Enema Side Effects

Enemas are used to relieve constipation when laxatives or dietary measures aren't working. A cleansing enema also is used to clear out the colon before a colonoscopy or other test. In traditional Chinese medicine, retention enemas may be used as part of treatment.

While they can be safe and effective, water enemas have side effects, as do mineral oil products when used at home and/or used too frequently. Sometimes, they can cause serious complications such as bowel perforation or sepsis, a life-threatening condition due to infection.

This article will explain when enemas are used, as well as the risks and possible complications of using them. It will also offer alternative ways to reduce constipation.

Safe Use of Enemas

Enemas work by getting fluid into your large intestine so it can soften up your stool and help it pass. The fluid is administered into the rectum and large intestine through the anus. Enemas are used for a variety of reasons:

• Before tests: One or more enemas might be used before having a test such as a colonoscopy, to clear the large intestine of all stool.
• During imaging of the colon: To get the large intestine to show up better on imaging, healthcare providers use barium enemas. Barium is a metallic substance that coats the lining of your colon. This makes it easier to detect abnormalities, such as colon cancer.
• To deliver medication: Certain medications can be delivered directly to the rectum or the sigmoid colon (the lowest part of the large intestine) as a treatment for conditions such as inflammatory bowel disease (IBD).
• To relieve constipation: Enemas can effectively relieve occasional constipation when nothing else works.
  

Plain water is used in some enemas but be sure to use a reputable product rather than making them at home. In some cases, the liquid used in an enema is just salt water or water mixed with baking soda. Some enemas contain a laxative.

Water Enema Side Effects

Water enemas can lead to side effects, which is a risk with all enema products. These side effects can include:

• Nausea and vomiting
• Abdominal pain or swelling
• Cold sweats
• Palpitations
• Dizziness

A study of warm water-based enema use (as well as saline enemas) in children before colonoscopy, followed by a single laxative before the procedure, found fewer of these side effects than in children who received more mineral oil laxative products.

Side effects also depend on other factors, including underlying health conditions and age. In older adults, warm water enemas may be needed to treat fecal impaction or prepare for a procedure.

Water-based enemas are generally safer than soapy enemas that can damage the lining of the colon. They also can limit the effects of electrolyte imbalance.

Oli-Based Enema Side Effects

The side effects of enemas that contain mineral oil (like Fleet brands) are similar to other adverse reactions to an enema. You may experience stomach cramping or pain, or have nausea and diarrhea. This also can occur with a glycerin laxative.

When you use a mineral oil enema, watch out for oily leakage from your rectum and general rectal irritation.

Some people may have a more serious and systemic allergic response to oil-based enemas. People with a latex allergy, for example, should choose a latex-free product.

Call your healthcare provider or contact 911 if you experience:

• A skin rash
• Itching or hives (urticaria)
• Swelling of the face, lips, or tongue
• Difficulty breathing

Stop using a mineral oil enema if you don't have a bowel movement within 15 minutes, and contact your healthcare provider for directions. Keep in mind, though, that how fast an enema or laxative works will depend on the specific product, like the 60-minute window for glycerin products (often used for children).

In older adults, mineral oil is considered a safer enema choice than phosphate enemas. Some products are sodium-free.

Interactions

Enema products do have a few known drug interactions, often with drugs that regulate fluid and electrolytes in your body or affect the kidneys (since enema products shift your body's fluids to aid in passing stool).

These medications can include nonsteroidal anti-inflammatory drugs (NSAIDs) and diuretics like Lasix (furosemide). They also can include the following blood pressure medications:

• Angiotensin converting enzyme (ACE) inhibitors
• Angiotensin receptor blockers (ARBs)

Complications and Warnings

Using an enema at home always comes with certain risks. An enema-related perforation is rare but it can result in serious and potentially fatal injury, including sepsis (a serious blood infection).

Other risks may include:

• Damage to or perforation (puncturing) of rectum or intestines due to stretching
• Disruption of the natural microflora in your gut
• Pain caused by using liquid that is too hot or cold
• Introducing too much liquid, which may stay in the body and come out without warning
• Infection introduced by equipment that's not sterile. This is especially a problem for people with autoimmune diseases or an otherwise compromised immune system.

Safe Alternatives

Water-based enemas and mineral oil enemas should be a last resort for treating constipation. In most cases, constipation can be relieved with lifestyle changes, such as:

• Adding fiber to your diet
• Exercising
• Drinking more water

Over-the-counter laxatives may be an option for you, but they also come with risks. Talk to your healthcare provider about them, especially if you have regular constipation.

Summary

Enemas work by releasing liquid into the colon and large intestine via a tube inserted into the anus. Enemas are used before tests such as a colonoscopy, which requires a clear view of the colon. They are also used to relieve constipation when other measures have not been successful.

Enemas can create a health risk when performed at home or repeatedly. They must be used under the supervision of a healthcare provider to avoid complications. Keep in mind that in some cases constipation can be a sign of a serious condition, such as neurological problems or colon cancer.

Always talk to your healthcare provider before attempting to give yourself an enema at home. They can provide information about lifestyle changes, medication, and other interventions to improve digestion.