Circa 1950 and a young woman has been admitted to the hospital by her physician for abdominal pain. She is scheduled to undergo a barium enema procedure later that day but her doctor has ordered "enemas until clear" to be administered first. A barium enema is a radiologic exam to diagnose abnormalities of the colon. In order to get a good study, the colon must be well cleaned out.
Today your doctor will recommend a medicine for you to use to prepare for your colonoscopy. It will most likely be a prescription laxative tablet and/or a laxative solution (such as Nulytely or Golytely) that you drink before your colonoscopy. This solution will be given to you as a powder that you will mix with 1 gal (3.8 L) of water. You may need to drink this laxative solution over 1 to 2 hours in the evening before the test. Or you may be asked to drink half the solution the evening before your test and the other half the morning of your test.
Prior to the use of medicines to clean the colon, the normal procedure was the
administration of a series of enemas until the returns were clear, indicating
that the colon was clean. Our patient, Renee, is being taken from her
hospital room to a special room in the hospital where she will receive her
enemas. After explaining the procedure to her, the nurse asks Renee if she
has had a bowel movement that morning.
to see a demonstration of Renee's sodium phosphate enema
Renee replies that she hasn't so the nurse is going to give
her a small sodium phosphate enema which will help her have a bowel movement to
make the subsequent enemas easier to take. After squeezing the contents of
the container into Renee's rectum, the nurse leaves the patient alone to allow
the enema to work. The nurse uses this time to fill the first enema bag.
Click Here to
see a demonstration of a soapsuds enema being administered to Renee
The nurse has filled the first enema bag with approximately 2000 cc's of warm
water. After Renee has changed into a backless hospital gown, the nurse attaches an inflatable nozzle to the hose, similar to the one
that will be used for Renee's barium enema procedure, and demonstrates how it
will be inflated inside Renee's rectum after insertion. The nozzle will
allow Renee to hold the enema, giving it more time to be effective. The
nurse also puts castile soap into the enema bag to help cleanse Renee's colon.
After instructing her patient to lie on her left side in the Simms position, the
nozzle is inserted, inflated, and the warm water is released.
Click Here to
see a demonstration of Renee's first clear water cleansing enema.
After expelling the first enema, the nurse prepares a second enema consisting
of 2000 cc's of warm water. Again, the inflatable nozzle will be used to
help facilitate the retention of the enema. This time, the nurse instructs
Renee to position herself up on her knees and down on her elbows. This
allows the water to flow toward the transverse colon and takes some pressure off
second clear water enema, the nurse checks the returns and determines that
her patient is well prepared for her upcoming barium enema.
Finally, a third
enema of 2500 cc's is prepared. Renee is positioned on her left side in
the Simms position and after inserting the inflatable nozzle into
Renee's rectum, the nurse inflates it and releases the clip on the hose so that
the warm water will flow into her colon. Renee is instructed to turn onto
her stomach and then onto her right side, giving the warm enema a chance to move
completely through her colon. The human colon has an
approximate capacity of 2500 cc's so this final enema should be adequate to
prepare Renee for her procedure. The nurse confirms that the return is
clear and allows Renee to return to her room to rest before being taken to the
Have you been given
enemas till clear? Share your experience anonymously.
I had to go have a barium enema several years ago during a bleeding episode,
which later turned out to be an internal hemorrhoid. I was given the standard
GoLytely prep a couple days before the test, and it was awful. The day of the
barium test, they did scout x-rays and said my prep wasn't complete. I was given
a choice of cancelling the test for a day, with more Go Lytely, or be given
several enemas immediately so the test could still be done. I reluctantly chose
getting enemas, because I wanted it over with. They sent me down the hall to an
empty patient room in a nearby ward. A young female CNA walked in within a
couple minutes, and asked me to remove my underwear from beneath my exam gown,
and lay on my left side on the bed. She removed a large bowel prep kit from a
plastic bag, and filled it completely full of a milky white solution. She
attached a long plastic pipe with two holes in the end, lubed it up, and
inserted it up my rectum several inches. She unceremoniously let the solution
gush in, and it flooded my insides really quick and was too warm. My belly
started hurting, and I asked her to stop the flow. She did, but then also
removed the pipe a little, then as she opened the flow again, slid it up by butt
all the way until the connector was resting between my cheeks. The cramping went
away, and I was able to take the rest of the bag. She walked me to the toilet,
removed the pipe, and I exploded. It amazed me at the junk still left inside me,
even after the GoLytely. She filled the bag back up, and I was on the bed again
for another enema, which was a piece of cake now. She did that to me a total of
3 times, until I was pooping clear. I had always feared rectal insertions would
hurt, even just a couple inches, but that girl put 6" of pipe up my rear, and I
barely felt it only when it first went in. She really cleaned me out good