Children are often tormented by constipation. Most often, parents try to relieve the child from constipation with the help of candles and children's enemas. Young mothers often do not know how to properly deliver them to the child, what should be the temperature of the water and what can be added to the wash water.
Doctors do not often recommend the use of suppositories or children's enemas for constipation, since these procedures attract unnecessary attention of the child to intestinal activity, which makes it difficult to solve the problem. Enema is an emergency measure to remove stagnant stool. She does not relieve the very cause of constipation. Treatment is necessary, without it, constipation will recur again and again.
An enema is the introduction into the rectum of various fluids for therapeutic or diagnostic purposes.
Indications and contraindications for a cleansing enema
It is used to liquefy and evacuate the contents of the lower colon. She is prescribed:
- With constipation.
- To remove toxic substances from poisoning or intestinal infections.
- Before operations.
- Before an X-ray examination of the intestine.
- Before using medicinal enemas.
Contraindications:
- Acute inflammation of the mucous membrane of the colon.
- Acute appendicitis.
- Gastrointestinal bleeding.
What should be the temperature of the water?
For a cleansing enema, water of room temperature (22-25 ° C) is needed. If warm water is introduced into the intestine, it will be absorbed by the intestinal mucosa and will not fulfill its task. If you need to stimulate bowel contractions, use cool water (12-20 ° C), to relax the muscles, take water at a temperature of 37-42 ° C.
What can be added to water?
To enhance the cleaning effect of the procedure, you can add a teaspoon of vegetable oil, glycerin, or half a teaspoon of soda to a glass of water. Dr. Eugene Komarovsky recommends an enema with baby soap. A piece of soap is dissolved in water. Enema with soap is contraindicated in infants, as the intestinal walls are too irritating.
What to do?
Enema in a children's hospital is done with the help of Esmarch's mug. This is a rubber tank that looks like a heating pad, with a volume of 1-2 liters, with an opening to which a rubber tube with a rubber tip is attached. At the end of the tube is a tap with which to regulate the pressure of water. Esmarch's mug is sold at any pharmacy.
At home, pears are used to pose a children's enema. They come in rubber and silicone. Baby enema pears are sold at any pharmacy. They are different: No. 2 (50 ml), No. 3 (75 ml), No. 4 (100 ml), No. 5 (150 ml), No. 6 (250 ml).
A baby enema for infants is placed with the smallest rubber pears with soft rubber tips.
The volume of water required for different enemas is presented in the table.
| Age | Cleansing | Siphon |
| 1-2 months | 30-40 | - |
| 2-4 months | 60 | 800-1000 |
| 6-9 months | 100-120 | 1000-1500 |
| 9-12 months | 200 | 1500-2000 |
| 2-5 years old | 300 | 2000-5000 |
| 6-10 years | 400-500 | 5000-8000 |
How to lay a baby?
Oilcloth is laid on the couch, a towel is placed on top.
The child needs to be laid on his left side, bend his knees and squeeze them to his stomach. In this position, the introduction of an enema tip will be the most painless.
The baby is laid on its back, the legs are lifted and slightly parted to the sides. The edge of the oilcloth should hang down into the pelvis.
How to make a children's enema using Esmarch's mug?
Esmarch’s mug is filled with water, then the tap is opened and the tube is filled with water, releasing air. After the water begins to pour out of the tap, you need to close it, hang the mug above the level of the bed.
With the fingers, the buttocks of the child are moved apart, the tip lubricated with petroleum jelly is carefully introduced into the rectum with rotational movements. Initially, the tip is introduced towards the navel, then parallel to the coccyx. They open the tap, raise the enema to a height of 60 cm. The lower the mug hangs, the slower the fluid will flow and the less disturbance the procedure will bring to the child.
If no fluid enters, the tip is slightly pushed back. The muscles of the rectum relax and contract in waves, so you can wait for the relaxation of the intestine. If the fluid does not pour in, you need to increase the pressure by raising the mug higher.
If the child complains of pain, reduce the pressure of water by lowering the mug.
After the introduction of fluid, connect the buttocks of the child, ask him not to defecate. To soften feces, water should be in the intestine for 5-10 minutes. Then the child is sent to the toilet or give a pot.
The used tip of a children's enema should be washed with warm water and soap and boiled.
How to make an enema with a pear?
The pear is completely filled with water to remove air from it. The end of the pear is smeared with petroleum jelly, soap or cream. Carefully, the pear is inserted into the anus to a depth of 3-5 cm. In order for the liquid to enter the intestine, you need to slowly squeeze the pear. The slower the water enters, the more painless the procedure and the longer the water lingers in the intestines.
If the water does not come out of the pear, it is slightly pushed back and waiting for the intestines to relax.
After the introduction of the fluid, slightly squeeze the buttocks so that the fluid lingers in the intestines for at least a few minutes to sufficiently soften the stool.
If after 15 minutes the water did not come out or came out without feces, the procedure is repeated.
Enema "Microlax"
Very convenient to use are microclysters "Microlax". They are produced in two types - for adults and children over 3 years old, for children from 0 years. They differ only in the length of the tip.
The prefix "micro" in the name indicates that you need to enter a very small volume of liquid - only 5 ml. Convenience is that for the introduction of the drug does not need preparation. No need to boil the pear or tip, no rubber tube needed, no need to adjust the force of pressing the pear or the height of the enema. A tube of the drug takes up little space, you can take it with you on vacation. The drug is small, so it is administered quickly, without causing any inconvenience.
To use microclysters, you need to break off the tip, squeeze out a drop of the drug and distribute it throughout the tip as a lubricant, and then insert the tip into the anus. The tip is inserted:
- for the entire length of children over 3 years old;
- half the length (there is a corresponding mark on it) for children under 3 years old;
- if a special children's enema "Mikrolaks" is used for 0 years, then the tip must be introduced to the full length.
Adults and children of all ages are given the entire drug (5 ml). The drug will begin to act in 5-15 minutes.
Microclyster "Microlax" weakens due to active substances: sodium citrate, sodium lauryl sulfoacetate and sorbitol. They break down feces into separate small particles, contributing to their softening, and also increase the amount of water in the intestine. As a result, feces become liquid and are easily evacuated outward.
Siphon enemas
They are prescribed for washing the intestines with:
- poisoning by metabolic products (for example, due to renal failure);
- intestinal obstruction - mechanical and dynamic;
- diagnosis of intestinal obstruction (the absence of feces or air bubbles in the washings indicates obstruction);
- inefficiencies of conventional cleansing enemas.
To set up an enema, they take a large funnel and a wide rubber tube. Bowel lavage in this way is similar to gastric lavage. Use boiled water, a weak solution of potassium permanganate, a 2% solution of sodium bicarbonate (soda). The funnel is kept just above the pelvis of the child, filled with liquid, raised up - the fluid enters the intestines. When all the liquid from the funnel enters the intestine, it is lowered lower, the liquid begins to pour back into the funnel along with feces. The contents are poured, the procedure is repeated until the water coming from the intestines is clear.
Medicinal
This is another type of therapeutic enema, their goal is the introduction of a medicinal substance. Their volume is usually not more than 50 ml.
30-40 minutes before the procedure, the intestines must be emptied with a cleansing enema. A drug enema is put at night, the medicine should be absorbed into the intestinal wall.
They are of three types:
- Enema of local action, or microclysters. They are put to provide local action on the walls of the rectum with its diseases. For example, a prednisolone solution is administered for chronic inflammation of the large intestine, and chamomile infusion for inflammation of the rectum.
- Enema general action. Many drugs, when administered by mouth or intravenously, are almost completely destroyed in the liver. With rectal administration of a drug, it immediately enters the general bloodstream, bypassing the liver. Therefore, some drugs that are destroyed by the liver are administered rectally.
- Drip enemas. Apply with a large loss of blood or fluid; as artificial nutrition through the rectum. For example, after vomiting, the child experiences severe dehydration, blood becomes viscous, and intravenous administration of drugs is difficult. In this case, a drip enema of saline is prescribed. Its feature is the duration of the procedure - it is left all night.
Other types of enemas
1. Oil. With spastic constipation, the doctor may prescribe an oil enema. Use any vegetable oil. It is heated to a temperature of 37 ° C. Oil enemas relax the intestinal wall, which leads to increased peristalsis. After administration, the child should lie down for 30 minutes. They put oil enemas in the evening, because the laxative effect will come only after 12 hours.
2. Hypertensive enemas. They are used for:
- atonic constipation to stimulate bowel movement;
- with edema of the meninges, since a hypertonic solution “draws” water from body tissues into the intestinal lumen.
3. Salt enemas make a 10 percent solution of sodium chloride or 30 percent solution of magnesium sulfate.
4. Starchy enemas. It is prescribed for colitis as an enveloping agent or as the basis for a medicinal enema, if you need to enter a substance that is highly irritating to the intestinal mucosa. Preparation: 5 g of starch is diluted in 100 ml of water, then 100 g of boiling water is added a little. Enter starch solution, heated to a temperature of 40 ° C.
5. Nutritious enemas. Assign as an additional method of nutrient intake in the body - a solution of glucose, amino acids.
Without a doctor’s prescription, only a cleansing enema with water (room temperature) can be used. All other options for enemas should be prescribed by a specialist after diagnosis. An improperly prescribed enema can harm the health of both an adult and a child.