Should you use enemas for constipation or IBS-C?
Do you feel like your body is full of poop and you just want it out fast?
Have you heard about enemas or considering them to help clean everything out so you can feel good again?
Likely, that’s what led you to this blog post. As a huge disclaimer, I am a healthcare provider (dietitian!) and I do not administer enemas. This means I do practice evidence-based care in my work and I do like to consider all sides of health with any recommendation I make. This also means I don’t benefit if you choose to move forward with an enema because I’m not selling them or profiting from them.
With that said, my goal for this article is to simply share what enemas are, how they work for those with constipation and irritable bowel syndrome (IBS), and what to consider as you decide what to do with your own body.
What are enemas?
An enema is a medical procedure used to introduce fluids into the rectum and colon through the anus. The rectum is the end of the large intestine where your poop is formed and stored until it’s time to evacuate.
Your anus is the opening of your body where you empty poop from the rectum and out of your body. This can be done for various reasons, including bowel cleansing, constipation relief, and medication administration.
Enemas work by stimulating bowel movements, softening stool, and promoting the evacuation of waste from the lower gastrointestinal tract. It is most often used for “cleansing” as the fluid added during the enema flushes out the the colon to clear out all stool and waste that’s there.
This is really attractive for those with chronic constipation because when you get backed up for many days, it can feel like your body is weighed down, uncomfortable, and that you’re unable to clear the backup on your own.
Types of enemas
There are different types of enemas, each serving a specific purpose. Here are some common types:
Cleansing Enema:
Purpose: Used to clear the lower bowel of fecal matter and prepare for medical procedures or examinations.
Solution: Typically involves using a saline solution, soapsuds, or other specialized enema solutions.
Retention Enema:
Purpose: Administer medication, nutrients, or other therapeutic substances that need to be retained in the colon for a longer period.
Solution: May include medications, oil-based solutions, or specialized mixtures based on the intended therapeutic effect.
Carminative Enema:
Purpose: Designed to relieve gas and bloating by introducing substances that help expel excess gas from the colon.
Solution: Often involves introducing a mixture containing substances like water, baking soda, or simethicone (helps break up gas bubbles).
Barium Enema:
Purpose: Used for diagnostic imaging of the colon, often to detect abnormalities such as polyps or tumors.
Solution: Contains barium sulfate, which is visible on X-rays, allowing for better visualization of the colon during imaging.
Oil Retention Enema:
Purpose: Helps lubricate and soften stool, making it easier to pass in cases of constipation.
Solution: Typically involves introducing mineral oil or other oil-based substances.
Coffee Enema:
Purpose: Use coffee to clear out the colon and stimulate more bowel movements with the purpose of bowel cleansing.
Solution: Coffee made with filtered water.
What about colonics?
Colonics are similar to enemas, but enemas involve a one-time infusion of water into the colon and colonics involve multiple infusions.
Enemas also typically clear out the lower part of the colon, focusing on the rectum, while colonics clear out more of the large intestine. These are very similar in their goals and in the considerations shared in the remainder of this article.
Want to learn more about IBS? Sign up for a free IBS mini course here!
What to consider with enemas and colonics
If your goal is eliminating constipation and backed up stool, enemas may seem like a perfect solution. However, these don’t come without risks so there are things to consider before making this part of your treatment plan.
As we go over considerations, know that we will be discussing enemas that clear out versus those that are used for tests or medications.
Who is administering the enema/colonic?
While some of these enemas have become available for people to administer themselves, these are still considered medical procedures. When these tubes and devices are inserted through the anus, there can be risk of perforation or physical damage to the tissue surround the anus and inside of the rectum.
This risk may be increased more for individuals that are at a higher risk, including those with chronic symptoms, IBS, IBD, and hemorrhoids or fissures. If you are doing this yourself or by someone who may not have experience with these increased risk, you could find yourself with damage that then needs specialized care to heal and resolve.
Are the benefits short term or long term?
This is a question I like to ask for any intervention that is recommended for constipation.
For some, clearing out backup will actually lead to long term results, because the backup was temporary due to a specific reason.
For those who struggle with chronic constipation and slow motility, clearing out backup doesn’t resolve the problem. You may get temporary relief as you are empty, but your gut will remain slow and get backed up again.
In these cases, the extreme clear out may actually disrupt the muscles of the colon more, leading to slower movement and more constipation. A good rule of thumb is that if you find yourself needing the enema or colonic over and over… maybe it’s not actually benefiting you.
What’s happening to your gut microbes?
Your gut microbiome is the makeup of microbes in your gut, primarily located in the colon. When your microbiome is diverse and made up of more beneficial microbes versus harmful microbes, this is the marker of gut health and overall health.
Enemas and colonics do clear out waste and poop. They also clear out microbes. Sometimes your body can bounce back and replenish microbes that have been lost.
In those with chronic gut issues and those who are clearing the gut more frequently (with enemas, colonics, antibiotics, “killing” supplement protocols), the gut may not bounce back and may instead be left with less diversity and more pathogenic microbes.
This would lead to more digestive symptoms and poor motility, which worsens constipation.
Should you get an enema?
If you are considering enema use, weigh the pros and cons for your specific case. Ask questions from the provider who will administer the enema and consider your entire strategy, ensuring you have more in place beyond this one option.
If you are feeling stuck in your care and need support to get control of your symptoms, working 1:1 with one of our Gutivate dietitians may be a good fit for you!
Do you want clear guidance to manage your IBS so you can feel confident in your body again?
Are you frustrated with your IBS symptoms? Do you desire to be confident in your food choices? Do you want to have a healthier relationship with your body and diet? Are you ready to take control of your IBS?
