Enema FAQs

Table of Contents  ~ Basic Information

  1. Temperature … ?
  2. Anatomy of the Colon … ?
  3. Positions … ?
  4. Capacity … ?
  5. Retention … ?
  6. Expulsion … ?
  7. Equipment … ?
  8. Warning …
  9. Enema Procedures… Written by Jack Knox
  10. Enema Information – First Enema
  11. The 4 Quart Enema: Fact Or Fiction?
         Enema Solutions Chart
              + Isotonic Enemas
              + Soapsuds Enemas
              + Oil Enemas
              + Coffee Enemas
              + Exotic Enema Solutions
        My Favorite Enema
        The Snake and I
        Mineral Oil Special

Temperature … ?

Most people find that a warm water enema can be held more easily than a cold one. I use a very warm enema when I want to fill myself with the maximum amount of water possible. I use a cool water enema when I need to force out water and material that is stuck in my bowel. The temperatures given are that of the water as it is poured into the bag. It cools off some before it gets into the colon. Don’t try to judge temperature with your fingers, they’re too unreliable. If you don’t want to use a thermometer, use your tongue! It’s a fairly reliable
reference for body temperature.

Cool water is 30 – 35 degrees C ( 86 – 95 degrees F )

Warm water is 40- 42 degrees C ( 104 – 108 degrees F )

Hot water is 43 – 45 degrees C( 110 – 113 degrees F )

Don’t take water any hotter than 45 C or 113 F or you can scald the colon. You can take it as cold as you can stand, some take crushed ice enemas, but I suspect most people couldn’t even accept water that cold into their bowel.

Anatomy of the Colon… ?

The Anus is the external sphincter that closes off the rectum from the outside of the body. It is a ring of muscles. It can easily stretch to about 1-inch diameter and can be stretched wider if you go about it slowly.

The rectum is a powerful muscular organ about 5 inches long, with a sphincter at each end. The sigmoid colon is a looped section of the bowel just above the rectum. It is shaped somewhat like a question mark, hence its name. The loop occurs at about a depth of ten inches, as can be felt if you push a firm object into the rectum, and up through the inner sphincter.

The sigmoid comes in two sizes in humans.  There is the long sigmoid and the short sigmoid, and few are born with one in between the two distributions of sizes. Those who have the big sigmoid can probably take about a full quart of water more than those with the short one.

The descending colon is in the left side of the lower abdomen and can be easily felt any time the abdominal muscles are fully relaxed. It hugs the left wall of the pelvis and reaches up to the splenetic flexure, which is just under the left rib cage.

The transverse colon extends from the splenetic flexure to the hepatic flexure, right across the abdomen on the right. It follows a sagging course across, and in many people sags about half of the way down in the middle.

The ascending colon is on the right side of the pelvis, and the lowest part of it is called the cecum, the part of the colon where the small intestine expels its contents into the colon in a liquid form. It is the part of the colon with the largest diameter and is most effective in absorbing water.

After taking a large enema, stand in front of a mirror, with the light from a ceiling lamp falling across the abdomen, and the shadows will make many of these structures readily apparent. The transverse should show up as a shadow about 2-3 inches below the belly button. When lying face down on a bed, the cecum will expand to an enormous size, then lift the body a few inches with the hands and knees and the right side of the belly will clearly show the shape and position of this part of the colon. The colon narrows gradually from the cecum (about 2-1/2 to 3 inches when distended) to the sigmoid, about 1 to 1-1/4 inches diameter.

Positions … ?

There are many positions in which an enema can be taken. Two of the most widely known are the “Sims” position and the “Knee-Chest” position. The Sims position has the recipient lying on the left side, with the right knee brought up near the chest. The Knee-chest position has the enemy supported by the knees and the shoulders, with the chest sagging down, so that the chest almost touches the floor. This places the abdomen nearly upside down so that the water can flow down from the rectum to the transverse colon by gravity. In cases of deep-seated constipation, this position will help the water reach way up into the colon for a good cleaning out. It is also useful in a technique for floating air or gas in the colon above the water so that the air can be expelled.

Standing upright requires you to hold the tube in the anus unless you use a nozzle that can be held in, but it allows me to accept more water than any other position.

Lying on the back is a favorite position, especially for the first enema of a session. You can watch the bag slowly deflate, and you can also watch the abdomen expand as the water enters the colon. You should lie down so that you can prop your head against a wall, like a pillow. You will probably be most comfortable if the knees are raised. You will first see the belly swell very low, just above the crotch, as the sigmoid expands. Then you will see the left side start to bulge as the water enters the descending colon. You will be in a position to massage the bowel as well as feel the shape and position of your colon.

Lying face down can be used, but pressing the belly on the floor restricts the abdomen’s need to expand.

Standing on the head uses gravity to force the water down into the transverse colon, which usually needs a good cleaning out anyway, but especially if you are quite constipated.

Reclining in the bathtub is quite comfortable, except that the tub may be cold. You don’t have to worry about leakage here.

Leaning over the edge of the bathtub is similar to getting on your hands and knees, but it leaves your hands and arms free and is a little easier to stay in that position for a while.

Sitting on the edge of the bathtub is comfortable, and is the way to do a faucet enema, described in equipment.

Capacity … ?

Every individual has his or her own capacity, and it will change from one enema to the next. The cleanliness of the colon and the amount of gas present will have a great effect on the volume of water that can be taken. Medical researchers have determined that the average adult human colon has a capacity of 7 quarts. I believe that this measurement may have been made using colons removed from cadavers, who wouldn’t complain about the pressure. It may be that the average colon has this capacity, but that no one except a woman who has just delivered a baby has that much room in the abdomen to allow the colon to expand to its fullest. You may want to experiment with this by taking the largest enema that is comfortable, and then rolling from side to side very slowly and seeing if the water runs downhill to distend the lower side more. You probably will find that the lower part of the colon will be noticeably more swollen, indicating that it is your abdomen that is unable to expand to allow the colon to accept any more fluid.

Fifty or so years ago, most adult patients receiving barium enemas were given 4 quarts of the barium solution and made to hold it during the X-ray procedure. At the same time, the enema bags sold in drugstores held 3 or 4 quarts, and many people felt that they could not be properly cleaned out unless they took the full bag. I took my first 4-quart enema at 12 years of age. I had to refill the bag in the middle – what a pain. Today’s drugstore fountain syringes do not hold over 2 quarts, which many feel is a real shame.

For more on this topic, see The 4 Quart Enema: Fact Or Fiction

Retention … ?

Most people will find it difficult to retain an enema for more than 5 minutes. If the bowel is not clean, then the peristaltic action of the colon will push against the fecal masses and produce intense pressure. This will frequently happen with your first enema in a series. Not much to do but expel and try again. If you get a strong cramp and an urge to expel, getting up is the worst thing you can do. Making the descending colon vertical adds gravity to the force pushing out. This is how to have an accident. If you can, wait while lying down. The pressure will pass in 10-15 seconds as the wave of peristalsis passes the sigmoid colon and reaches the end. Then you can get up and expel without straining to hold it in. If you must go to the toilet, and the pressure is intense, you can hold the buttocks together with both hands. This helps the anal muscles keep it in.

A trick I use is to lie face down on the bed and wait for three waves of cramps to pass down. After the third cramp, I can walk leisurely to the toilet to expel, and I get a real good expulsion of all that stuff. If the cramps are extreme, however, I just don’t wait. Another aid in retaining the water is to get into the knee-chest position when the pressure builds. This causes gravity to help hold the water in.

Another method is to lie on your back and massage the colon with both hands. Whenever you feel the pressure building, or can feel a big bulge with your hands, massage around that area until the pressure relaxes.

Some people recommend rolling from one side to the other every minute or so. The idea is that the water will flow repeatedly downhill, alternately filling the descending and sigmoid colon and then running down to the cecum. This is supposed to break up any messes in the transverse.

Expulsion … ?

Obviously, most people expel their enemas while seated on the toilet. This is probably not the best position for expelling water from the colon because of the need for the wide cecum to push the water uphill to the transverse, and then for the transverse to pump it back up its bag to get it to the descending. A large volume in the descending will cause the descending colon to slide down the left side and kink where it meets the sigmoid. This can get you stuck! If you can feel lots of water bulging on the left side, but can’t get it out, you need to change positions. Get up and lie down for a moment, or get into the knee-chest position, or just turn around as if you are looking over your right shoulder. These techniques can un-kink the descending, and get the water passing out again

Some people prefer to expel in the bathtub, which is much easier because the colon does not need to lift water to get it out. This is extremely messy, however, so don’t do it unless you don’t mind cleaning up. If the colon becomes severely blocked while holding an enema, you may prefer to do this rather than calling the paramedics. In the hospital, patients are frequently given a bedpan when expelling enemas, to get the same benefit of the position.

If there is substantial gas in the colon, it may be very difficult for the colon to lift water when large air bubbles are present. These like to collect at the hepatic flexure, high on the right side and can be detected by a rumbling sound when you press there. If you want to get the gas out, you can sit on the floor and make sure the gas is at the hepatic. Roll slowly onto the right side, then massage the transverse, following its course with your hands. You will know that you are moving that gas by the rumbling. When you have the gas moved to the splenic flexure, move quickly to the knee-chest position. Now massage the descending colon upward, from the ribs to the groin on the left side (you’re upside down, remember) until the gas has moved to the sigmoid. Use heavy massage in the groin area, to move water out of the sigmoid, and move the gas in. When this is done, get on the toilet quickly, and you should be able to expel a prodigious gas blast. You may have to repeat this procedure several times, but when all the gas is out of the colon you should be able to expel the water quickly.

Don’t sit on the toilet for more than a few minutes if there is no water coming out. Sitting too long and straining are the chief causes of hemorrhoids. Those will certainly ruin your enema pleasure. If nothing is coming out, lie down either face down or up, or lie on your left side, or get into the knee-chest position. These will help the water move, and soon you can go back to the pot.

Equipment … ?

Standard Brands:

The standard enema apparatus available in the drug store can be divided into several types. There is the open-top fountain syringe, usable for enemas and douches. There is the closed-top type bag, which can also be used as a hot-water bottle. There is the four-way type, which also is intended to be used as an ice bag. Most of these units offer a 2-quart capacity. If that is the limit of your capacity, the open-top fountain syringe is the best type to use, because it is very convenient. The enema and douche nozzles that come with these units leave much to be desired. There are also discreet type units sold primarily for feminine hygiene use, but some come with enema tips also. These are good because a woman can put them in her purse. 

Shy – An expandable syringe that is filled by pressing the mouth of the bag against the sink faucet. This bag will hold 4 quarts. The big drawback is that it has no way to shut off the flow except to remove the bag from the tube, which will cause the water to flow from the rectum. What you need to do is to attach a hose with a clamp to the nozzle, which is inserted into the bag. You can pour the liquid soap into the bag before filling it with water.

Special Hardware:

Here are some descriptions of exotic enema equipment you can build from commonly available items.

The faucet enema is not for the inexperienced. If you don’t have much enema experience, I suggest that you start with a standard 2-quart open-top fountain syringe from the local drug store. When you get able to take 2 fillings of the bag at one time, then you are ready to get more exotic.

Actually, the equipment for the faucet enema is available at any hardware store. It is called a shower hose adapter for the bathtub faucet. It has a rubber fitting that fits over the bathtub faucet, a hose, and a rubber shower head. Attach the faucet fitting to the bathtub faucet, remove the showerhead from the end of the hose, and you are ready. Set the faucets to a gentle flow, with a temperature that feels a little warm to the tongue. Sit on the edge of the tub, and ease the flowing hose against and then into your anus. You will feel the water filling your rectum. Relax the bowels as much as you can, and you don’t need to worry about spilling a little water into the tub. When the bowels feel full, remove the hose and wait a moment.  The feeling of pressure should pass, then insert again. When you are totally full, move to the toilet and expel the water. You can repeat the process as many times as you like. Since the water is always running, you can move back and forth between the tub and toilet very quickly, and get a good cleaning out in about a half-hour to 45 minutes. When the bowel is clean, take as much water as you can, and then enjoy the sexual release. When completely filled, don’t miss looking at your distended belly in the mirror. You can also adopt a colon tube or other nozzle to the flexible hose on a personal showerhead.

A few cautionary notes about the above procedure! The pressure from the water faucet is enough to burst the colon. Don’t let the pressure rise too much in the bowel. When the pressure is strong, pull the tube out, or let the water pass out of your rectum. Don’t take water that is too hot. Use some lubricant on the anus first, and after every few insertions. If you have a very large colon or have heart disease, the water absorption can be deadly. You must use water with salt in it to avoid “hyponatremic shock” – dilution of blood electrolytes.

A 4-quart enema jug can be made from a Rubbermaid 1 gallon orange-juice pitcher. Drill a hole near the bottom of the pitcher, insert an all-thread pipe nipple of about 3/8″ size, and seal with nuts pressing on rubber washers sealed with RTV (bathtub caulk) or contact cement. Attach plastic tubing to the exposed end of pipe nipple, held with a hose clamp, and sealed with some sealant. You will have to make or order a large diameter enema nozzle or colon tube, although the end of the plastic tube can be smoothed off and used just like that.

A 4-quart bag can be made from a Faultless brand ice bag. Drill a hole in the center of the plastic cap, and adapt as above with the pipe nipple, etc. Get an 8-32 Eye Bolt with machine screw threads, 2 8-32 fender washers as large as available, and 2 8-32 nuts. Poke a hole in the center of the end of the bag opposite the filling mouth just big enough to take the eye bolt. Screw one nut onto the eye bolt. Place a washer on the eye bolt. Put contact cement onto the washer facing away from the ring end. Push into the bag from the outside. Coat the other washer with contact cement, and place it over the exposed end of the eye bolt inside the bag. Screw the other nut on to hold the bag between the two washers. This should provide a leak-proof hanging hook for the bag. Glop some contact cement on the inside washer and nut to prevent rust. Voila! A 4-quart enema bag!

Nozzles and tubes: There are many different types of nozzles and tubes available for inserting into the rectum. What you want is either a colon tube (a rubber tube from <” to =” diameter and anywhere from 10″ to 3 feet long) or a nozzle with a bulb on the end, to help you hold it in. These are called “N-Tips”. Some of the best drug stores carry these items, but you will have to ask for them. Some drug stores also carry the fleet high-volume bag enema or an equivalent brand, these are made of plastic and will not deteriorate when oils are used, as a rubber bag will. The “high-volume bag” usually holds 2500 CC (over 2 quarts) but in the same series, the manufacturers make a barium enema container that can be ordered, and it has 3500 cc capacity (almost 4 quarts). Medical and ostomy stores carry many of these items. These are considered disposable, but with a little care they will last a
long time.