In Arts And Literature
In the 17th century, satirists made physicians a favorite target, resembling Molière‘s caricature whose prescription for anything was “clyster, bleed, purge,” or “purge, bleed, clyster”.
In Grace Metalious‘s novel Peyton Place, the town doctor tells of “a young boy with the worst case of dehydration I ever saw. It came from getting too many enemas that he didn’t need. Sex, with a capital S-E-X.”. As a teenager, the boy enjoys receiving enemas from his mother.
In Anne Sexton‘s poem “Cripples And Other Stories”, is the couplet “Oh the enemas of childhood, reeking of outhouses and shame!”
How Do I Use The Enema
Follow the directions that come with the enema. The following are general steps to follow:
- Choose a comfortable position. One position is to lie on your left side with your right knee pulled up to your chest. The other position is to kneel and put the left side of your face on the floor.
- Gently and slowly insert the tip into your rectum. Remove the plastic cover before you insert the tip. Use a side-to-side motion as you insert the tip. It may help to push down like you are having a bowel movement. This can help relax the muscles and make it easier to insert the tip. Do not force the tip into your rectum. The force may damage your rectum.
- Squeeze the bottle to push the liquid into your rectum. You do not need to squeeze all of the liquid into your rectum. Squeeze until you have a feeling of fullness in the area.
- Stay in the same position until you feel the urge to have a bowel movement. This usually takes 1 to 5 minutes. If you do not feel the urge within 5 minutes, try to have a bowel movement. Do not use another enema if you do not have a bowel movement within 5 minutes. Contact your healthcare provider for instructions.
The Process Of Guidelines Formation
An expert committee was convened that included experienced physicians from the departments of Surgery, Gastroenterology, Geriatrics, Nephrology, and Emergency Medicine, and experts from the Risk-Management Unit and Pharmacy. The literature was reviewed, and the results of the retrospective study were discussed. Clinical guidelines for the diagnosis and treatment of acute constipation were written and distributed in the medical center. An implementation program was carried out in the ED, over a period of 2 months.
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Considerations For Choosing An Enema Kit
There are a variety of enema kits available, so its important to buy one from a credible source and pay attention to the materials used. There are single-use disposable enema kits as well as ones with reusable materials. If youre allergic to latex, make sure to check the list of ingredients. Lastly, try to find an enema kit with a release valve so that you can manage the flow of the enema solution.
Disposable enema kits should still be able to work with a large amount of fluid. Make sure the tip and the tube are sterilized plastic. A vinyl bag is also a good choice, because it can work with gravity or you can squeeze it during use.
Reusable enema kits are usually made of tougher materials. Look for soft rubber, durable plastic, and silicone. Some higher-end enema kits use stainless steel fluid containers. You will also want to pay attention to the applicators. Enema kits with multiple applicator types mean you can find the one thats most comfortable. Because you need to clean reusable kits, think about how easy or difficult it will be to take apart and sterilize.
Enema For Constipation Relief
An enema is considered a laxative to help alleviate symptoms of constipation and/or fecal impaction. The main ingredient in these types of laxatives is the fluid which is injected into the rectum.
Most enemas involve using a saline-solution. Some enemas may include baking soda, soap, and mineral oil. These ingredients may help improve the effectiveness of the enemas. They can also cause minor irritation and should be used carefully.
Fluid inserted into the rectum irritates your lower bowel which stimulates muscle contractions. It can also soften or hydrate hard stools to help with eliminating them. Contractions help you expel impacted feces along with enema fluid.
Enemas work quickly, usually only taking a few minutes to empty the bowels. You might feel some cramping initially, but this passes after about 15 minutes.
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What Is An Enema Administration Used For
Constipation is a common gastrointestinal condition. It occurs when the colon is unable to remove waste through the rectum. People with this condition have three or fewer bowel movements over a seven-day period. Mild constipation often occurs when you dont eat enough fiber or drink enough water on a regular basis. Daily exercise also helps to prevent constipation.
An enema administration is most commonly used to clean the lower bowel. However, this is normally the last resort for constipation treatment. If diet and exercise are not enough to keep you regular, your doctor might recommend a laxative before trying an enema. In some cases, laxatives are used the night before an enema administration to encourage waste flow.
Enemas may also be used before medical examinations of the colon. Your doctor may order an enema prior to an X-ray of the colon to detect polyps so that they can get a clearer picture. This procedure may also be done prior to a colonoscopy.
Home Remedies For Constipation
Before employing medication for constipation relief, it is important to try natural remedies first.
A few examples of ways you can help relieve – and prevent – constipation, and get back on track with a regular bowel routine include:
- Proper hydration
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Common Questions About Docusate
Docusate helps to soften your poo by increasing the amount of water in it. This makes it easier for you to go to the toilet.
Docusate capsules and liquid normally take 1 or 2 days to work. The enema usually works after 5 to 20 minutes, so it’s best to stay close to a toilet.
Talk to your doctor or pharmacist if you are still constipated after a week.
Take docusate for up to 1 week. If you take docusate for longer, your bowel can start to rely on it, rather than working on its own.
If you are still constipated after taking docusate for a week, talk to your doctor.
If your constipation is caused by an illness or a medicine you’re taking, your doctor will advise you about when it’s best to stop taking docusate.
It’s best to use docusate occasionally and for a few days at a time.
Using laxatives like docusate for longer can lead to long term diarrhoea.
They can also cause an electrolyte imbalance. This means that levels of salts and minerals like sodium, potassium and magnesium in your body get too high or too low. A severe electrolyte imbalance can cause serious health problems such as muscle spasm and twitching, and even fits or seizures.
Using docusate for many weeks, even months, could also stop your bowel working properly on its own.
For most people, 1 laxative will be enough to relieve constipation.
Occasionally, you may need to take 2 different types of laxatives at the same time to get your bowels moving again.
You can eat and drink normally while taking docusate.
What Are The Different Enema Solutions
Some commonly-used enema solutions include:
- Normal saline solution. It is a combination of salt and water. The salt of the mixture sends the body’s water into the bowels to make the feces soft.
- Glycerin. It stimulates the lining of the colon to cause bowel movements.
- Castile soap. It is a mild soap made of many oils, like olive oil. This mild soap is added to saline solution, which is then inserted through an enema. This solution stimulates the bowel to create movements.
- Coffee. It is a mixture of brewed coffee and water, used to remove bile from the colon.
- Phosphate solution. A phosphate solution enema attracts water into the bowel to soften the hardened feces. Remember that too much phosphate in your body may cause health risks. So never go for more than one enema a day. Phosphate enema is also not recommended for people with kidney problems.
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The Most Important Take
Heres what I hope youll take away from this article:
1.Know that constipation is common but shouldnt be considered a normal part of aging. It deserves to be evaluated and managed by your healthcare providers.
- Be sure to ask for help, if youve noticed any difficulties having a comfortable bowel movement every 1-2 days.
- A log of bowel movements and related symptoms will be very helpful to your health providers.
2. If an older person with Alzheimers or another dementia is acting out, consider the possibility of constipation.
3. Be sure to speak up if youve noticed any alarm symptoms.
- The main ones to look for are red blood in the stool, black or tarry stools, unintended weight loss, and new or worsening symptoms.
4. An initial evaluation of constipation should include the following:
- A review of concerning symptoms
- A review of diet, fiber, and fluid intake
- Checking for medications that cause or aggravate constipation and making sure that any prescribed iron is really necessary
5. Most garden-variety constipation can be effectively managed through a combination of lifestyle changes, deprescribing constipating medications, and using over-the-counter laxatives.
6. It is often ok to use OTC oral laxatives daily or regularly.
- Many older adults will need to use OTC laxatives to maintain regular bowel movements.
- There is no credible evidence that its harmful to use OTC oral laxatives long-term.
9. Its best to have a bowel maintenance plan and also a rescue plan.
How To Use An Enema Safely
A Step-by-Step Guide on Proper Usage
An enema is an injection of fluid through the rectum that cleans stool out of your bowel or stimulates your bowel so it will empty. It’s a common, long-time treatment for constipation, which can make it hard to pass stool. Enemas also are helpful before bowel surgery and for diagnostic procedures like a colonoscopy.
You can give yourself an enema at home, using a kit with an enema bottle or enema bag. Or, it may be done by a nurse or other healthcare professional.
This article looks at how to use an enema at home. It also discusses why they’re used, potential problems, and when you shouldn’t use them.
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The Laxative Myth You Shouldnt Believe
People often have concerns about using laxatives more than occasionally, because theyve heard this can be dangerous, or risky.
This is a myth that really should be dispelled. Although medical experts used to worry that chronic use of laxatives would result in a lazy bowel, there is no scientific evidence to support this concern.
In fact, in their technical review covering constipation, the American Society of Gastroenterology notes that Contrary to earlier studies, stimulant laxatives do not appear to damage the enteric nervous system.
Lifestyle changes and over-the-counter oral laxatives are the approaches endorsed as the first-line of constipation therapy, by the American Gastroenterology Society and others. There are no evidence-based guidelines that caution clinicians to only use laxatives for a limited time period.
The four types of OTC laxatives that Ill cover in the next section have been used by clinicians and older adults for decades, and when used correctly, are considered safe and do not seem to cause any long-term problems.
Thats not to say that they should be used willy-nilly, or in any which way. You absolutely should understand the basics of how each type works, so lets cover that now.
How To Prepare An Enema At Home
Follow these steps to prepare an at-home enema:
An enema should take an hour or less to work.
What Is A Fleet Enema
A Fleet enema is liquid medicine used to help you have a bowel movement. You may need the enema to relieve constipation. An enema may also be used to clean out your bowel before you have a procedure or surgery. This enema is available at drugstores without a prescription. Your healthcare provider will tell you which kind to get and how often to use it.
How Much Fiber Do You Need Per Day
The Institute of Medicine of the National Academies recommends 38 grams of fiber for adult men and 25 grams of fiber for adult women.
Laxatives are grouped into the following categories:
*Source: Young, Frank E. Heckler, Margaret M. PA OTC Compilation, Part I. Federal Register Vol. 50:No.10, 106-113, January 15, 1985.
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When To Seek Medical Attention
Medications Associated With Constipation
Several commonly used medications can cause or worsen constipation in older adults. They include:
- Anticholinergics, a broad class which includes sedating antihistamines, medications for overactive bladder, muscle relaxants, anti-nausea medications, and more.
- Opiate painkillers, such as codeine, morphine, oxycodone
- Some forms of calcium supplementation
- Some forms of iron supplementation
Its not always possible or desirable to stop every medication associated with constipation. If a medication is otherwise providing an important health benefit and theres no less constipating alternative, we can continue the medication and look for other ways to improve bowel function.
Still, its important to consider whether any current medications can be deprescribed, before deciding to use laxatives and other management approaches.
If opioids are absolutely necessary to manage pain , a special type of medication can be used, to counter the constipating effect of opioids in the bowel. This is generally better than depriving a person of much-needed pain medication.
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What The Research Says About Enemas
There are plenty of holistic and nontraditional advocates for enemas as a beneficial method for internal cleansing. For Western medicine at large, the verdict is still out on whether regularly administered home enemas have proven benefits. Not much conclusive research has been done into their long-term health benefits. The occasional use of enemas for colon irrigation and relief of constipation will most likely not harm you, as long as your equipment is sterile and you follow directions carefully. But keep in mind that administering enemas has risks.