Enemas

enemas , types, procedure, basics of medical practice

1. SEMEY MEDICAL UNIVERSITY Topic- Enemas SIW SUBMITTED BY- HITESH KUMAR GODRA GROUP- 249 SUBMITTED TO- NATALIYA MAM SEMEY-2019 BASICS OF MEDICAL PRACTICE

2. PLAN Introduction Indications Contraindications Requirements Procedure Types Evacuant enema Retention enema Reference

3. INTRODUCTION An enema is the procedure of introducing liquids into the rectum and colon via the anus. Enemas is carried out as treatment for medical conditions in Ayurveda as well as naturopathy. Definition “Enema is a method of treatment in which liquid is introduced into the rectum and colon through the anus, then flushed out through the bowels”.

4. INDICATIONS » Constipation » Digestive disorder » Diarrhea » Obesity » Warm infection

5. CONTRAINDICATIONS » Bleeding piles » Acute inflammation of colon » Ulcer » Pregnancy » Rectum malignancy

6. REQUIREMENTS » Standard enema tube » Enema pot » Rubber enema catheter » Liquid

7. PROCEDURE » Lie down on a hard bed » Buttocks should be higher then rest of the body » The enema bag with water should be suspended from a nail at a height of 3feet from the body

8. PROCEDURE » The nozzle should be introduced in the rectum » Open the stop cork & allow liquid to flow inside rectum » Ask the patient to walk briskly for 10 minutes and then evacuate

9. TYPES Evacuant enemas are intended to be Returned . Retention enemas are intended to be Retained. Evacuant Retention Warm water 1. Starch opium 2. Enema saponis 2. Normal saline Glycerine Astringent 4. Olive oil Nutrient 5. Castor oil 5. Magnesium sulphate Turpentine 6. Barium

10. Evacuant enemas Enema Saponis - It is used to empty the lower bowel in constipation and in preoperative preparations of patients. Glycerine - 2-4 drachms of glycerine is mixed with equal volume of water and given rectally. It acts by irritating the wall of the rctum . Olive oil- 5-10 ft oz of olive oil warmed at 37⁰C is given to soften the hard scybala . Castor oil- 1-2 ft oz castor oil is well mixed with 2-4 fl oz of olive oil and given slowly. It is used in severe constipation with impacted feces.

11. Evacuant enemas Turpentine- Oil of turpentine ½ fl oz is mixed with starch or soap and water enema. There must be no floating globules. Petroleum jelly should be smeared around the anus to prevent irritation. It is useful in postoperative distension and in distension following enteric fever. Dangers Ulceration of the rectum. It may get absorbed and damage the kidneys.

12. Retention enemas Starch opium enema- This is prepared by taking starch and making a smooth paste with cold water to this opium is added and heated to 37⁰C. It is injected by glass syringe or catheter rubber tubing and syringe barrel. It is given for relief of pain or to treat excessive diarrhea. Normal saline enema- T his is sometimes given to counteract shock or dehydration. Patient can absorb up to 2-3L of fluids in 24 hr and the danger of I.V. infusion is avoided. Nutrient enema- Predigested food can be given rectally as rectum can absorb fluids.

13. Retention enemas Astringent enema- It is ordered in sydentary and ulcerative conditions of rectum and colon. It is injected very gently and the patient is encouraged to retain it as long as possible. The amount is gradually up to 1-2 ½ L. The patient lies on the back with hips raised. Magnesium sulphate - Epson salts 1-2 oz is dissolved in 4-8 fl oz of boiling water and cooled. It is used to reduce raised intracranial pressure by osmotically drawing fluid into the gut. It should be given slowly and retained as long as possible.

14. Retention enemas Barium enema- It is an X-ray exam that can detect changes or abnormalities in the large intestine (colon). The procedure is also called a colon X-ray. In this enema technique a liquid that contains a metallic substance (barium) is injected into rectum through small tube. Barium coats the lining of the colon that results into a relatively clear silhouette of the colon.

15. REFERANCE BOOKS Practical Medicine – P.J.Mehta’s Nursing Skills and Practice INTERNET www.mayoclinic.org/bariumenema www.healthline.com/emema

16. Thankyou for your Attention!