Enema
An enema (plural enemata or enemas) is the procedure of introducing liquids into the rectum and colon via the anus. Enemas can be carried out for medical reasons, as part of alternative therapies, and also for erotic purposes, particularly as part of BDSM activities. In earlier times, they were often known as clysters.
Medical usage
The main medical usages of enemas are:
- As a laxative. The patient expels feces along with the enema in the toilet after administration. Enemas may be used to relieve constipation and fecal impaction, although in many medical settings their use has been largely replaced by oral laxatives and laxative suppositories. Laxative enemas may consist of water, which works primarily as a mechanical laxative; sodium phosphate solution, which draws additional water from the bloodstream into the colon and increases the effectiveness of the enema; or mineral oil, which functions as a lubricant and stool softener. Other types of solutions are available as well. In the past soap was a common additive to enemas, but it has largely fallen out of use because of the risk of chemical-induced colitis as well as the ready availability of other enema preparations that are more effective than soap.
- Cleaning the lower bowel prior to a medical or surgical procedure such as sigmoidoscopy or colonoscopy. Enemas used for this purpose are commonly the sodium phosphate variety.
- The administration of substances into the bloodstream. This may be done in situations where it is undesirable or impossible to deliver a medication by mouth, such as antiemetics given to reduce nausea (although it should be noted that not all antiemetics are delivered by enema). An enema may also be used for hydration purposes. See also route of administration.
- The topical administration of medications into the rectum, such as corticosteroids and mesalamine used in the treatment of inflammatory bowel disease. Administration by enema avoids having the medication pass through the entire gastrointestinal tract, therefore simplifying the delivery of the medication to the affected area and limiting the amount that is absorbed into the bloodstream.
- A barium enema is used as a contrast substance in the radiological imaging of the bowel.
Most enemas are packaged in single-use bottles that come with a nozzle attached to the top. Some enemas are administered using disposable bags connected to disposable tubing. In medical settings reusable enema equipment is now rare because of the difficulty and expense of disinfecting it. For home use disposable bottles are common, but reusable rubber or vinyl bags or enema bulbs may also be used. In former times, enemas were frequently administered using clyster syringes.
In certain countries such as the United States, enema usage went well into the 20th century; it was thought a good idea to cleanse the bowel in case of fever; also, pregnant women were given enemas prior to labor so as to reduce the risk of feces being passed during contractions as well as inducing contractions. This latter usage has since been largely abandoned, in part because the health benefits are unclear and because women generally found the procedure unpleasant.
Non-medical usage
The paraphilia directed towards enemas is known as klismaphilia. Enemas are available as a service from many practitioners in the sex industry to cater to klismaphiliac desires, and may be used as part of BDSM activities.
A small enema may be taken prior to anal sex in order to remove feces.
Colonic irrigation
Colonic irrigation or colon hydrotherapy is a large enema which cleanses the whole colon. It was in vogue for hygienic purposes at the beginning of the 20th century (see John Harvey Kellogg) and remains popular as an alternative health therapy in most parts of the world. Advocates believe that, when carried out by trained personnel using sterile equipment, it can be a safe and valuable tool for eliminating toxins from the body and restoring normal muscular activity in the colon.
Ritual use
Ritual enemas were practiced by the Maya and many other Central American and South American Indian tribes; some tribes have continued the practice to the present day. Substances used in the enemas include alcohol, tobacco, peyote, and hallucinogenic drugs. While the precise nature of the substances used by the Maya are unknown except from pictures of pots bubbling liquids, it is presumed these contained alcohol or other drugs.
References and further reading
- M. R. Strict, Intimate Invasion: The Erotic Ins & Outs of Enema Play, Greenery Press, 2004. ISBN 1890159514.