de Boer AG, Moolenaar F, de Leede LG, Breimer DD (1982). "Rectal drug administration: clinical pharmacokinetic considerations". Clin Pharmacokinet. 7 (4): 285–311. doi: 10.2165/00003088-198207040-00002. PMID 6126289. S2CID 41562861. Neil A. Lewis (1 January 2005). "Fresh Details Emerge on Harsh Methods at Guantánamo". Archives – 2005. The New York Times . Retrieved 20 April 2019. The truth about chlorine dioxide and other miracle cures for autism". Health24. 11 November 2015 . Retrieved 24 March 2019. Patients who have a bowel disability, a medical condition which impairs control of defecation, e.g., fecal incontinence or constipation, [51] can use bowel management techniques to choose a predictable time and place to evacuate. [51] Without bowel management, such persons might either suffer from the feeling of not getting relief, or they might soil themselves. [51] In the vastly influential Argentine text Facundo, or Civilization and Barbarism, for example, Domingo Faustino Sarmiento describes the use of pepper and turpentine enemas by police forces as a way of discouraging political dissent in post-independence Argentina. [152] Turpentine enemas are very harsh purgatives. [153]

A coffee enema can cause numerous maladies including infections, sepsis (including campylobacter sepsis), severe electrolyte imbalance, colitis, polymicrobial enteric sepsis, proctocolitis, salmonella, brain abscess, and heart failure, [119] [120] [121] [122] [123] [124] [125] [126] [127] and deaths related to coffee enemas have been documented. [128] Richter JM, Arshi NK, Oster G. Oral 5-Aminosalicylate, Mesalamine Suppository, and Mesalamine Enema as Initial Therapy for Ulcerative Proctitis in Clinical Practice with Quality of Care Implications. Can J Gastroenterol Hepatol. 2016;2016:6928710. doi:10.1155/2016/6928710 Portalatin M, Winstead N. Medical management of constipation. Clin Colon Rectal Surg. 2012;25(1):12–19. doi:10.1055/s-0032-1301754 a b c Denko, JD. (April 1976). "Amplification of the erotic enema deviance". Am J Psychother. 30 (2): 236–55. doi: 10.1176/appi.psychotherapy.1976.30.2.236. PMID 937588.de Vries, Henry J.C.; van der Bij, Akke K.; Fennema, Johan S.A.; Smit, Colette; de Wolf, Frank; Prins, Maria; Coutinho, Roel A.; MorrÉ, Servaas (2008). "Lymphogranuloma venereum proctitis in men who have sex with men is associated with anal enema use and high-risk behavior". Sexually Transmitted Diseases. 35 (2): 203–208. doi: 10.1097/OLQ.0b013e31815abb08. PMID 18091565. S2CID 2065170. The administration of substances into the bloodstream. This may be done in situations where it is undesirable or impossible to deliver a medication by mouth, such as antiemetics given to reduce nausea (though not many antiemetics are delivered by enema). Additionally, several anti-angiogenic agents, which work better without digestion, can be safely administered via a gentle enema. ATC code A06 Drugs for constipation is a therapeutic subgroup of the Anatomical Therapeutic Chemical Classification System, a system of alphanumeric codes developed by the World Health Organization (WHO) for the classification of drugs and other medical products. [23] [24] [25] Subgroup A06 is part of the anatomical group A Alimentary tract and metabolism. [26]

Normal saline is least irritating to the colon. Like plain water, it simply functions mechanically to expand the colon, but having a neutral concentration gradient, it neither draws electrolytes from the body, as happens with plain water, nor draws water into the colon, as occurs with phosphates. Thus, a salt water solution can be used when a longer period of retention is desired, such as to soften an impaction.

a b "Colon Therapy". American Cancer Society. 11 January 2008. Archived from the original on 24 April 2015 . Retrieved 13 May 2011. Nicholls, Pam Hufford; Metules, Terri J (April 2001). "Some old-fashioned enemas still work and are still used". RN. 64: 80. Weitzman S (1998). "Alternative Nutritional Cancer Therapies". International Journal of Cancer. 78 (S11): 69–72. doi: 10.1002/(SICI)1097-0215(1998)78:11+<69::AID-IJC20>3.0.CO;2-7. PMID 9876483. S2CID 20633344. Make sure the person receiving the enema is relaxed and calm. It is much harder to insert the enema and its contents if the muscles are too tight. There might be some liquid leaking out, therefore the towels will make cleanup much easier. Equal parts of milk and molasses heated together to slightly above normal body temperature have been used. [18] Neither the milk sugars and proteins nor the molasses are absorbed in the lower intestine, thus keeping the water from the enema in the intestine. [19] Studies have shown that milk and molasses enemas have a low complication rate when used in the emergency department [20] and are safe and effective with minimal side effects. [21]

As bowel stimulants, enemas are employed for the same purposes as orally administered laxatives: to relieve constipation; to treat fecal impaction; to empty the colon prior to a medical procedure such as a colonoscopy. When oral laxatives are not indicated or are not sufficiently effective, enemas may be a sensible and necessary measure. [9] If you get any of the solution on uncovered skin, you should wash the area with cold running water for at least 10 minutes.Sodium phosphate. [37] [38] Also known by the brand name Fleet. Available at drugstores; usually self-administered. Buffered sodium phosphate solution draws additional water from the bloodstream into the colon to increase the effectiveness of the enema. But it can be rather irritating to the colon, causing intense cramping or "griping." [39] Fleet enemas usually causes a bowel movement in 1 to 5 minutes. Known adverse effects.

This is different from klismaphilia, in which the enema is enjoyed for itself and as a part of sexual arousal and gratification. [143] Raqib, R.; Sarker, P.; Mily, A.; Alam, N. H.; Arifuzzaman, A. S.; Rekha, R. S.; Andersson, J.; Gudmundsson, G. H.; Cravioto, A.; Agerberth, B. (10 May 2012). "Efficacy of sodium butyrate adjunct therapy in shigellosis: a randomized, double-blind, placebo-controlled clinical trial". BMC Infectious Diseases. U.S. Department of Health & Human Services, National Institutes of Health (NIH). 12: 111. doi: 10.1186/1471-2334-12-111. PMC 3447723. PMID 22574737. Mineral Oil rectal enema". Drugs, Devices & Supplements. Cleveland Clinic . Retrieved 1 April 2019.An international consensus on when and how to use transanal irrigation for people with bowel problems was published in 2013, offering practitioners a clear, comprehensive and simple guide to practice for the emerging therapeutic area of transanal irrigation. [50] Sykes, Nigel P. (2011). "Constipation during active cancer therapy". Supportive Oncology. pp. 177–186. doi: 10.1016/B978-1-4377-1015-1.00018-7. ISBN 9781437710151.