Enema
Enema
An enema is an injection of fluid Into the large intestine and through the rectum. The main purpose of an enema Is to remove feces and fiatus (gas) from the colon and rectum. In addition, enemas can be used to relieve intestinal congestion and give medication. Before some surgeries, X-ray procedures, and childbirth, enemas may be ordered to clear the bowel of fecal material. The order may state, “enemas until clear.” This means that enemas are given until the return solution is the same as that injected, and no fecal material is present.
Enemas are frequently classified as retendon or nonretention enemas:
• Retention enemas are small amounts of solution that are retained, or kept, in the intestine for a specified period of time after they are given. They are used to instill medications, soften stool, aid in elimination of intestinal parasites. lubricate the rectum, or expel fiatus.
• Nonretention enemas are usually expelled in 5 to 10 minutes. Larger quantities of solution are usually given, and the enemas are generally used to clean the bowel of feces and flatus (gas).
Enema types
• Cleansing enema: Usually a soap-solution, tap-water enema, or saline solution. Soap- solution enemas irritate the intestine, so they are no longer used as frequently as tap-water enemas. A large amount of the solution, from 750 to 1,000 cubic centimeters, is usually given. The main purpose is to remove stool and flatus.
• Disposable enema: Also a cleansing enema, in most cases. However, these enemas come in prepared, disposable containers, each usually containing 4 to 6 ounces (120 to 180 cubic centimeters). The solution tends to be hyper-tonic, meaning that it draws fluid from the body to stimulate peristalsis and elimination of stool and flatus.
• Oil retention enema: Mineral or olive oil may be used. Commercially prepared enemas containing oil are also available. Four to six ounces is the usual amount. These enemas are retained for at least 30 to 60 minutes. The
main purpose is to soften fecal material so that it can be expelled. An oil retention enema is sometimes followed with a cleansing enema.
The patient receiving an enema is usually placed in the Sims (left lateral) position. This encourages the solution to flow from the rectum to the sigmoid portion of the colon. The patient should be encouraged to breathe deeply during enema administration. Deep breathing encourages relaxation and increases retention of the solution for more effective results. Results must be observed after an enema is given. Amount, type, and color of stool, and/or the amount of flatus expelled should be recorded. An Impaction is a large, hard mass of fecal material lodged in the intestine or rectum. Oil-retention enemas are frequently ordered to soften the impaction so it can be expelled. If it cannot be removed by an enema, it is sometimes necessary to insert a lubricated, gloved pitcher to measure the amount needed.