Tap-water enema

For most nonhospitalized persons with acute constipation, the infrequent use (less than every few weeks) of most laxative products is acceptable however, before more potent laxative or cathartics are used, relatively simple measures may be tried. For example, acute constipation may be relieved by the use of a tap-water enema or a glycerin suppository if neither is effective, the use of oral sorbitol, low doses of bisacodyl or senna, or saline laxatives (e.g., milk of magnesia) may provide relief. 

In the hospitalized patient without GI disease, constipation may be related to the use of general anesthesia and/or opiate substances. Most orally or rectally administered laxatives may be used. For prompt initiation of a bowel movement, a tap-water enema or glycerin suppository is recommended, or milk of magnesia. 

Tap-water enemas may be used to treat simple constipation. The administration of 200 mL of water by enema to an adult often results in a bowel movement within 1.5 hours. Soapsuds are no longer recommended for use in enemas because their use may result in proctitis or colitis. 

For acute constipation in most age groups, a tap-water enema or glycerin suppository may be helpful. Occasional use of milk of magnesia or an anthraquinone laxative in low doses is justified as well. 

Sodium polystyrene sulfonate 15-60 g in 20% sorbitol suspension enterally. As an enema, prepare 50 g in 70% sorbitol plus 100 mL tap water. This solution should be retained for 30-60 min... 

Enemas commonly are employed either by themselves or as adjuncts to bowel preparation regimens to empty the distal colon or rectum of retained solid material. Bowel distention by any means will produce an evacuation reflex in most people, and almost any form of enema, including normal saline solution, can achieve this. Specialized enemas contain additional substances that either are osmoticaUy active or irritant however, their safety and efficacy have not been studied in a rigorous manner. Repeated enemas with tap water or other hypotonic solutions can cause hyponatremia repeated enemas with sodium phosphate-containing solution can cause hypocalcemia. Phosphate-containing enemas also are known to alter the appearance of rectal mucosa. 

In the dark lumen technique the colon is filled with 2,000-2,500 ml of warm tap water using hydrostatic pressure after placement of a rectal enema tube or a... 

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