Inserting liquids into the rectum and colon via the anal opening is knows as enema. In medicine, enema is used for both, treatment and diagnostic purposes. Enema is also frequently misused for various other purposes. Various medically appropriate uses of enema are described in this article.
The inserted liquid via the anal opening causes expansion of the rectum and lower portions of the colon. This causes a feeling of extreme urgency to pass stool. Passing stool results in nearly complete evacuation of rectum and lower colon. Constipation is one of the most common indications for the use of enema.
Enema with a solution of immunomodulator drugs like corticosteroids is sometimes used for treatment of ulcerative colitis.
Imaging of Bowel
Barium Enema is used for imaging of the lower segments of the bowel (rectum and colon). Barium sulfate solution functions as a contrast agent that can be seen on radiographs.
Prior to Sigmoidoscopy/Colonoscopy
Enema is used for cleansing the lower segments of gastrointestinal tract before the endoscopic examination (Sigmoidoscopy or Colonoscopy).
Other than the above listed uses, enemas are sometimes misused for variety of other purposes. Such misuse of enema is risky and is discouraged.
The paraphilia in which sexual arousal is received from enema is known as klismaphilia. The person having such paraphilia should use correct technique while administering enema. Experimenting with new techniques or administering increased quantity of liquids might be life-threatening sometimes.
Enema is also used for cleansing the anal canal and rectum before anal intercourse. They may also be used as a part of BDSM activities. Enemas for such activities should not be used regularly as it may be harmful for the anal cavity and the rectum. Moreover, only plain luke-warm water should be used for administering enema.
Administer Recreational Drugs/Alcohol
Many drugs, including alcohol are absorbed rapidly from the colon. Moreover, the absorbed drugs directly reach bloodstream without being first metabolized in the liver. This results in higher levels of drug/alcohol concentration in the blood. Alcohol enema is most frequently abused and this practice should be discouraged. Numerous hospitalizations and even deaths have been reported because of alcohol enema.
As a "Detox" Therapy
Many different types of enemas are being "promoted" as a method to detoxify the body of "harmful" chemicals. Examples of such detox therapies are coffee enemas and colon cleansing. Such practices have not been proven to have any benefit. Moreover, they have required hospitalization on numerous occasions because of the side effects. Coffee enema is particularly dangerous and deaths have been reported because of it.
Adverse Effects of Enema
Most commonly, repeated enemas cause electrolyte imbalances. Enema may also sometimes cause reflex vagus nerve stimulation which may cause lowering of the heart rate. Severe vagal response may cause dizziness or fainting due to profound lowering of the heart rate (bradycardia). More severe complications like rupture of lower bowel segments are rare if enema is correctly administered and the person receiving enema is not already suffering from any bowel disease.
Coffee enemas are sometimes associated with much more severe complications like severe electrolyte imbalance, septicemia, internal burning of the rectum and colon, inflammation of the bowel wall and even brain abscess. As already mentioned, deaths have been reported because of coffee enemas.