Enemas are utilized to alleviate constipation and purify the colon. Those based on water or saline are generally the least risky. Nonetheless, enemas might lead to side effects like disrupting gut flora and altering the body’s electrolyte equilibrium.
Enemas are rectal injections of fluid intended to cleanse or stimulate the emptying of your bowel.
They have been used for centuries to treat chronic constipation and prepare people for certain medical tests and surgeries.
Enemas can be administered by a medical professional or self-administered at home.
This article reviews different types of enemas and their potential benefits and health concerns.
What are enemas?
Constipation occurs when stool movement slows down, resulting in hard, dry feces that are challenging to pass. Many individuals face this persistent issue and might need remedies such as rectally-inserted laxatives or enemas.
Enemas can also be recommended to cleanse the colon before specific diagnostic tests or surgical procedures. A clear bowel is essential for these operations to minimize the risk of infection and ensure feces don’t obstruct the process.
Some proponents of enemas believe that accumulated waste in the colon can cause symptoms like depression, fatigue, headaches, allergies, and irritability. They claim that enemas can alleviate these issues.
Though many who suffer from chronic constipation also report feelings of depression and other psychological distress, there isn’t concrete evidence linking waste accumulation to the other mentioned symptoms directly.
Enemas primarily fall into two categories: cleansing and retention.
Cleansing enemas are water-based and must be held in the rectum briefly to flush your colon. Once injected, they’re retained for a few minutes until your body rids itself of the fluid, along with loose matter and impacted stool in your bowel.
Some of the most common cleansing enemas include:
- Water or saline. The least irritating of all options, water or saline — salt water that mimics your body’s sodium concentration — are used primarily for their ability to expand the colon and mechanically promote defecation.
- Epsom salt. This is similar to a water or saline enema, but magnesium-rich Epsom salt is said to be more effective at relaxing bowel muscles and relieving constipation.
- Sodium phosphate. This is a common over-the-counter enema that works by irritating your rectum, causing it to expand and release waste.
- Lemon juice. Lemon juice mixed with warm, filtered water is said to balance your body’s pH while cleansing your colon.
- Apple cider vinegar. Advocates say that mixing apple cider vinegar with warm, filtered water can quickly clear the bowel and may have other antiviral healing effects on your digestive system.
- Soap suds. Adding castile soap, or another mild soap with minimal additives, to water mildly irritates the bowel, encouraging stool excretion.
Retention enemas are designed to be held in your bowel for an extended period — usually at least 15 minutes — before being released. Retention enemas may be water- or oil-based, which softens the stool and makes it easier for your body to expel.
Some of the most common retention enemas include:
- Coffee. Coffee enemas are a mixture of brewed, caffeinated coffee and water thought to promote bile removal from the colon. They were popularized by Max Gerson, a physician who used them to help treat cancer patients.
- Mineral oil. This type of enema works primarily by lubricating waste inside of your colon, sealing it with water, and promoting its removal.
- Probiotic. Mixing probiotics with water may cleanse your bowel while helping colonize your good gut bacteria. Lactobacillus reuteri enemas have been shown to reduce inflammation in children with ulcerative colitis.
- Herbal. Some people use herbs like garlic, catnip tea, or red raspberry leaf mixed with water to make herbal enemas with purported nutritional, infection-fighting, and anti-inflammatory benefits.
Summary: Enemas are rectal fluid injections intended to cleanse your bowel or treat chronic constipation. The two main types — cleansing and retention enemas — come in various solutions and can be injected at home.
Potential benefits of enemas
Enemas can treat constipation and clear out your bowel. However, many people choose to use enemas for other purported health benefits.
Some advocates claim that enemas can support weight loss, remove toxins and heavy metals from your body, and improve your skin, immunity, blood pressure, and energy levels.
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Still, evidence is limited to suggest that enemas are adequate for these purposes or that they benefit everyone who uses them. Despite their widespread use in modern medicine, most evidence supports their effectiveness is anecdotal.
Enemas appear to be most effective when used to relieve chronic constipation in a medical setting, though they come with many risks, especially when self-administered at home.
Summary: Enemas can effectively clean the bowel and treat chronic constipation, but most evidence in their favor is anecdotal rather than science-based.
Potential side effects and dangers of enemas
Though enemas can clean out your bowel, you should consider their risks and take certain precautions before using one.
Enemas may interrupt your body’s natural balances
Enemas may disturb your gut bacteria and reduce your electrolyte balance.
Research shows that enemas used in preparation for medical procedures significantly disrupt gut bacteria, though the effect appears to be temporary. However, enemas that are split and administered in two doses seem to have fewer effects on the microbiome.
Electrolyte disturbances have been observed with various types of enemas, such as large-volume soap suds enemas and those containing minerals.
For instance, there have been reports of Epsom salt enemas causing death from magnesium overdose. In another case, an older man died from severe electrolyte disruption caused by taking two sodium phosphate enemas.
Other reports note that the overuse of enemas to flush out the colon may lead to severe dehydration, which can be fatal.
Enema solutions can harm your bowel
Lemon juice, apple cider vinegar, and coffee enemas are highly acidic, and scientific evidence to suggest their effectiveness or safety is lacking.
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Moreover, the evidence shows that their acidity and makeup can harm your bowel and lead to rectal burns, inflammation, infections, and even death.
Similarly, there are reports of children being given acidic hydrogen peroxide enemas, which resulted in an inflamed colon, bloody diarrhea, vomiting, and long-term complications.
Furthermore, herbal enemas have caused internal bleeding in some people requiring blood transfusion and colon removal.
Dirty or improperly used tools can cause infection and damage
If you self-administer an enema at home, you must ensure that your tools are sterile and free of harmful germs. Dirty tools increase your risk of contracting a potentially dangerous infection.
Improper tool use may also cause physical damage to your rectum, anus, or colon. Studies indicate that perforation of the bowel is not a rare complication of frequent enema use that could put your internal organs at risk of infection.
Sterile enema injection kits, which usually include a bucket, tubing, solution, and sometimes a bulb, can be found online or at many local drug stores. They come with directions for cleaning and safe use.
Summary: Though enemas can be safe and effective, they have many risks, especially when administered at home. Improperly used enemas can cause potentially life-threatening physical and chemical damage to your rectum or colon.
Alternatives to enemas
If you’re mainly considering an enema to stimulate and clean out your digestive system, there may be other, less invasive options.
Some potential alternatives to enemas, which can promote waste excretion and bowel regularity, include:
- drinking caffeinated coffee, which is known to stimulate defecation
- staying well hydrated with water
- getting regular exercises like walking, running, biking, or aerobics
- trying an over-the-counter oral laxative like magnesium
- increasing your fiber intake by eating whole plant foods like fruits, vegetables, whole grains, nuts, and seeds.
If you have severe constipation or other medical issues, speak to your medical provider to determine whether an enema would be a safe and appropriate treatment.
Summary: Less risky alternatives to enemas that can help stimulate bowel movements include staying hydrated, getting regular exercise, and following a healthy, high-fiber diet.
Enemas help alleviate constipation and purify the colon by introducing water- or oil-based solutions into the bowel via the rectum to remove accumulated waste.
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Using mild enemas, such as those made with water or saline, is safer. However, discussing this with a healthcare professional before trying one at home is essential. Moreover, using clean and sterile equipment is crucial to ensure safety.
While many individuals vouch for enemas to maintain bowel regularity and avoid constipation, there isn’t ample scientific evidence supporting their efficacy.
In many situations, considering other, less hazardous methods might be more beneficial.