Giving Enema to Patients

Nurses may look good in white and sure, we do look neat and clean in our tidy uniform, but how ironic is it that the same people who others view as pristine and cool while performing tasks such as administering medication, carrying out doctors’ orders and assisting the sick to recover, are also the ones who are down to do the dirty job? That despite the respectable image that we are upholding, we are also capable of performing nursing interventions that would make others scrunch their nose and say, ‘gross?’ Take administering enemas for example.

For others, it would be an ultimate no-no, but for us, nurses? Easy peasy. Not a sweat broken.

But wait, how exactly do we do that? And how do nurses like us manage to still look calm when doing that? What steps should be followed?

Steps on How to Give an Enema

  • Wash the hands thoroughly with soap and warm water for a minimum of 15 seconds before beginning the procedure.
  • Gather the needed materials (enema bag or bulb, lubricant, gloves, enema solution, ramp clamp, and a towel).
  • Warm the solution before placing it into an enema bag or bulb to a temperature between 99 and 106 degrees.
  • Place a towel under the patient to collect any leakage during the procedure. Lay the patient in a position to receive the enema. The ideal positions for enema administration are the right side position, left side position, knee chest position, and on the back. It is advised that the patient remain in one of these positions to receive the enema for one-third of the time.
  • Lubricate the tip of the enema applicator before inserting it into the rectum of the patient. Ensure that the entire length of the enema tip is lubricated and that the opening of the tip remains free from clogs so that the solution flows freely when the time comes to administer the enema.
  • Insert the lubricated enema tip into the patient’s rectum and release the enema tubing clamp.
  • Monitor the patient for cramping as the enema solutions flows comfortably into the patient’s rectum. Signs of cramping may include abdominal muscle tension. If signs of cramping are notices while monitoring the patient, stop the flow and ask the patient to take several deep breaths. Continue the process once the patient becomes comfortable again.
  • Gently massage the patient’s abdominal area. Massage down the left portion of the patient’s abdomen then massage from left to right across the lower belly button. Continue to massage up the right portion of the abdomen then massage from right to left under the patient’s rib cage.
  • Remove the tip of the enema from the patient’s rectum once the device is empty. Ask the patient to remain in the current position until he or she has a strong urge for a bowel movement.
  • The patient may need assistance with walking to the restroom so the nurse should provide this help if needed. Many patients may have the ability to walk to the restroom on their own while the solution is still in the colon.
  • Ask the patient to massage the abdomen while the enema is being expelled from the body. Tell the patient to massage the area under the belly button from right to left, starting on the right side and from left to right under the patient’s rib cage. The massaging process helps to loosen fecal matter.
  • Dispose of the gloves used to administer the enema. Wash hands with soap and water after the process is complete.


Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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