How exactly does an enema work and how effective are they? Those seeking ways to improve their health, comfort, and well-being often turn to enemas as one way to clear the colon and lighten their toxin load.
Enemas have long been a common method for colon cleansing and relief of digestive issues such as constipation and the cramping and discomfort that accompanies it.
Enema administration has been a common practice in hospitals for decades. They’ve been used in home environments for generations. In the 1600’s, members of the Royal Court of France were expected to have the procedure almost daily.
Today, traditional and not-so-traditional recipes and formulas for enemas often make choosing one that safe and effective challenging.
As such, understanding how enemas work, what they do, and how they benefit health and wellness are a relevant and timely topic of discussion.
But before seeking one type of enema formula over another, it’s important to understand colon function, how enemas are given, and safety issues associated with use.
How Does an Enema Work?
Use of enemas to promote colon cleansing has been practiced for generations and is considered an acceptable method for colon cleansing and relief of constipation – when done correctly.
Enemas work by flushing the lower colon with a fluid solution that hydrates and soften fecal remnants and promotes evacuation, relieving abdominal cramps caused by constipation.
While frequency and timing of bowel movements differs among individuals, going more than three days without a bowel movement increases the risk of constipation. The longer fecal matter remains in the colon, the harder it gets, making it difficult to pass.
In one study of Soap Suds Enemas, they were reported to work with an 82% rate of efficacy in patients suffering from abdominal pain due to fecal impaction. Different solutions are used to trigger the need to go to the bathroom.
According to one source, constipation is often caused by:
- Changes in diet
- Lack of hydration
- Overuse of laxatives
Enemas are also a method to promote colon cleansing for detoxification. Colon cleansing is believed to be beneficial in improving the efficacy of the digestive system, maintaining regularity, and improving the body’s ability to absorb vitamins and nutrients.
Routine colon cleansing, also known as colonic irrigation, is a controversial practice. The medical community in general deems it unnecessary, believing that the body is capable of removing bacteria and waste by itself.
Little evidence exists regarding the efficacy of colon cleansing through enemas to remove toxins, boost immune system health or energy.
Brief History of Use
Use of enemas to achieve colon cleansing and gut health is not new. Early historical writings from countries around the world regarding practice of enema usage has been found dating back to 1500 B.C.
Mention of enemas is found in great literary works including those of Shakespeare. In pre-revolutionary France, it was common for people to take an enema after dinner; at the time it was considered a way to maintain health and wellness.
Louis XIV was reported to have undergone thousands of enemas over the course of his life. They were believed to have wide-ranging benefits for optimal health and hygeine.
Colon-cleansing enemas are still considered beneficial, when done safely and appropriately. Consult with a qualified healthcare practitioner to determine whether this is an appropriate treatment for you.
Important Facts About Colon Function
Understanding how the colon works is important for those considering enemas for relief of constipation or colon-cleaning benefits.
Enemas have long been an accepted method for promoting colon health. The colon, also known as the large intestine, contains massive numbers of microorganisms.
These microorganisms are vital for breaking down residual components of food and other body waste that has not been absorbed by the small intestine or digested and used by the body for energy.
The large intestine secretes mucus that protects the walls of the colon and aids in stool formation.
An automatic process in the body known as peristalsis moves fecal waste, which eventually forms into a stool, through the colon in wave-like movements. These periods of movement occur roughly several times a day.
Fecal matter moves through the colon until it reaches the rectum. Sensory fibers in the rectum trigger sensations of contraction and relaxation and trigger the automatic reflex for defecation. This reflex occurs when feces enter the rectum.
Certain factors can influence peristalsis and slow down movement of the fecal matter through the colon. Constipation is caused by decreased secretions of mucus in the colon, leading to hard stool formation and greater difficulty passing the stool.
The gastrointestinal tract and its functions can affect – and is affected – by numerous factors including use of medications, an illness, or a disease process.
When to Give an Enema
Most physicians today don’t recommend an enema on a daily basis because it has the potential to irritate the bowel. Used occasionally, enemas have been deemed beneficial in a number of scenarios.
One of the most common reasons for enema administration is the relief of constipation, although many form of colon irritation used will typically only be able to cleanse the lower bowel.
There are types of enema procedures used to reach the upper colonic area, but many first-time users start with a standard lower rectum therapy.
For increased efficiency, taking a laxative the night before the enema administration may prove beneficial.
The overall purpose of an enema is to cleanse and flush out the colon. In addition to the relief of constipation, these cleanses have been used to relieve fatigue, headaches and backaches.
Cleansing enemas are used to stimulate peristalsis or movement of fecal matter through the large intestine. The solution is held in approximately 15 minutes – or longer if possible – which is usually adequate to expel hard fecal matter.
Not all enema formulas, solutions, or home kits today contain the same ingredients. One enema administration may be effective in relieving occasional bouts of constipation for some while others may require several administrations.
Little conclusive scientific research has been conducted regarding the benefits of daily or weekly colon cleansing. However, risks of harm are low as long as sterility of components and directions are carefully followed.
Even so, administration of enemas does come with some risk.
Overuse of enemas can trigger irritation, inflammation, or tissue damage to the anus and rectum or cause irritation to the lining of the colon. Risks increase with the frequency of enema administration, along with lack of properly cleansed tubing.
Colon cleansing for constipation is not recommended more than one time daily, preferably at the same time to promote evacuation.
Watch for bleeding or blood in the stool, which is often an indication that some tissue damage has occurred.
Overuse of enemas can increase risk for dehydration. Dehydration can trigger changes in chemical balances involved in metabolic processes. It can also pose dangers for those diagnosed with any form of kidney or heart disease. 
A wide variety of home preparation formulas and pre-prepared enema kits are available over-the-counter from pharmacies. Some contain harsher ingredients than others.
Use of enemas on younger and healthy populations poses little risk or adverse reactions. However, use on elderly, frail, or older individuals or those diagnosed with chronic illnesses may prove more harmful than beneficial.
Insufficient evidence exists as to the benefits of long-term use of enemas for evacuation of the bowels, for colon cleansing, or for relief of chronic symptoms of gastrointestinal issues such as irritable bowel syndrome.
Traditional medical approaches to chronic constipation recommend change in diet, increased fiber intake, hydration, and increased activity. Use of probiotic supplements can also help.
However, when recommended and in cases where response to such approaches fails, occasional use of enemas, stimulant laxatives, polyethylene glycol may be indicated. 
If symptoms persist following enema administration, or severe abdominal pain is present and a bowel movement hasn’t occurred in the past few days, seek medical attention, as a fecal impaction is a possibility – and a dangerous situation that requires immediate medical attention.
Use of enemas to relieve constipation or occasional cleansing of the colon is relatively safe and doesn’t cause any ill side effects.
Before and after enema administration, focus on hydration is recommended to reduce risk of dehydration.
Individuals experiencing chronic constipation or other gastrointestinal issues should consult with their medical provider or a healthcare professional to determine whether an enema is indicated.
Learning how an enema works is important for anyone considering use.
- Michael F. Picco, M.D. Is colon cleansing a good way to eliminate toxins from your body? Mayo Clinic
- Mearin F, Ciriza C, Mínguez M, Rey E, Mascort JJ, Peña E, Cañones P, Júdez J. Recommendations on chronic constipation (including constipation associated with irritable bowel syndrome) treatment. Can J Gastroenterol. 2007 Apr; 21(Suppl B): 3B–22B.