Enemas can help your child’s chronic constipation when nothing else works. You can do an enema for child at home, but it’s best to get instructions from your doctor before you start.
What Is an Enema?
An enema is a procedure where you insert a liquid or laxative into the rectum through a small tube to flush out stool. If your child has chronic or severe constipation, your doctor might recommend doing enemas at home to help their symptoms.
Your doctor might also recommend an enema to:
How Does an Enema Work?
There are two types of enemas: evacuant or cleansing enemas and retention enemas.
Cleansing enemas. As the term suggests, a cleansing enema cleans out the bowels. Some solutions act as stimulants and irritate the colon, leading to a bowel movement. Other solutions pull water into the stool, which softens the stool and causes your rectum to swell and bloat. The body responds by contracting muscles in the rectum and causing a bowel movement.
These types of solutions include:
Retention enema. These types of enemas are when you insert a fluid or medication into the rectum and keep it in for an extended period, usually overnight. They can help treat colon problems or clean out the bowels by softening and bulking up the stool.
Retention enema solutions include:
- Medications like prednisolone
- Mineral oil
If your child has a bowel disease that causes symptoms of urgency, they might only hold a retention enema for a short time.
Other enemas. Barium enemas are another type that helps guide X-ray scans of your colon. The X-ray technician will insert barium liquid into your child’s rectum with a small tube. The barium coats the colon lining and creates a clear picture of the bowel, which is normally hard to see on an X-ray.
What Are the Enema Side Effects?
Enemas are safe if they’re done properly and used either short-term as a last resort or under your doctor’s instructions. Some side effects are possible.
Discomfort. Pressure builds up in the colon and rectum when you add water to the area. It feels like a stronger urge to pass stool, so it can feel uncomfortable. The fluid can also cause bloating and some cramping, but these will usually go away once your child has a bowel movement.
Older children might feel embarrassed or uncomfortable with the procedure, too. Explain why you need to do the enema and distract them with videos or books to help ease fears.
Electrolyte imbalance. Long-term, chronic use of enemas can cause dehydration and electrolyte imbalances. Phosphate enemas can also lead to dangerously high levels of phosphate in the body.
Colon tears. Part of the enema process is inserting a tube with a tip on the end into your child’s rectum. If you do this too quickly or roughly, you could tear the colon wall. This is called a perforated colon and can cause air and stool to leak into your child’s abdomen.
Infection. It’s important to sterilize your enema equipment or use single-use supplies. Otherwise, dirty enema supplies can lead to serious infections.
Gut bacteria imbalances. Your colon holds friendly bacteria and other organisms that are part of your natural microbiome. Regular enemas can disturb the delicate balance of bacteria in your gut and can lead to digestive symptoms.
Worsened constipation. If you give enemas too often, the colon lining can become irritated and inflamed, which can cause pain and discomfort. Your child might avoid passing stool and might hold it instead, making constipation worse.
How to Give an Enema
A pediatric enema can take up to one hour to complete. Before you begin, make sure you have private access to a bathroom. You can do an enema at home, but if you’re unsure or feel uncomfortable, ask your doctor for instructions.
Before you begin, collect your supplies. You’ll need:
- Silicone tubing and tip
- Enema bag
- Enema solution
- Thick towel
- Petroleum jelly
- Videos or books
To give the enema:
- Ask your child to empty their bladder before you start. This will help ease some pressure in the colon.
- Clamp the tubing and fill the enema bag with the solution. Follow the package instructions.
- Lay the towel on the floor. Have your child lie on their left side with their knees to their chest or on their belly with their knees toward their stomach and their bottom in the air. This is a good time to use your distraction videos or books.
- Lubricate the tip and your child’s anus with petroleum jelly.
- Gently insert the tip into your child’s bottom about 4 inches. Don’t force it if they resist. Instead, tell them to push like they’re passing stool and breathe through their mouth.
- Lift the enema bag and open the clamp.
- Slowly squeeze the solution in until the bag is empty.
- Keep your child in position for 15 to 20 minutes. Hold their butt cheeks together so they don’t push the tip out.
- After 15 to 20 minutes, have them sit on a bedpan or the toilet for 30 to 45 minutes or until all the solution is out and their bowels are empty.
- Discard any single-use items and wash your equipment with hot soapy water.
When to See a Doctor After a Pediatric Enema
Your child should pass stool within an hour of receiving the liquid. If they don’t, talk to your doctor. Complications can happen, especially after using a phosphate solution. If your child has any of the following symptoms, see a doctor right away:
Bottom Line: Ask Your Doctor First
Enemas can be a helpful tool for managing chronic constipation or other bowel problems. There are some precautions to take with a pediatric enema, though. If you think your child needs an enema, talk to your doctor first.