An enema is the cleansing of the colon or large intestine. It involves the injection of a solution into the rectum to soften the feces, distend the colon and rectum, and thereby cause the easy emptying of the bowel. An enema is often given for relieving constipation, cleanse the colon or part of a body detoxification program.

The solution most commonly used is a mixture of mild soap and approximately a liter or two of warm water that is placed in a container with a flexible tube and enema nozzle. The end of the nozzle will be lubricated and inserted into the rectum, after which the solution will be slowly administered.

Temperature?

Most people find that a warm water enema can be held more easily than a cold one. Some people use a cool water enema when they need to force out water and material that is stuck in the bowel. The temperatures given are that of the water as it is poured into the bag. It cools off some before it gets into the colon. Don't try to judge temperature with your fingers, they're too unreliable. If you don't want to use a thermometer, use your tongue! It's a fairly reliable reference for body temperature. Cool water is 30 - 35 degrees C ( 86 - 95 degrees F ) Warm water is 40- 42 degrees C ( 104 - 108 degrees F ) Hot water is 43 - 45 degrees C( 110 - 113 degrees F ) Don't take water any hotter than 45 C or 113 F or you can scald the colon. You can take it as cold as you can stand, some take crushed ice enemas, but I suspect most people couldn't even accept water that cold into their bowel.

Anatomy of the Colon?

Please see the following diagram of the colon.

Positions?

There are many positions in which an enema can be taken. Two of the most widely known are the "Sims" position and the "Knee-Chest" position. The Sims position has the recipient lying on the left side, with the right knee brought up near the chest. The Knee-chest position has the enema supported by the knees and the shoulders, with the chest sagging down, so that the chest almost touches the floor. This places the abdomen nearly upside down, so that the water can flow down from the rectum to the transverse colon by gravity. In cases of deep-seated constipation, this position will help the water reach way up into the colon for a good cleaning out. It is also useful in a technique for floating air or gas in the colon above the water so that the air can be expelled.

Lying on the back is a favorite position, especially for the first enema of a session. You can watch the bag slowly deflate, and you can also watch the abdomen expand as the water enters the colon. You should lie down so that you can prop your head against a wall, like a pillow. You will probably be most comfortable if the knees are raised. You will first see the belly swell very low, just above the crotch, as the sigmoid expands. Then you will see the left side start to bulge as the water enters the descending colon. You will be in a position to massage the bowel as well as feel the shape and position of your colon.

Lying face down can be used, but pressing the belly on the floor restricts the abdomen's need to expand

Lying face down and arching the back by raising the upper body on the elbows is a very stimulating position, and lifts the belly up from the floor. This presses the genital area against the floor, and leaves the hands free to massage the breasts, etc.

Lying on the right side is the opposite of the Sims position, and causes the water to flow down into the cecum. When you do this, feel the ballooning out of the cecum, the part of the colon with the largest diameter.

Standing on the head uses gravity to force the water down into the transverse colon, which usually needs a good cleaning out anyway, but especially if you are quite constipated.

Reclining in the bathtub is quite comfortable, except that the tub may be cold. You don't have to worry about leakage here.

Leaning over the edge of the bathtub is similar to getting on your hands and knees, but it leaves your hands and arms free, and is a little easier to stay in that position for a while.

Capacity?

Every individual has his or her own capacity, and it will change from each enema to the next. The cleanliness of the colon and the amount of gas present will have a great effect on the volume of water that can be taken. Medical researchers have determined that the average adult human colon has a capacity of 7 quarts. I believe that this measurement may have been made using colons removed from cadavers, who wouldn't complain about the pressure. It may be that the average colon has this capacity, but that no one except a woman who has just delivered a baby has that much room in the abdomen to allow the colon to expand to its fullest. You may want to experiment with this by taking the largest enema that is comfortable, and then rolling from side to side very slowly and seeing if the water runs downhill to distend the lower side more. You probably will find that the lower part of the colon will be noticeably more swollen, indicating that it is your abdomen that is unable to expand to allow the colon to accept any more fluid.

Retention?

Most people will find it difficult to retain an enema for more than 5 minutes. If the bowel is not clean, then the peristaltic action of the colon will push against the fecal masses and produce intense pressure. This will frequently happen with your first enema in a series. Not much to do but expel and try again. If you get a strong cramp and an urge to expel, getting up is the worst thing you can do. Making the descending colon vertical adds gravity to the force pushing out. This is how to have an accident. If you can, wait while lying down. The pressure will pass in 10-15 seconds as the wave of peristalsis passes the sigmoid colon and reaches the end. Then you can get up and expel without straining to hold it in. If you must go to the toilet, and the pressure is intense, you can hold the buttocks together with both hands. This helps the anal muscles keep it in.

Another method is to lie on your back, and massage the colon with both hands. Whenever you feel pressure building, or can feel a big bulge with your hands, massage around that area until the pressure relaxes.

Some people recommend rolling from one side to the other every minute or so. The idea is that the water will flow repeatedly downhill, alternately filling the descending and sigmoid colon and then running down to the cecum. This is supposed to break up any masses in the transverse.

Expulsion?

Most people will find it difficult to retain an enema for more than 5 minutes. If the bowel is not clean, then the peristaltic action of the colon will push against the fecal masses and produce intense pressure. This will frequently happen with your first enema in a series. Not much to do but expel and try again. If you get a strong cramp and an urge to expel, getting up is the worst thing you can do. Making the descending colon vertical adds gravity to the force pushing out. This is how to have an accident. If you can, wait while lying down. The pressure will pass in 10-15 seconds as the wave of peristalsis passes the sigmoid colon and reaches the end. Then you can get up and expel without straining to hold it in. If you must go to the toilet, and the pressure is intense, you can hold the buttocks together with both hands. This helps the anal muscles keep it in.

Another method is to lie on your back, and massage the colon with both hands. Whenever you feel pressure building, or can feel a big bulge with your hands, massage around that area until the pressure relaxes.

Some people recommend rolling from one side to the other every minute or so. The idea is that the water will flow repeatedly downhill, alternately filling the descending and sigmoid colon and then running down to the cecum. This is supposed to break up any masses in the transverse.