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HOW TO GIVE YOURSELF AN ENEMA

An enema is a great way to stimulate a bowel movement.  It will not cleanse the entire intestine nor will it condition the muscle.  However, it can bring instant relief when you are “in a bind”.

EQUIPMENT NEEDED
• An enema bag.  You can obtain this in any pharmacy.
• K-Y Jelly or any edible oil. This is used to make insertion of the rectal tube easier and more comfortable.
• Something to hang the bag if self-administered. The enema bag should be suspended no more than 18-24 inches above the level of the rectum.
• A good location:  the best place to give yourself an enema is on the bed or in the bathroom either lying on a rug or in the bathtub.
• A pad or heavy bath towel to be placed underneath the buttocks during the enema.
• A healthy source of water.  Your colon will be absorbing this water into your body.  Use the same water you would drink, preferably filtered or spring water.

PROCEDURE
For best results, and your own comfort, the enema should be taken while lying down.  If you will be giving the enema to yourself the first thing you should do is set up the area for the procedure. Make sure the hook is suspended at the proper height (18-24 inches above the rectum). Then place a pad or bath towel where you will be lying down. Slide the shutoff clamp to a point on the tubing where you will be able easily reach it while in position. Check this out ahead of time by hanging the empty bag and assuming the position, just to be sure.  Prepare the solution. The water temperature should be slightly above body temperature, between 98 and 105 degrees F at time of use.  You may need to heat water on the stove but BE SURE NOT TO USE HOT water that could hurt you, cool it down if necessary till it’s comfortable to the touch.   Fill the enema bag 90% full with the water.  Lubricate the rectal nozzle with K-Y jelly or oil.  Open the shutoff for a moment and allow enough solution to flow to expel the air from the enema tubing. This helps to reduce cramping. Lubricate your anal area with a generous amount of K-Y Jelly or oil. Work your index finger up into the rectum lubricating the entire interior area where you can reach.   Hang the enema bag on the hook.  Lie down in position. On the bed this should be on the left side with the left leg straight and the right knee flexed (Sim's position). Your left arm should be behind your back and if the shutoff is properly positioned you will be able to control it with your left hand. Your right hand will comfortably rest under your pillow. On the bathroom floor or in the tub, lie on your back with both legs drawn up, knees bent. Make sure you can easily reach the shutoff valve. Put a pillow under your head.

If someone else is giving you the enema you may find it more comfortable to assume the knee-chest position. To accomplish this, get on your hands and knees and then put one or two pillows underneath your chest, and lean forward on them. Turn your face sideways and rest it on another pillow, and snuggle both arms underneath. This particular position is an especially comfortable one to have an enema during pregnancy, but if you attempt it on your own the rectal tube tends to slip out and it is difficult to work the shutoff. If you do this on the bathroom floor rather than the bed, make sure your knees are cushioned by a pillow or a pad, or the pressure on them might cause knee damage.

Gently insert the rectal tube 3 to 4 inches into the rectum. Rotate or twist the tube back and forth to make for easier insertion.  Open the shutoff valve and allow the solution to flow. At the first indication of discomfort stop and wait a few moments. Then release the shutoff and allow the enema to resume. Feel free to interrupt the flow as frequently as is necessary to assist in minimizing the discomfort. Taking slow deep breaths will help, and if you feel cramping at any point "pant like a dog" with shallow quick breathing. As the enema progresses a feeling of fullness will develop. This is normal, and discomfort can be minimized by insuring that not too much solution is introduced too quickly.  Take your time.

When the bag is empty clamp off the shutoff and slowly remove the rectal tube. Remain in position and retain the solution for a while. For a maintenance enema a few minutes are sufficient, but if you are constipated try to hold it in for 5 to 15 minutes.   Go to the toilet and expel the enema. An enema seldom comes out in a single movement so stay near the toilet for one half to one hour. After evacuating, most people find it comfortable to lie on the bed in a prone position to rest for a while. Clean the equipment thoroughly and hang it all up to dry. An enema bag takes several days to thoroughly dry out, and should never be put away while even slightly wet.

TIPS FOR MINIMIZING DISCOMFORT
There are three primary reasons that cause an enema to be a more uncomfortable procedure than it has to be:

• Wrong position:  Use the positions suggested here and don’t give yourself and enema while seated on a toilet.
• Wrong temperature:  An enema solution too cool can cause excessive cramping. If it is too hot it can damage the delicate mucosa lining the bowel. Body temperature or slightly above (98-105F) is just right.
• Too much pressure:  If the bag or can is suspended too high, excessive pressure can cause severe discomfort. The bag should be just high enough to allow the solution to barely flow

TIPS FOR MAXIMIZING RESULTS
• Use a sufficient volume of solution
• Retain the solution for 5 to 15 minutes.
• Retaining the enema for a while before expelling it can significantly contribute to good results.

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