Editing Enema (section)

== Adverse effects ==

Improper administration of an enema can cause electrolyte imbalance (with repeated enemas) or ruptures to the bowel or rectal tissues which can be unnoticed as the rectum is insensitive to pain,<ref name=enemapain>{{cite journal |last1=Lee |first1=Seokyoun |last2=Kwon |first2=Jungnam |last3=Lee |first3=Junhee |title=Rectal perforations caused by cleansing enemas in chronically constipated patients: Two case reports |journal=SAGE Open Medical Case Reports |date=8 July 2020 |volume=8 |pages=2050313X20938251 |doi=10.1177/2050313X20938251 |pmid=32685153 |pmc=7346698 }}</ref> resulting in internal [[bleeding]]. However, these occurrences are rare in healthy, [[sobriety|sober]] adults. Internal bleeding or rupture may expose the individual to infections from intestinal bacteria. Blood resulting from tears in the colon may not always be visible, but can be distinguished if the feces are unusually dark or have a red hue. If intestinal rupture is suspected, medical assistance should be obtained immediately.<ref name=Nursing_and_Allied_Health>{{Cite encyclopedia |title=Enema administration |encyclopedia=Encyclopedia of Nursing and Allied Health |first=Mary Elizabeth |last=Martelli |url=http://findarticles.com/p/articles/mi_gGENH/is_/ai_2699003276.htm |access-date=11 January 2008 |via=[[FindArticles]] |url-status=dead |archive-date=23 January 2008 |archive-url=https://web.archive.org/web/20080123073414/http://findarticles.com/p/articles/mi_gGENH/is_/ai_2699003276.htm}}</ref> Frequent use of enemas can cause laxative dependency.<ref>{{Cite web |url=https://www.webmd.com/drugs/2/drug-14831/fleet-enema-rectal/details |title=Fleet Enema Rectal: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing |website=WebMD}}</ref>

The enema tube and solution may stimulate the [[vagus nerve]], which may trigger an [[Heart arrhythmia|arrhythmia]] such as [[bradycardia]].

Enemas should not be used if there is an undiagnosed [[abdominal pain]] since the peristalsis of the bowel can cause an inflamed [[Vermiform appendix|appendix]] to [[Appendicitis|rupture]].

There are arguments both for and against colonic irrigation in people with [[diverticulitis]], [[ulcerative colitis]], [[Crohn's disease]], severe or internal [[hemorrhoids]] or [[tumors]] in the rectum or [[Colon (anatomy)|colon]]. Its usage is not recommended soon after bowel [[surgery]] (unless directed by one's [[health care provider]]). Regular treatments should be avoided by people with [[heart disease]] or [[kidney failure]]. Colonics are inappropriate for people with bowel, rectal or anal [[disease|pathologies]] where the pathology contributes to the risk of [[bowel perforation]].<ref name="ihealth">{{cite web|title=Colon Hydrotherapy |website=Aetna IntelliHealth |url=http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/358752.html?d=dmtContent |date=1 July 2005 |access-date=23 April 2007 |url-status=dead |archive-url=https://web.archive.org/web/20070807002412/http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/358752.html?d=dmtContent |archive-date=7 August 2007 }}</ref>

Recent research has shown that ozone water, which is sometimes used in enemas, can immediately cause [[microscopic colitis]].<ref name= OzoneEnema>{{cite journal |vauthors = Eliakim R, Karmeli F, Rachmilewitz D, Cohen P, Zimran A |title = Ozone Enema: A Model of Microscopic Colitis in Rats |journal = Digestive Diseases and Sciences |volume = 46 |issue = 11 |pages = 2515–20 |date = 4 January 2004 |pmid = 11713963 |doi = 10.1023/A:1012348525208 |s2cid = 11489322 }}</ref>

A recent case series<ref>{{cite journal |vauthors = Ori Y, Rozen-Zvi B, Chagnac A, Herman M, Zingerman B, Atar E, Gafter U, Korzets A |title = Fatalities and Severe Metabolic Disorders Associated With the Use of Sodium Phosphate Enemas |journal = Archives of Internal Medicine |volume = 172 |issue = 3 |pages = 263–5 |year = 2012 |pmid = 22332159 |doi = 10.1001/archinternmed.2011.694 }}</ref> of 11 patients with five deaths illustrated the danger of phosphate enemas in high-risk patients.