Enema Prolapse
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Enema Prolapse
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Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.
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Jay Yepuri, MD, MS, is a board-certified gastroenterologist and a practicing partner at Digestive Health Associates of Texas (DHAT).
Enemas are sometimes used for constipation when other measures like laxatives or dietary measures aren't working. They are also used to clear out the colon before a colonoscopy or other test.
While they can be safe and effective, enemas do have risks when performed at home, or if they're used too frequently. Sometimes, they can cause serious complications such as bowel perforation or sepsis, a life-threatening condition due to infection. 1
This article will explain when enemas are used, as well as the risks and possible complications of using them. It will also offer alternative ways to reduce constipation.
Enemas work by getting fluid into your large intestine so it can soften up your stool and help it pass. The fluid is administered into the rectum and large intestine through the anus. Enemas are used for a variety of reasons:
If your healthcare provider recommends an at-home enema, you can buy an over-the-counter enema kit. Most of them contain water and salt, mineral oil, or a mild laxative.
Purchase the kind your healthcare provider recommends. Don't add anything to it and make sure you follow the directions carefully. Don't try to put together a "DIY" enema using your own supplies or liquids.
Using an enema at home always comes with certain risks. Risks of a single enema include:
An enema-related perforation can result in sepsis (a serious blood infection), which one study found is fatal about 4% of the time. 3
The repeated use of enemas can, over time, cause serious problems, such as:
One type of enema sometimes used in alternative medicine is called a high colonic or colon hydrotherapy. These are invasive and can be harmful if you use them to clear out stool on a regular basis. 4
If you have hemorrhoids , enemas may cause extra pain. If you have a rectal prolapse (in which the end of the lower intestine protrudes from the rectum), you should avoid using an enema.
In 2014, the U.S. Food and Drug Administration (FDA) issued a warning against the repeated use of enemas containing sodium phosphate. These are found in some store brands, including the Fleet Enema. The sodium phosphate enema is especially dangerous for people over 55 and should never be used in children under two years old. It can lead to hyperphosphatemia —an electrolyte disorder that involves high phosphate levels and low calcium levels in the blood. This can lead to pain, rash, muscle cramps, intermittent spasms, kidney and liver damage, and (rarely) death. 5
A lot of people tout at-home enemas, often with "special" ingredients, for cleansing your bowel, improving digestive health, or other supposed benefits. These types of enemas are not recommended by the medical community.
Fad enemas may contain coffee, herbs, minerals such as Epsom salts, soap suds, acidic solutions, and more. In addition to the regular risks of enemas, these fad enemas can cause:
Never use ingredients that have not been approved by your healthcare provider to give yourself an enema.
Again, an enema should be a last resort for treating constipation. In most cases, constipation can be relieved with lifestyle changes, such as:
Over-the-counter laxatives may be an option for you, but they also come with risks. Talk to your healthcare provider about them, especially if you have regular constipation.
Enemas work by releasing liquid into the colon and large intestine via a tube inserted into the anus. Enemas are used before tests, such as a colonoscopy, which requires a clear view of the colon. They are also used to relieve constipation sometimes when other measures have not been successful. Enemas can be dangerous when performed at home or repeatedly. They must be used under the supervision of a healthcare provider to avoid complications.
If treatments such as dietary measures or laxatives have not relieved your constipation, you might want to consider using an enema. Always talk to your healthcare provider before attempting to give yourself an enema at home. They can help you choose the right one and give you advice on how to use it properly and safely. Keep in mind that in some cases constipation can be a sign of a serious condition, such as neurological problems or colon cancer . If you have repeated bouts of constipation that are hard to relieve, especially if they are followed by diarrhea, talk to your healthcare provider.
The FDA warns against using sodium phosphate enemas (commonly found over-the-counter) in babies under two years old due to the possibility of serious complications. 5
Always follow the package directions when preparing an enema. Talk to your pharmacist or healthcare provider if you have any questions.
Your healthcare provider can advise you on how often it is safe to use an enema.
Portalatin M, Winstead N. Medical management of constipation . Clin Colon Rectal Surg . 2012;25(1):12–19. doi:10.1055/s-0032-1301754
Niv G, Grinberg T, Dickman R, Wasserberg N, Niv Y. Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable . Int J Gen Med . 2013;6:323-328. doi:10.2147/IJGM.S44417
Seow-choen F. The physiology of colonic hydrotherapy . Colorectal Dis. 2009;11(7):686-8.
National Digestive Diseases Information Clearinghouse, NIH Publication No. 04–2673 2004. Facts and Fallacies About Digestive Diseases.
Niv G, Grinberg T, Dickman R, Wasserberg N, Niv Y. Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable . Int J Gen Med . 2013 Apr 26;6:323-8. doi:10.2147/IJGM.S44417
United States Food and Drug Administration (FDA) 2014. FDA Drug Safety Communication: FDA warns of possible harm from exceeding recommended dose of over-the counter sodium phosphate products to treat constipation. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-possible-harm-exceeding-recommended-dose-over-counter-sodium
By Amber J. Tresca
Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.
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