Enema definition and types

Enema definition and types

DEFINITION

An enema is the procedure of introducing liquids into the Enema and colon via the anus for cleansing, medicinal, diagnostic or such other purpose.

PURPOSES OF ENEMA

• To relieve constipation.


• Before operation.


• After certain operations.


• To cleanse the bowel before &, after barium enema.


• To cleanse the bowel before retention enema, a vaginal or rectal examination.


• To stimulate uterine contractions, & to help the child birth.

CONTRAINDICATIONS

• Dehydration


• Young infants


• Fluid and electrolyte imbalance


• Hypothermia


• Abdominal cramps

 

TYPES OF ENEMA

RETURNING ENEMA  It’s given to cause stimulation of the bowel or lubrication of the bowel contents & cause defecation to take place.

• . Oil enema – is used to treat severe constipation. It has to be retained for ½ to 1 hour to soften the feces. Solutions used are – olive oil, sweet oil.


• Cleansing enema – is given to cleanse the bowel before x ray studies, an abdominal or pelvic & perineum, surgery on rectum. Solutions used are – normal saline, sodium bicarbonate etc.


• Carminative enema – it produces relief by distending the lower bowel & stimulating peristalsis. Solutions used are – turpentine, milk & molasses, tincture asafetida in different mixtures & amounts.


• Anthelimenthic enema – it’s given to destroy & expel worms from the intestines. Cleansing enema must be provided prior to antihelimenthic enema. Solutions used – infusion of quassia, hypertonic saline solution.


• Astringent enema – is given in the treatment of colitis & dysentery. It contracts the blood vessels & tissues, controls bleeding & inflammation reduces mucus discharge & gives temporary relief in inflamed area. It’s given in the form of rectal or colonic irrigation. Solutions used are tannic acid, alum, silver nitrate mixed in water. It’s given as hot as the patients can tolerate.


• Ice enema / cold enema – used to reduce the body temperature in hyperpyrexia & heat stroke cases. It’s given by drip method or given as soap water enema but to be given very slowly using a small catheter.


• Temperature of solutions 27 to 32 ⁰C

Complications – hypothermia, abdominal cramps

RETENTION ENEMA  In this type the fluid injected into the bowel has to be retained

• Nutrient enema – it’s given to supply nutrients to the body. Fluids are given according to the ability of the colon to absorb it. It's useful in the treatment of hemophilia. infusion are not beneficial.  Solutions normally used are normal saline, glucose saline 2 to 5 percent Peptonised milk 120 ml.


• Sedative enema – this type of enema contains a sedative drug to induce sleep. Drugs been used are paraldehyde, potassium bromide, chloral hydrate.


• Stimulant enema – it’s given when it’s impossible to give fluids, medication or nourishment by mouth i.e. to treat the shock & collapse condition poisoning cases. Black coffee enema is given in opium poisoning. Solutions usually been used are – Black coffee, Brandy.


• Anesthetic enema – it contains anesthetic drug to produce anesthesia in patient. Drug been used are avertine.


• Medicinal enema – few medicines are administered by giving enema e.g. in diarrhea starch opium.

METHODS USED IN GIVING ENEMA

USING CAN AND TUBE   When large amounts of fluids are to be given, this method is to be used e.g. soap and water enema

FUNNEL AND CATHETER METHOD   When small quantity of fluids are to given, this method is used e.g. oil enema

GLYCERINE SYRINGE AND CATHETER METHOD  When small quantity of fluid is to be given, this method is to be used e.g. purgative enema

DRIP METHOD  When the fluid is to be administered very slowly in order to aid in its absorption e.g. nutrient enema