Enemas Till Clear

What happens when your doctor orders "enemas till clear."

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Enemas Till Clear


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.

Click Here to see the nurse explain the procedure to Renee

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. 

Click Here 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 the rectum.

After Renee's 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 radiology department.

Have you been given enemas till clear?  Share your experience anonymously.

Other's Experiences

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 though.

Kate writes: About 10 years ago I had a sigmoidoscope. That's the one where they only go in part way. The instructions the nurse gave me for preparation was a restricted diet for 3 days, then 3 enemas the morning of. The instructions said Fleets were OK but they recommended large volume enemas with a bag. I did 2 with castile soap and the last one with just a little salt. The doctor said I did a good job.

Jerry writes: In the 50ís and 60ís I donít think they did colonoscopies, but they did do Barium enemas. In those days you checked into the hospital and they did the workup, which consisted of a fast acting laxative and enemas all night till you had a clear return, and look out if you drew the wrong nurse. My ex wife said she got enemas all night up until an hour before she got the Barium enema, and said they used a retention nozzle and filled her with barium till she thought she was going to burst. My ex mother in law said she got high enemas with a colon tube.



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