ENEMA

ENEMA

An enema is the introduction of fluid into the large intestine by way of the anus for the purpose of removing stool from the rectum. There are several reasons a person would be given an enema. Enemas are used to relieve constipation and fecal impactions and to empty the intestine of fecal material before surgery or certain diagnostic tests. Sometimes enemas are used as part of a bowel training program.

Types of Enemas

Several types of enemas are used in the health caresetting . Some are prepared by the nurse or nursing assistant, and others come prepackaged.The solution that i placed into the rectum varies according to the reason the enema was ordered.
■ Cleansing enemas. Cleansing enemas are primarily used to remove feces from the lower large intestine.Tap water enemas and saline (salt water)enemas help soften the stool and stimulate peristalsis.Enemas containing these solutions should not be given repeatedly because the intestine can absorb the solution, causing a fluid imbalance in the body. Soapsuds enemas consist of water and a small amount of a very gentle soap called castile soap. The soap solution irritates the lining of the bowel, stimulating peristalsis. These, too, must be used with caution because too much soap can cause damage to the lining of the intestines.
■ Oil retention enemas. An oil retention enema contains mineral, olive, or cottonseed oil. The oil lubricates the inside of the intestine and any stool that is present, making the stool easier to pass or remove. Oil retention enemas are useful for helping to remove fecal impactions.
■ Commercial enemas. Commercially prepared and packaged enemas usually contain 120 mL of a solution that irritates the intestinal mucosa to promote peristalsis. Some commercial enemas contain a solution that is absorbed into the stool to make it softer and easier to pass.

There are many different types of enema solutions. (A) Commercially
prepared enema solutions. (B) A soapsuds enema is prepared using castile soap and water
(not shown) and administered using an enema bag.

Administering Enemas
Enemas are ordered by a doctor and usually given by a nurse. Some facilities allow nursing assistants to administer enemas after adequate training. Make sure you are familiar with your facility’s policies on the administration of enemas. If you are permitted to give enemas, be sure to follow proper procedure and the doctor’s orders closely. Make sure the solution is correct for the person,that you have the correct amount of solution, and that the solution is at the proper temperature. Enema solutions that are too cool can cause abdominal cramping and pain, while solutions that are too hot can cause serious injury and possibly even death. When you are assisting with the administration of an enema, make sure that a bed protector and bedpan are in place, or that the path to the bathroom is clear. When it comes time for the person to expel the enema, she will need immediate access to toilet facilities.An enema is given with the person on her left sidein Sims’ position. When a person is lying on her left side in Sims’ position, the intestine is positioned to take the best advantage of gravity. The solution will flow downward to clean a longer segment of bowel

Enema Device for bowel irrigation

Having the person lie on her right side in Sims’ position is not as effective because the enema solution flows only as far as the rectum and does not clean as much of the bowel. After the enema has been administered, the person is asked to hold the solution in the bowel for the specified amount of time, and then to expel the solution. The doctor may order a cleansing enema to be administered “until clear,” which means that enemas are to be given until the enema return from the person does not contain any fecal material. If you are responsible for giving a cleansing enema, make sure to ask the nurse how many enemas are allowed to
be given during a particular session.Receiving an enema can be uncomfortable and
embarrassing. To make the procedure easier for the person,keep the person covered as much as possible and ensure that she has as much privacy as possible. Having the person take a few slow, deep breaths as the enema
tubing is inserted into the rectum may help to relax the
person and make insertion easier.

The left Sims’ position is used when
a person is to receive an enema. This position exposes the greatest amount of the bowel to the enema solution.