Bowel Management through daily enema

[Peloton]

John -

I follow your routine, only I tend to use about 4-5 bottles worth. I want to make sure I get a good clean out so I can go a full 24 hours without having a bowel movement. Both my colorectal surgeon and oncologist said there was no risk with using a disposable Fleet enema daily (again, with tab water, not the laxative solution) so long as it is used correctly.

I tried using one of the large enema bags you can buy at CVS, but didn't like it. It was too cumbersome and time consuming. The Fleet disposables are just so much easier to use and dispose of. I've also found, as you seem to imply, that using a Fleet disposable is faster. It doesn't take long to get the water in there, whereas using the large enema bag, tubing, etc., was more time consuming (probably added about 15 minutes, total, to the procedure).

2.) It can reduce the effectiveness of muscles in the area over time as they are underutilized. Keep in mind that this isn't really a concern for someone like me as the muscles or nerves aren't doing their job properly as it is.

This is essentially what my colorectal surgeon told me. He said that enemas, over time, can weaken push muscles. But, since I had my entire rectum removed, I don't have push muscles in the lower part of my colon anymore. So this concern doesn't apply to me.

As with most things related to bowel management, there is not a single correct way to use an enema for bowel regulation. For anyone considering this, I strongly suggest speaking with a supportive physician and finding a system that works for you.

I'm really happy you've found a system that works, John, and enjoy the wedding. I completely relate to how a simple daily enema has changed my life.

[ams5796]

Do you perform the enema in the shower standing up?

[CRP]

I do my enema either in the shower or sitting on the toilet. In both cases the bag hangs from a hook on the ceiling. Your use of the fleets bottle is a nice introduction but you really must do a 2 quart tap water enema to make the program work. Once again, the key is the nozzle. You must have an inflatable soft rubber nozzle or you risk puncturing your rectal wall. Because the inflated nozzle seals in the water, you can relax your anal muscles and not have to hold in the tip. If it is on the toilet, you can read the paper etc. Without the correct nozzle you cannot make the daily enema a quick daily routine.

[Peloton]

Do you perform the enema in the shower standing up?

I administer the enema in the Simms position (i.e., lying on my left side). I fill up a couple of disposable Fleet enema bottles with tap water, line them up, add additional lubrication and administer them one by one. I place a towel under me for comfort and in case any water spills . I've found it works relatively well. There is minimal discomfort and it takes but a few minutes to administer the enema.

I break the routine into three distinct parts: (1) administering the enema; (2) waiting for the, um, fireworks to start; and (3) getting completely emptied out. The first part usually takes 5-8 minutes, depending on how many bottles I use. The second and third parts each take about 10 minutes each, give or take. Typically, the third part takes the longest.

During the second part, I clean up any water that spilled (which is not typical), put the towel in the hamper, wash my hands, and brush my teeth (including flossing and mouth wash). At that point, it's usually time to get on the potty.

You must have an inflatable soft rubber nozzle or you risk puncturing your rectal wall

CRP -

I really appreciate everything you have done with encouraging people to experiment with a daily enema. Your website was an invaluable source of information and inspiration for me while I was contemplating using such a routine for bowel management.

With that said, unless you are a trained medical professional, I don't think it's appropriate for you to render what is, in essence, medical advice about how to administer an enema. I don't think it's necessary that someone must have a soft rubber nozzle to effectively and safely use an enema.

I have spoken with my board certified colorectal surgeon and board certified oncologist in great detail about my routine with a disposable Fleet enema. They both assured me that using one on a daily basis is safe (assuming it is done correctly). I researched your website and asked about a soft rubber nozzle. Both said that a soft rubber nozzle was not necessary. I make sure to insert only the very end part of the enema tip into my colon, and that allows me to "shoot" the water into my colon.

I'm a firm believer that people should work with medically trained professionals and find a routine that works for them. There are many different ways to effectively and safely incorporate using an enema into a daily routine. Anyone considering the routine should be encouraged to, in consultation with their doctors, experiment with the different ways to administer an enema and find a system that works best for them.

[rrojas76]

I am about three weeks into the daily enema and am feeling great. I use the standard kit that can be found at any local drugstore. I am doing this right before I go to bed and it seems to be working just fine. Maybe later on I will look into upgrading the equipment I use. I have not taken any immodium or used an adult diaper that i had become accustomed to, which means I can go jogging or practice baseball with my son and not worry about any accidents. My colorectal surgeon has approved this process and as long as i am careful, he feels this should help me.

[ams5796]

Do any of you have stomach cramps after the daily enema? Gas?

[John72]

If you have cramps or gas, it means there is more that wants to come out.

As I've progressed now for a few weeks, what I've found works for me is:

1. Breakfast.
2. 24 oz water.
3. 4-5 fleet enema bottles of tap water.
4. Restroom. Takes maybe 10 minutes.
5. I take a 10 minute break and do some mild physical activity. Maybe get on the treadmill for a bit.
6. Repeat the enema bottles. Usually cramp bad after 2-3 bottles.
7. Go once more. Usually only around 3-4 minutes this time.
8. Shower. Go to work. Enjoy my day without having to go to the restroom again until the following morning.

[ams5796]

That's great information. Thanks, John!

Ann

[Jachut]

Well, I finally got up the nerve to try this!

It worked brilliantly I've been struggling because although I feel a lot better on my low fodmap diet, it hasnt fixed the constipation problem, only calmed my tummy. And technically, I cant rely on my lactulose because, well, the reason it works so quickly and violently on me is probably because I'm lactose intolerant. Using it will ruin the challenge process. So what do I swap to? Miralax, oxmolax and similar, they're all polyethylene glycol and I'm not supposed to use any "ol"s either (xylitol, sorbitol, mannitol). I'm not prepared to go down the stimulant laxative path, just dont want to take the risk.

So..... I finally did it. You cant buy enema equipment in the pharmacy here. I had a big medicine syringe So I did it.

I was going out for dinner, I wanted to enjoy it and feel well. I didnt need litres of water (but then I'm not fighting frequency, urgency and diarrhoea, just some kind of weird refusal by my new pouch to tell my body that it's full and ready to empty), I just need a cup or so of water, twice, spaced half an hour apart. A few squirts is all it took. And from thinking "maybe I need to go" I managed to produce an impressive amount - so obviously I really AM walking round with a fair bit of baggage on a day to day basis.

I have ordered proper equipment, but its easy as. I dont need to shove anything IN there. A quick squirt in the general direction seems to work for me. So now I can time it, no waiting for three, four, five hours for the whole process to work. And when I've got the proper equipment (I just ordered a 450ml bulb) then I will probably be able to do it in one go.

I feel much better about this. No drugs working their evil destructive ways on my guts, although my doctor tells me and tells me I can use an osmotic laxative for the rest of my life, I'm not happy with that longer term. And it is a tedious and long process that I struggle to find time for. This plus the diet, its soooo nice not to feel like I'm having a food baby. I can finallly wear jeans again!

I still dont think school camp, actually CAMPING, is on the cards though! I can tell you, its pretty hard to make it from the kitchen to the bathroom with a bowel full of water, doing this routine in a public bathroom in a campsite whilst in charge of 81 children is a bit of a tall order. I guess I just have to be very thankful for what I can still do and the normal life I can still lead and accept the very few limitations.

[Peloton]

Jachut -

I'm glad you have discovered a routine that has the potential to bring you relief. Like you, it took me some time to build up the nerve to try it. Finally, my frustration reached a high point after a few bad weeks. My surgeon convinced me to try it, and I'm glad I did.

In fact, just yesterday I returned from a week-long trip to London, with a few days in France. I packed enough supplies, did my routine (explained above) in the hotel room each morning, and had no problems at all. I spent my time in London taking in the sites and drinking a fair amount of beer. I stayed out all day and into the night and never had to run to the bathroom.

After a few days there, I drove to Normandy (Deauville, for those familiar with the area) via the Chunnel were you can drive a car onto a train. The entire trip took about six hours. I did my routine before I picked up the rental car. Once again, no issues during the trip, which included a stop for a small lunch. The only time I got nervous about having an issue was driving out of London with a right-sided steering wheel and on the left side of the road. I would imagine that experience would cause - um - concern even for people who have their rectums.

In France, I drove around all day (spending one day at the WWII sites, which was very moving). I would eat a wonderful breakfast of bread, cheese, and croissants, have a hefty lunch (usually a ham and cheese), and then enjoy a great dinner (steak frites, duck, etc) usually followed by a creme brûlée or custard for dessert. Oh yeah, I surely drank a fair amount of wonderful wine and cider, too. Literally, I would be out and away from the hotel for 12-14 hours and never had to run to a bathroom. (Out of habit, I always kept an eye out for one though - old habits die hard.)

To top it off, I treated myself to a business class ticket and once again ate and drank until my heart was content on both legs of the journey (including in the airport lounge), without any issues. The only foods I avoided were raw vegetables and seafood. Don't have the courage for that yet, even here in the States (although that might change soon, at least with respect to seafood).

Using a daily enema has changed my life. Traveling has always been important to me and I had visited over two dozen countries - ranging from Asia, India, Africa, Turkey, and Western Europe to Argentina, Brazil, and Panama - before being diagnosed with a low-lying stage 3c rectal tumor in 2010 at 30 years of age. I was terrified that the damage caused from my treatments would affect my ability to travel. It feels great knowing that, aside from the minor nuisance of doing a daily enema in a hotel room, traveling is not an issue.

Good luck experimenting with a daily enema routine. I hope it works out for you the same as it has for me.

[Jachut]

It works even better after an 8km run!

I dont have quite as much of the travel bug as you, but we did have a family holiday to Thailand booked in 2010, and were leaving less than three weeks after I was diagnosed. Had to cancel the whole thing as I had to start radiation. Lost a ton of money, despite insurance and was devastated because I honestly thought that with a reversed ileostomy and no rectum, Asia and Indonesia was off the cards for me - I've had Bali Belly and I'm pretty sure Phuket Belly would be the same! Not something to attempt without all your plumbing.

Well, we're leaving for Koh Samui in eight short weeks. I never WAS worried about my bowels this time, more worried about how I'm going to eat without touching onions and garlic, sigh. Thai is my fave cuisine but I suspect i'll be on the coconut rice and western fare.

[John72]

I can eat basically anything now. The only bad stuff would be large amounts of dairy because it gives me has if I eat more than a couple slices of cheese or whatever. So not ice cream, milk, or milkshakes.

Made a four and a half hour drive to Vegas a few weeks ago, no problems at all. Even stopped to eat lunch halfway there.

Glad you found something that worked Jachut....you're stories have made me cringe :

I don't think I'll go camping either...at least not without a trailer with a decent sized restroom. But I'm happy wih how things turned out

[susie0915]

It's been awhile since anyone has posted regarding this subject. I began doing the daily enema 6 months ago
and it has been a game changer. My rectal cancer required the removal of most of my rectum. My problem was
frequent bowel movements and feeling of never fully evacuating. After trying many different things, I went to the
University of Michigan Bowel Control Program. While they suggested meeting with a dietician, pelvic floor physical
therapy ( which I did), the doctor also suggested suppositories or enema to empty colon. I had to do an enema one
day for a test and I felt great the whole day. I talked to the Dr. about doing them daily and he had no issue with it. It can be a bit awkward at first but once you become comfortable with the procedure it is quite simple, and gives me a whole day of freedom from the bathroom. I've been able to finally gain weight because I'm not afraid of eating, plan outings and vacations without worrying about bathroom issues, less medication, just feel better overall. I use an enema bag I bought on amazon and it works great. I would like to hear from any others that have incorporated this into their daily routing. I'm surprised more doctors don't suggest this to patients that have this problem, especially with removal of the rectum. I feel it is no different than someone who irrigates their stoma. I did tell my surgeon who is from a different hospital than U of M, that I was doing enemas and he just said okay, didn't really five an opinion one way or another.

[James65]

Hi All,
I have a permanent colostomy and irrigate my stoma nearly every day with cold water. After chemo, my colon pretty much shut down and I relied on Senakot to keep things moving, but that had its downsides. Irrigating is a good way to maintain regularity and predictability in bowel movements and is something commonly done by people with colostomies.

I read the how to on the website and have a simpler idea. Hang the bad from the shower curtain or a high hook, sit on the toilet, irrigate, and finish. It doesn't seem like a good idea to do it while in the shower.

Best,
James

[CRguy]

just FYI
another ongoing topic also addresses this subject

On surgeon's advice, going to try the - gulp - daily enema
by member tammylayne

Cheers
CR