The injection of a mixture of water and soap into the colon.
The soapsuds enema uses a mixture of a mild soap and warm water injected into the colon in order to stimulate a bowel movement. Normally given to relieve constipation or for bowel cleansing before a medical examination or procedure. Contrary to what the name implies, soapsuds are not necessary for the enema to be effective. It is the presence of soap in the solution that increases the effectiveness of the enema.
For adults the normal volume given is 500cc to 1500cc (one to three pints). Castile soap, which is a mild, vegetable oil based soap is commonly used. For liquid Castile soap, approximately one teaspoon per 1000cc (quart) of water is used. Castile bar soap, and other bar soap with minimal additives such as Ivory may be used, however these present difficulty in judging the approriate amount of soap to add to the solution. In general, add no more than is required to turn the water a slightly milky color. Liquid handsoaps and detergents should not be used.
The large volume of water in the enema causes the colon to expand, which stimulates involuntary contractions of the colon (peristalsis). The soap has an irritating effect on the colon, which also contributes to peristalsis, resulting in a more effective enema than tap water alone. In order for the enema to be the effective the patient should retain the solution for five to ten minutes, if possible. Although a retention period is necessary for the enema to be fully effective, the soapsuds enema is not classified as a retention enema, but is usually referred to as a cleansing or evacuant enema.
The patient normally lies on their left side to receive the enema. If the patient is in good health and mobile, the knee chest position may also be used.
The solution is typically given in an enema bag or bucket, although a bulb syringe may also be used. The enema tube or nozzle should be lubricated and then inserted two to four inches into the patient’s rectum. The bag or bucket is raised appoximately 18 inches above the patients hips and the solution is administered slowly over a period of minutes. If a bulb syringe is used, the bulb should be squeezed slowly while injecting the solution.
Approximately one half hour should be set aside when administering the enema. Allow at least five minutes for administration, a retention period of five to ten minutes, with the resulting bowel movement taking ten to fifteen minutes. If given to relieve constipation, one enema is usually sufficient. Some medical procedures call for several enemas to be administered in order to completely clear the colon. If more than one enema is required, the soapsuds enema should be given first, and the following enemas normally contain plain tap water. More than one soapsuds enema should not be given unless ordered by a doctor.
Impaction is a serious form of constipation which in extreme cases may be lifethreatening. While the soapsuds enema may be used in a home setting to relieve occasional constipation, medical care may be required for more severe cases of constipation, or for recurring constipation.
Word origin: Late Latin, from Greek, from enīenai, to send in, inject.