Is It Safe to Do an Enema at Home? 6 Risks

Doctors may prescribe enemas:

• Before a colonoscopy 
• Before childbirth (in pregnant women)
• In cases of severe constipation or fecal impaction (in children and the elderly)

If you are told to administer an enema at home, make sure you follow your doctor’s instructions, use only the recommended amount of enema fluid, and obtain a home enema kit from a pharmacy. These kits contain a pre-sterilized enema bag, tube, and cleansing solution. They also come with detailed instruction manuals and are safer to use than homemade solutions or tap water.

1. Damage to the rectum and anus: When incorrectly administered, especially with solutions made with diluted coffee, peroxide, or vinegar, an enema can damage the lining of your rectum or colon. If an enema is given too forcefully, it can injure the anus and even result in bowel perforation.
2. Risk of infection: If an unsterile device is used for the purpose of an enema, it can cause localized infection or abscess formation.
3. Electrolyte imbalances: If given daily for a long term, enemas can cause electrolyte imbalances in the body. Electrolyte imbalances are common if large volume enemas are given in severely dehydrated individuals or those with renal insufficiency.
4. Hypothermia: If the water used to give the enema is very cold, it may cause dangerously low body temperatures (hypothermia).
5. Nausea: Infusing the solution too quickly into the rectum may stimulate the vagus nerve and result in reflux dizziness and nausea.
6. Microbial dysbiosis: Doing enemas too often can flush out both bad and good bacteria that colonize your intestine. Good bacterial colonies help digest food, regulate hunger and satiety, and even help with immunity. Loss of such bacteria can cause digestive upset, vaginal discharge, and other issues.

• Cleansing enema: Administered before a diagnostic procedure or surgery so that the scope passes with ease and fecal matter does not obstruct the surgeon’s view. It may also be used as an intervention for severe constipation. It is given using an enema kit and saline water in a fixed volume. “Detox” enemas are a type of cleansing enema.
• Pre-packaged disposable enema: Contains an intestinal stimulant drug called bisacodyl or sodium phosphate in hypertonic saline. It stimulates the rectum and draws the fluid out into the bowel. It is given before surgery and sometimes used in the elderly to soften stools and relieve chronic constipation. It may be used at home if recommended by a doctor.
• Oil-retention enema: Often given to soften hard, impacted feces in the elderly, especially those who take drugs for Parkinson’s disease. These come in commercially packaged pouches with a 90- to 120-mL solution of castor oil. The oil needs to be retained for at least one hour for an enema to be effective. This type of enema is usually followed by a cleansing enema.
• Return-flow enema: Used to clear intestinal gas and stimulate gut movement. It is often given in the hospital after abdominal surgeries. A large volume fluid is gradually administered in 100-200 mL increments at a time to stimulate bowel movements.
• Cooling enema: In rare cases, precooled saline solution may be given as an enema to lower the body temperature rapidly in cases of very high fever.

1. Do not eat for at least 30 minutes before using the enema.
2. Make sure you are well hydrated. 
3. Wash your hands with soap and water and keep all things at hand. 
4. Stay where you can get to a toilet easily for the next few hours because you may need to use the toilet repeatedly. 
5. Warm the enema in a bowl or sink of warm water, making sure it is not too hot. 
6. Make sure there are no air bubbles in the enema bag by adjusting the clamp and releasing air bubbles through the hose. 
7. Use a lubricant around your anus so that the tube of the enema bag slides in with ease. 
8. Lie down on your side and raise your knees to chest level. 
9. Gently, insert the tube into your anus and slide it toward the rectum, relaxing your anal muscles. 
10. Make sure you insert the tube into your rectum to only one finger length. 
11. Take slow, deep breaths as the fluid drains inside your rectum. 
12. Stay lying down even after the fluid is administered and the hose is taken out. 
13. Stand up slowly and sit on the toilet waiting for a bowel movement. 
14. You may pass stools for up to an hour after you have administered the enema. 

Temporary side effects of enemas may include bloating and cramping, which should go away in the next few hours.