Enema is the procedure of introducing liquids into the rectum and colon via the anus. Simple water enema is used for bowel wash. Luke warm water, saline water (0. 9%) is used for cleansing impacted faecal matter. Routinely enema is given for all new patients for one to three days. Thereafter depending upon requirement alternate day or twice a week enema is given. Neem decoction is also used in certain clinical conditions.

Warm Enema
Indications – Dyspepsia, chronic intestinal inactivity, biliousness, chronic auto-intoxication, gaseous distension, flatulence, jaundice, gall stones, hepatitis, catarrh of bile ducts, fever. Intestinal obstruction, piles, hard faeces, cerebral congestion, pulmonary congestion.

Hot Enema
Indications – Pid, pelvic congestion, prostatic inflammation, dysuria, cholera, toxemia, hepatic or biliary colic, uterine pains during parturition, threatened collapse in typhoid, irregular contraction of uterus, pseudo membranous colitis, surgical shock, collapse, intestinal haemorrhage in typhoid, intestinal sepsis, infantile diarrhoea.

Cold Enema
Indications – Atony of colon, excessive dilatation of colon, yellow fever, typhoid, constipation, post abdominal surgery, fever, ulcerative colitis, crohn’s disease, dysentery, appendicitis, carcinoma of lower bowels, peptic ulcer, fistula.

Nutritional Enema
Indications – Persistent vomiting, stomach bleeding, chronic disease of upper gut, fever, starvation.

Graduated Enema
Indications – To overcome enema habit.

*Contra indications – Bleeding piles, rectal surgery, anal fissures, open wounds, anal sphincter incontinence.