1. Enema Administration

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

3. 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

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

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

6. 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

7. 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

8. Types of Enemas

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

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

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

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

13. 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