Enema Administration

Definition An enema is an insertion of a solution into the rectum and sigmoid colon to stimulate defecation

Purposes: Relieve constipation / impaction Prevent involuntary escape of fecal material during surgical procedures and childbirth Promote visualization of the bowel when an x-ray or exam is to be performed Assist with bowel training program

A doctor’s order is needed ! Tip to Remember A doctor’s order is needed !

Irritation of bowel mucosal Etiology Enemas stimulate peristalsis through: Bowel Distention Irritation of bowel mucosal Both

Bowel Distention Occurs by: 1. Filling the bowel via Large-volume enema from an external source 2. Filling the bowel via small volume enema which draws internal fluid into the bowel. Both of these initiate the defecation reflex

Osmosis Movement of water through a semi-permeable membrane to equalize the concentration of particles on both sides of the membrane. Flow is from: higher concentration Lower concentration

Types of Enemas

Cleansing Hypotonic – tap water enema Flow of water is out of Bowel into the interstitial Tissues which have a High osmotic pressure

Hypertonic These enemas pull Fluid out of the interstitial Tissues into the colon Which has a higher Osmotic pressure

Isotonic / Saline Equal concentration / Osmotic pressure on Both sides of the membrane

Soap Suds Enema Creates the effect of intestinal mucosal irritation to stimulate peristalsis

Retention Enemas These enemas must remain in the colon for a pro- longed period of time Oil- retention Feces absorb the oil and becomes softer and easier to pass