ENEMA ADMINISTRATION TECHNIQUE
ENEMA ADMINISTRATION
- Enema administration is a technique that helps to expel waste from the rectum.
- It is a liquid treatment most commonly used to relieve severe constipation.
This article was prepared to describe the enema administration and reviews the meaning of enema, types of enema, use of enema, its potential risk, and in addition also some of the potential benefits and health concerns of enema administration.
ENEMA
Enema is rectal injections of fluid intended to cleanse or stimulate the emptying of your bowel. They have been used for hundreds of years to treat chronic constipation and prepare people for certain medical tests and surgeries. Enemas are available for purchase over the counter for home administration, but you should ask a doctor or nurse for specific instructions to avoid injury.
WHAT ARE ENEMA USE FOR?
Enemas can be used in several situations or conditions. These include:
- Constipation. It occurs when bowel movements happen less often than normal and when stools become difficult to pass. If you’ve tried other constipation remedies unsuccessfully, your healthcare provider may suggest an at-home enema. The flow of fluid through your lower colon may stimulate the muscles to move that impacted stool.
- Pre-procedure cleanse. This helps ensure that they’ll have a clear view of your colon and tissues. It will be easy to spot the polyps.
- Detoxification. This is not a medical term or practice but many people promote enemas as a way to cleanse your colon of impurities, bacteria, and a buildup that makes you sick. However, there isn’t any scientific evidence to support the use of enemas for the reason.
- Medication. People can administer medication using an enema. This can especially help with treating health problems affecting the colon, such as inflammatory bowel disease.
In some cases, an enema can deliver other types of medication. This is because the network of blood vessels in the rectum can transport medicine quickly to other parts of the body.
There are two primary types of enemas. These include:
Cleansing Enema
These water-based enemas other ingredients to help move impacted bowels along more quickly. They are used to treat constipation and are available over the counter in a drugstore or pharmacy. Fleet is a popular brand of these types of enemas.
A typical solution may include:
- Sodium and phosphate
- Mineral oil
- Bisacodyl
Barium / Diagnostic Enema
Barium enemas are typically performed by your doctor or radiologist for medical testing. Your provider will insert a metallic liquid solution into your rectum. The metal shows up as bright contrast on the X-ray images. This gives your provider a better view of what’s happening inside your body.
Sample procedures are:
- Preparation for surgery. It is usually necessary to have an empty bowel before surgery on the rectum, colon, or gut. A person may need to use an enema at home before surgery, or a medical professional may give an enema in the hospital.
- Colonoscopy. A colonoscopy is the use of a small camera to check the health of the rectum or bowel. The bowel will need to be empty before this procedure.
- Cancer screening. A barium enema can help check for bowel or colon cancer. One enema empties the bowel, and another puts liquid barium into the rectum. This shows up on an X-ray to give clear images of the bowels. After the procedure, the barium passes from the body in a bowel movement.
Other types of an enema:
- Therapeutic enema. It is an enema that cleans out the colon rectum, relieves constipation, and treats diseases, such as inflammatory bowel disease.
- Retention enema. It is used to stimulates the bowels, but the solution is intended to be “held” in the body for 15 minutes or more.
RIGHT POSITION FOR ENEMA
- Left-side position – Lie on the left with the knee bent, and arm resting comfortably.
- Knee-chest position – Kneel, then lower head and chest forward until the left side of the face is resting on the surface with left arm folded comfortably.
PREPARING ENEMA
If you plan to administer an enema at home, make sure that all of the equipment you are using has been sterilized and that you have a lubricant on hand. Enema administration at home can be less expensive but, If you are unfamiliar with enemas, you should consider having a medical professional administer one for you.
HOW TO ADMINISTER AN ENEMA AT HOME WITH A CAREGIVER
- Wash hands.
- Place the patient on the left side with the right knee flexed. Keep a waterproof pad underneath the patient, and cover with a bath blanket.
- Provide a bedpan or bedside commode in position for patients who cannot ambulate to the toilet or who may have difficulty with sphincter control.
- Remove the plastic cover over the tubing.
- Lubricate the tip of enema tubing 3 to 4 inches unless prepackaged. Even prepackaged enema may need more lubricant.
- Apply disposable gloves.
- Separate buttocks, and locate rectum.
- Meanwhile, Instruct that you will be inserting tubing slowly, and patients need to breathe deeply.
- Insert tubing 3-4 inches for adult patients.
- Slowly instill the solution using a clamp and the height of the container to adjust the flow rate if using an enema bag and tubing. For high enemas, raise enema container 12-18 inches above anus; for low enemas, 12 inches.
- If using a prepackaged enema, slowly squeeze the container until all the solution is instilled.
- Lower container or clamp tubing if patients complain of cramping.
- Remove rectal tubing after enema solution has been instilled and until it is clear.
- Instruct the patient to hold the solution as much as possible until a feeling of distention may be felt.
- Discard supplies in the appropriate trash receptacle.
- Assist patients on the bedpan or to the bedside commode or in the toilet when the urge to defecate occurs.
- Observe enema return amount, fecal content.
- Instruct the patient not to flush the toilet until the nurse has seen the result.
Follow-up phase
- Document the type of enema given, volume, and results on the appropriate chart forms.
- Assist the patient with washing perineum and rectal area, if indicated; Gown and linen may also need to change
POTENTIAL RISK OF ENEMA ADMINISTRATION
Forcing an enema into the rectum can cause irritation and damage to surrounding tissue so, never force the tube into the rectum. If problems persist call your doctor.
In extremely rare cases, the incorrect enema administration can cause an embolism to form and one example is pulmonary embolisms, which occur in the lungs and can be fatal. In other rare cases, an incorrectly administered barium enema can result in perforation Trusted Source of the rectum.
DOES IT HURT?
An enema should not cause pain. But, if you’re performing an enema for the first time, you may experience some minor discomfort.
Severe pain may be a sign of an underlying problem. If you experience pain when inserting the enema tube stop immediately and call your healthcare provider or local medical services.
HOW TO MINIMIZE DISCOMFORT
- Try listening to calming music.
- Practicing deep breathing.
- First soaking in a hot bath to ease your muscles and your mind.
- Breathe deeply. As you’re inserting the tube, inhale for a count of 10.
- Bear down. If you have difficulty inserting the tube, bear down, as if you were trying to pass a bowel movement.
REFERENCES:
Health line (https://www.healthline.com/health/enema-administration )
Wikipedia ( en.wikipedia.org )