gradually begin to weaken.

Enemas from a Nurse's viewpoint.
If improperly given an enema may cause electrolyte imbalance in the body as the solution stimulates the colon which draw's fluid out of the body to help flush feces from the body, yet this only becomes a concern after enemas are given repeatedly. The colon's primary function is to absorb water and salt from waste before it is excreted completely from the body, when the colon is stimulated by an enema it does not have the chance to do this and therefore the electrolyte imbalance is created. As a Nurse I have yet to encounter a case where prolonged use of Enema's has been recommended though I do also realize that there are also some who manage their bowel's solely on the use of enemas and laxatives and that is a personal and private choice of treatment. Everyone is different and prefers to look after themselves in a different way, I have geared this more towards those who have yet to try an enema to find relief from constipation or other discomforts.

It is also my experience that receiving an enema is an understandably unpleasant experience for many people but at the same time when it is effective it is also a source of great relief from constipation which is just as uncomfortable. Fecal impaction is also dangerous of course as feces is the waste of the body, and should that waste be permitted to build up then the person would become quite ill and so helping the body clear itself of its waste is very important.

I am by no mean's trying to discourage the use of enema's as when used with care they can be very helpful though I do encourage anyone who is considering using one to read the instruction's very carefully first and also consult a doctor before doing so as your doctor will know your past health history and if there are any reason's why you should not be using an enema in the first place. Again, I do strongly encourage anyone who has concerns about their bowel function to see their family doctor as this is intended as just a very brief overview of enema's and their use as well as potential risk's and this is all written from my own knowledge on proper bowel function as Nurse's tend to be like the real estate agent's of bowel's, we like to keep things moving!

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