Administering an enema: indications, types, equipment and procedure

An enema is a liquid administered via the rectal route either to aid bowel evacuation or to administer medication (Galbraith et al, 2013; Dougherty and Lister, 2015). This article will discuss the use of enemas for constipation in adult patients.

Indications for the use of enemas include to:

The use of enemas is contraindicated in patients with a paralytic ileus or chronic obstruction. It is also contraindicated where administration may cause circulatory overload, mucosal damage, necrosis, perforation, haemorrhage or following any gastrointestinal or gynaecological surgery where sutures may be ruptured (Dougherty and Lister, 2015).

Most commonly, enemas are used to relieve and treat constipation. NICE (2017) defines constipation as a symptomatic disorder of unsatisfactory defaecation due to difficulty or infrequency of passing stools that is a change to the individual's normal bowel pattern. Chronic constipation is diagnosed when symptoms persist for at least 12 weeks in the past 6 months (NICE, 2017). Early assessment and treatment of constipation is necessary to prevent long-term implications such as faecal loading, impaction or retention, haemorrhoids, anal fissures, distension or loss of sensory and motor functions (NICE, 2017).