At an enema, tempered liquid, usually water, is fed into the anus. This was common in ancient times to relieve the intestine and cleanse it. Today enemas have a wide variety of uses. For example, before an operation to empty the intestine, before giving birth, as a preparatory measure for a colonoscopy, as a therapeutic measure, as a natural colon cleansing, for constipation or fever and much more.
The intestine consists of a small and large intestine. Depending on the type of enema, the entire colon or only the rectum is emptied. Oral ingestion with suitable preparations is necessary to clean the small intestine.
A slightly bizarre story was the beginning of the enema. The ancient Egyptians believed that they observed that the holy ibis (a stork-like bird from the family of ibises and spoonbills) stuck its beak into his anus again and again. But the truth was different: he removed a secretion from his coccyx to grease his plumage. However, this was the beginning of the enema.
The enema, a utensil that is still common today, was already modern at the time. The current name comes from the Greek, so "klysterion" means cleaning.
Such enemas were already used in ancient times primarily to empty the intestine, but also to apply drugs or nutrients. They should serve to feed the sick who could not eat or could not keep anything with them. So-called nutrient enemas contained, for example, broths, wine, milk or pureed meat.
Already 3000 years before Christ, the view was held that diseases can also result from constipation. Added to this was the widespread opinion that so-called "disease demons" could leave the body through the intestine. An enema administered should accelerate this. At that time, an enema consisted of a cut cow horn.
According to the teachings of the famous Greek doctor Hippocrates, health only existed when the body fluids were balanced. Back then constipation was called an imbalance. Rejection procedures, such as bloodletting, cupping and enema, were among the therapies used and are now modern in naturopathy.
In the 16th and 17th centuries, the heyday of the enema was a real enema addiction. And not just for colon cleansing, but to stay healthy and young and to keep youthful skin. The enema was even used every day.
The execution of an enema is possible with different devices.
Depending on the capacity, this includes disposable enemas, micro-enemas and irrigators. The single-use enemas have a capacity of 100 to 200 milliliters, the micro-enemas five to ten milliliters and with the irrigators a liquid volume of one to two liters is possible.
The most common enema devices used to perform colon cleansing at home are irrigators, single-use enemas, enema syringes, and klyso pumps. The running-in devices are available in the pharmacy or online and differ in structure and application.
The irrigator consists of a container, a tube and an intestinal tube. This is inserted up to 30 centimeters, very gently, into the anus. With this device, a liquid supply of up to two liters is possible. When used, the term "high enema" is often used because it can be used to clean the entire colon.
With the single-use enema (or micro-enema) only the rectum is "irritated". Between five and 200 milliliters of liquid, which is usually a hypertonic solution, are used. This binds the water in the intestine so that the stool becomes softer. With a disposable enema, an intestinal tube is not necessary. This is the treatment of choice especially for constipation and can also be used for babies and toddlers.
With a so-called Klyso pump, it is possible to introduce a larger amount of flushing liquid, namely up to two liters. The liquid in a separate container is drawn in with the pump and then pumped into the anus with the help of a hose.
Enema - therapeutic
Therapeutic indications for enema include preparation for childbirth, persistent constipation (constipation), constipation after surgery and medication via the intestine. If a patient is unable to take medication orally, this can happen through the intestinal mucosa. An enema is then carried out.
If a patient has a high level of ammonia in the blood, which usually happens as a result of cirrhosis of the liver, medicine uses the lactulose enema. Lactulose (lactulose is a double sugar that draws water into the colon and binds ammonia) can bind the excess of ammonia, which is then excreted.
Another example is the so-called resonance enema, which is used in connection with chronic renal failure. If the kidney function is impaired, the potassium in the blood may be increased (hyperkalaemia). Resonium (it exchanges sodium for potassium ions in the intestine) supports the excretion of potassium.
Risks and side effects
A careful, properly performed enema usually leads to no side effects. This also depends on the person who gets the enema. Some people are sensitive to it. If the enema is carried out too often, this can damage the intestinal flora.
The wrong water temperature may cause cramps or scalds. If any acidic substances are added to the liquid, this can lead to irritation of the intestinal mucosa. In the worst case, anaphylactic shock in response to the irrigation fluid used is possible. Other side effects include circulatory problems, diarrhea, nausea and vomiting. Improper use can damage the intestinal wall or the anus.
The following contraindications exist for enemas:
- Bowel obstruction,
- Malformations in the intestine,
- Kidney disease,
- inflammatory bowel disease,
- Heart disease,
- Bleeding in the gastrointestinal tract
- and acute abdominal disorders.
How often is an enema done?
As already mentioned, enemas that are carried out too frequently can damage the intestinal mucosa. Whoever suffers from constipation should under no circumstances exaggerate this measure. However, an enema once a month is not a problem.
If the intestine is cleaned beforehand in connection with therapeutic fasting, this is harmless twice a year. But listen to your belly - feel total discomfort, even if you think of an enema, then don't do it.
The enema at home
If you want, you can make an enema yourself at home. It is best to start with a small amount of liquid at the beginning in order to familiarize yourself with the process. Be sure to find a place near a toilet to carry it out. You should have enough time and rest. Obtain an enema set, for example an irrigator, from the pharmacy and read the instructions carefully.
The longer the water remains in the intestine, the better the effect. Ten to fifteen minutes are recommended. But don't despair if you can't. Even if you need to go to the toilet faster, it doesn't mean that the enema is unsuccessful. An enema is for those who find the use of an irrigator too complicated. Especially for self-use, this is much easier and therefore recommended. In the pharmacy or a well-stocked drugstore, ready-made "mini enemas" are also available, for example with the additives glycerin, olive oil and chamomile.
In general, you should rest after the enema. You may need some warmth. Lie comfortably on the couch with a blanket and a hot water bottle.
As a rule, lukewarm water with a temperature of around 37 ° C is used as the rinsing liquid. Chamomile tea has an anti-inflammatory effect and calms the intestines somewhat. Additives such as table salt, glycerin, healing earth or oil can be added to the water. However, the recommended amount of the additive must be observed and the enema should be stopped immediately in the event of symptoms or discomfort.
The enema is advertised with coffee again and again. This is supposed to detoxify the liver and bile. However, this belongs in the hands of a therapist and is not suitable for the arbitrary procedure at home. Side effects such as circulatory problems, massive nervousness or disturbances in the electrolyte balance can occur.
Even if enema sets are freely available for sale and online self-implementation is advertised as simple and recommendable, an enema can still be associated with risks and side effects. This procedure should be avoided, especially if the intestinal flora has already been attacked or has become highly inflammatory. If you are not sure, it is best to ask your doctor or naturopath beforehand. Anyone who does an enema at home should not be alone. If there are any circulatory problems, nausea or vomiting, help is immediately on site.
Enema due to recurrent constipation is not a permanent solution. The reason for constipation must be found and properly treated. (sw)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Susanne Waschke, Barbara Schindewolf-Lensch
- Kerstin Adler, "The Coffee Enema: Detoxification and Pain Therapy", AKSE Verlag 2017
- Yoko Uchiyama-Tanaka, "Colon irrigation causes lymphocyte movement from gut-associated lymphatic tissues to peripheral blood", J-STAGE Biomedical Research Volume 30 (2009) Issue 5, 2009, J-Stage Biomedical Research
- Lee Smith "Coffee: Friend or Enema ?: Coffee Enemas and Detoxification", CreateSpace Independent Publishing Platform 2011