What is an Enema?
The enema - also called enema or enema - is a procedure with which liquid solutions, generally medicated, are introduced into the rectum and colon, through a tube introduced into the anus. There are different types, each with a specific purpose.
Types of Enema
Laxative enemas
Enemas based on lukewarm water (500-1000 cc), in which purgative substances (eg glycerin) have been dissolved, are recommended for their evacuating action in the presence of constipation (evacuating enema).
Instead of glycerin, two or four tablespoons of olive oil can also be added, or other substances - preferably natural - with a purgative action (in the past soap was widely used, about 20 grams per 500 cc of water, but today for its irritant action, it is preferred to replace it with natural or saline substances).
Evacuating enemas are also performed in preparation for surgery or a diagnostic examination of the last section of the intestine, often in association with laxatives. For example, in preparation for colonoscopy, one or two enemas with Sorbiclis ® or Macrolax ® can be practiced.
Therapeutic enemas
Enemas based on medicated solutions (therapeutic enema) are used to introduce drugs with systemic or local action (for example corticosteroids or mesalazine in the treatment of ulcerative proctitis); their use is valuable whenever, for any reason, it is not possible to use the oral route (for example in the presence of vomiting or when the drug is absorbed or metabolized in an undesirable way by the digestive system).
Diagnostic enemas
Barium sulphate-based enemas (traditional and double-contrast barium enema) are used for X-ray examination of the colon (barium is opaque to X-rays and allows you to observe the walls of the large intestine).
Colon hydrotherapy
The practice of the enema is also proposed in the absence of a real organic need to promote the state of general well-being, thanks to the elimination of toxins accumulated in the body.
In this regard, aqueous solutions are used in which purifying substances are dissolved and the operation is repeated several times over time; however, despite being fascinating, the practice of colon hydrotherapy lacks a real scientific basis, consequently it does not find consensus. unanimous of the experts.
Tips and Directions for Use
The practice of enemas has a certain diffusion also in the domestic environment and it is therefore very important to respect some precautions, which make the operation as useful and less harmful as possible.
First of all, the solution used must be possibly sterile, to avoid the risk of introducing pathogenic germs into the colon. Its volume, in case an evacuating or cleaning effect is sought, is 500-1000 ml and must not exceed 1500 ml ; otherwise, especially if you perform enemas with a certain frequency (which must not be more than two treatments a day), you risk water intoxication (which is absorbed by the colon by increasing the plasma volume and diluting the salts, with the danger of hyponatremia; there is also a recall of electrolytes in the intestinal lumen by osmotic action).
The pre-prepared solutions that can be purchased in pharmacies have more or less the same osmolarity as plasma and this limits the danger of irritation and excessive dilution of the internal medium (they are often pre-dosed).
In children, of course, the quantities must be adapted in relation to body size (an approximate indication is 30 ml for each year of age).
The water temperature should be similar to that of the body and in any case not exceed 37.5 ° C to avoid irritating the intestinal mucosa and causing shock, which is possible even when the solution is too cold.
The devices for practicing the enema should be, as anticipated, possibly sterile, such as those of the "disposable" type that can be purchased in pharmacies. Furthermore, it is important to respect the instructions for use, which require generous lubrication before anal insertion.
An adequate device also ensures the right infusion pressure, which is important to avoid excessive absorption of the solution and save trauma to the intestinal mucosa (thanks to the joint use of lubricant and soft rubber materials). If these occur, even in an inconspicuous way (for example if you notice unusually dark or blood-streaked stools), it is important to seek prompt medical attention.
Contraindications
It should be remembered that enemas should never be used, especially in the home environment, in the presence of inflammation (Crohn's disease and ulcerative colitis), intestinal bleeding, appendicitis, peritonitis, severe haemorrhoids or tumors of the rectum-colon; caution also in presence of heart disease or kidney failure.
