Enema Administration

Enema: Procedure of introducing liquids into the rectum and colon to expel its contents.

CSS Considerations:

  • An enema is part of a bowel routine prescribed by an physician.
  • Assess the client for wounds, bleeding, or skin breakdown in the perineal area and determine how to proceed.
  • Assess for physical obstructions or barriers (i.e. inability to reposition the client, a wound dressing over the area) which would prevent safe administration of an enema.

PSW Considerations:

  • Report immediately to the office at 416-635-2860 and do not proceed with the enema administration if the client has:
    • Exposed or open wounds in the perineal area
    • Bleeding from the rectum or surrounding areas
    • Broken skin
    • Pain in the rectum or abdomen
    • Resistance on insertion of the enema
  • If the client refuses treatment, do not proceed and report to the office.
  • Report to the office if the client does not have a bowel movement after administration of the enema.
  • Report to the office but proceed with the enema administration if the client has diarrhea or constipation.

Required Supplies:

  • Enema solution
  • Enema bag
  • Warm water (if instructed)
  • Soap and water
  • Gloves
  • Enema tip
  • Lubricant
  • Bedpan or commode (if needed)
  • Bed protector (if needed)

Procedure for Enema Administration:

Preparation for Insertion of Enema

  1. Open the package and remove the plastic container with the enema solution. If instructed to be warmed, place the container with the solution into warm water.
  2. Wash hands thoroughly with soap. Put on gloves.
  3. If the toilet is not readily available, place a bedpan or commode nearby.
  4. Assist the client to turn on their left side.
  5. Place the bed protector under the client.

Insertion of Enema

  1. Expose the client’s buttocks.
  2. Remove the cover from the enema tip and gently squeeze to ensure the tip is undamaged.
  3. If the tip is not pre-lubricated, use the lubricant recommended by the healthcare professional.
  4. Separate the buttocks to expose the anus.
  5. Instruct the client to breathe deeply.
  6. Insert the lubricated enema tip 2 inches into the rectum towards the navel.
  7. Squeeze the plastic container at a slow and steady rate from the bottom of the container until all the fluids have entered the client’s body.
  8. Stop if there is excessive resistance or if the client is experiencing discomfort. Monitor for verbal and non-verbal signs of discomfort.

Removal of Enema and Defecation

  1. Encourage the client to hold the solution for as long as possible. The enema should be retained for 20 minutes, or as long as instructed.
  2. Remove the enema tip from the client. Replace the used enema unit in its original container and discard.
  3. When the client feels the urge to defecate, assist them with toileting.
  4. Remove gloves and wash hands thoroughly with soap.

Video Resource

Please click on the video links below for a visual demonstration of the procedure:

References: