Tuesday, February 9, 2016

Taber's Medical Dictionary: Enema

[Gr.enema, injection] 

1. The introduction of a solution into the rectum and colon to stimulate bowel activity and cause emptying of the lower intestine, for feeding or therapeutic purposes, to give anesthesia, or to aid in radiographic studies. 

2. A solution introduced into the rectum. 
Video for Cleansing Enema:

Air contrast enema:
An enema in which two contrast agents, thick barium sulfate and air, are introduced simultaneously under fluoroscopic control, followed by multiple radiographs of the colon. This technique produces better visualization of mucosal lining lesions, such as polyps or diverticula, than barium enemas performed without air.
Barium enema:

High enema:
An enema designed to reach most of the colon. A rubber tube is inserted into the rectum to carry water as far as possible.

Lubricating enema:
An enema to soften and ease the passage of feces through the anal canal. 

Nutrient Enema:
An enema containing predigested foods to nourish a patient unable to be fed otherwise.

Physiological salt solution Enema:
An enema consisting of normal saline solution. It may be used, on rare occasions, to treat dehydration.

Purgative Enema:
A strong, high-colonic purgative used when other enemas fail.
Retention Enema:
An enema that may be used to provide nourishment, medication, or anesthetic. It should be made from fluids that will not stimulate peristalsis. A small amount of solution (e.g., 100 to 250 mL) is typically used in adults.

The procedure and expected sensations are explained to the patient. Necessary equipment is assembled; the patient is draped for warmth and privacy and assisted into a left side-lying position with the right knee flexed (Sim position). The tubing is cleared of air, and the small lubricated tube is inserted 3 to 4 in (7.5 to 10.0 cm) into the rectum and is not removed (unless absolutely necessary) until the procedure is completed. The fluid is allowed to flow very slowly, with stops made at intervals to aid retention. If the patient experiences an urge to defecate, the fluid flow is stopped until the urge passes. When the entire volume has been instilled, the tube is quickly withdrawn, the patient's buttocks are compressed together for a few minutes to prevent evacuation, and the patient is encouraged to retain the enema for at least 30 min. The type and amount of fluid instilled, the patient's ability to retain it, and the amount, type, and consistency of the returned fluid and stool are documented.

Soapsuds Enema:
An enema consisting of prepared soapsuds or, if liquid soap is used, 30 mL of liquid soap to (1000 mL of water. Strong soapsuds should not be used because of the danger of injuring intestinal mucosa. Mild white soaps, such as castile, are best.