Enema FAQ (II)

technical info, anatomy, positions

There is a lot to know about enemas before you can safely enter into any enema play. The information below covers the technical aspects of enemas. As always, it's a very good idea to make sure both partners are fully aware of what they're entering into.

Solutions

When we are talking about fluid-based enemas, "solutions" are THE topic. If you're inexperienced, start with using lukewarm (hand warm) milk or a mixture of half milk/half water. Plain (lukewarm) water is a good idea too, although less effective. The most effective solution is soapy water and the pro will add glycerin (50/50 soap/glycerin - about one teaspoon of each will do nicely) to the second and next enema which will both boost the effect and protect the intestines.

Soaps

Ivory bar soap works well. Just let the water flow over the soap bar when filling the bag and you'll have enough soap. A few drops of glycerine, vegetable oil and/or a bit of camomile will improve the effects. For a stronger soapy solution, use a container and swish the water around to dissolve more soap. Castile Enema soap (or other brands in other countries - usually available from your local pharmacy) in premeasured packets. Standard packet is 2/3 oz of soap. Instructions on packet usually say something like: "Dilute contents of packet with 1 or 2 quarts of lukewarm water" ... but for our purposes about half that strength usually is more than enough. Adding a few drops of peppermint oil (do NOT use Eucalyptus oil for this) will have a cooling - surprising - effect. It is a good idea to always end with a plain water enema to deal with any possible soap residue.

Non-soap solutions

Plain tap water can be used, but be warned that the colon will absorb quite a bit of the water, which will dilute the blood electrolytes. Then the various tissues of the body absorb the excess water and swell. Your brain swells, too, and there isn't any place for it to expand into. This is called cerebral edema. A few 2 quart plain water enemas won't do any harm (in fact will have a positive effect as described above), but if you plan to use large or many enemas, use salt water.

Salt Water enema (Saline Enema) is just warm water with one tablespoon of salt to the quart. The salt is used to prevent absorption of the water by the colon.

Baking soda enema (which can also have salt added as above) has one or two tablespoons of baking soda dissolved in each quart of water.

Beer (usually warm) can be used. It is pretty irritating and - obviously - at least one of you will get drunk.

Oil Retention enema is an injection of about 4-8 fl. oz. of mineral oil, vegetable oil or olive oil. It is held in the colon for an hour or more before a soapy water enema is given. The soapy water enema can be very strong because the oil will protect the colon from irritation. The oil coats the lining of the colon, and also softens the bowel contents, making for a spectacularly powerful evacuation. When the oil is in the colon, do not be fooled by what feels like the urge to expel gas. If you do, you will expel a blast of dirty oil with it, and it will be a mess. If you absolutely must pass the gas, get into the knee-chest position (see below) for one minute, and then hold a piece of toilet paper over the anus, to prevent the release of the oil. Do not expel the oil before taking the soapy water enema. You will need to take at least three soapy enemas to remove all trace of the oil, or dirty oil will leak out of the anus for about 12 hours.

Urine is sometimes used. It can be used safely provided the person donating the urine is disease free and the general advice is to use water-diluted urine (see the Watersports FAQ).

Temperature

Most people find that a warm water enema can be held more easily than a cold one. Here's some information on ranges of temperatures:

Cool water is 30 - 35 degrees C (86 - 95 degrees F) - this is lukewarm and the most frequently used temperature that most people are comfortable with.

Warm water is 40 - 42 degrees C (104 - 108 degrees F) - slightly warmer and as such more effective if you want something more difficult to hold.

Hot water is 43 - 45 degrees C (110 - 113 degrees F) - the "pro" temperature - still safe to use provided it is followed by one or two cooler ones.

Don't use solutions over 45 C or 113 F or you can scald the colon. Water between 15 and 30 degrees C will improve the general condition of the intestines if you have a problem there, but do not use it too often and most people can't stand a solution that has a temperature below their average body temperature.

Anatomy of the colon

The anus (a muscular ring) is the external sphincter which closes off the rectum from the outside of the body. It can easily stretch to about 1 inch diameter, and - with care - can be stretched wider. The rectum is a powerful muscular organ about 5 inches long, with a sphincter at each end. The sigmoid colon is a looped section of the bowel just above the rectum. Its shape resembles a question mark. The loop occurrs at about a depth of ten inches, as can be felt during anal fisting (known as "the second barrier"). The size of the sigmoid is different for different people. There is the long sigmoid and the short sigmoid, and a few people are born with one in between. Those who have the big sigmoid can take about a full quart of water more than those with the short one.

The descending colon is on the left side of the lower abdomen, and can easily be felt any time the abdominal muscles are fully relaxed. It hugs the left wall of the pelvis, and reaches up to the splenic flexure, which is just under the left rib cage. The transverse colon extends from the splenic flexure to the hepatic flexure, right across the abdomen on the right. It follows a sagging course across, and in many people sags about 3/4 of the way down in the middle. The ascending colon is on the right side of the pelvis, and the lowest part of it is called the cecum, the part of the colon where the small intestine expels its contents in a liquid form. It is the part of the colon with the largest diameter, and is most effective in absorbing water. After taking a large enema, stand in front of a mirror, with the light from a ceiling lamp falling across the abdomen, and the shadows will make many of these structures readily apparent. The transverse should show up as a shadow about 2-3 inches below the belly button. When lying face down on a bed, the cecum will expand to an enormous size, then lift the body a few inches with the hands and knees and the right side of the belly will clearly show the shape and position of this part of the colon. The colon narrows gradually from the cecum (about 2-1/2 to 3 inches when distended) to the sigmoid, about 1 to 1-1/4 inches diameter.

Positions

There are many positions in which an enema can be taken. Two of the most widely known are the "Sims" position and the "Knee-Chest" position. The "Sims" position - the position generally advised to nurses - has the recipient laying on the left side, with the right knee brought up near the chest. The "Knee-Chest" position has the recipient in a kneeling position, supported by the knees and the shoulders, with the chest sagging down, so that the chest almost touches the floor. This places the abdomen nearly upside down, so that the water can flow down from the rectum to the transverse colon by gravity. In hospitals this position is sometimes used as an alternative to the "high enema" (a "high enema" is something you should NOT try and administer yourself unless you're a trained nurse - the "Knee-Chest" position is the safe alternative) in cases of deep-seated constipation, this position will help the water reach way up into the colon for a good cleaning out.

Tip: It is also useful as a technique for floating air or gas in the colon above the water so that the air can be expelled (discussed in more detail in the Expulsion section in part three of this FAQ).

Standing upright requires you to hold the tube in the anus unless you use a nozzle that can be held in, but it makes it possible to accept more water than any other position.

Lying on the back is a favorite position, especially for the first enema of a session. In this position the recipient can watch the bag slowly deflate, and can also watch the abdomen expand as the water enters the colon. The best is to lie down so that you can prop your head against a wall, like a pillow. Raising the knees increases the comfort in this position.

Lying face down can be used, but pressing the belly on the floor restricts the abdomen's need to expand. Lying face down and arching the back by raising the upper body on the elbows is a very stimulating position, and lifts the belly up from the floor. This presses the genital area against the floor, and leaves the breasts and nipples free for other stimulation.

Lying on the right side is the opposite of the "Sims" position, and causes the water to flow down into the cecum. When you do this, feel the ballooning out of the cecum, the part of the colon with the largest diameter.

Sitting on the floor allows a person to tense certain skeletal muscles, and can lead to a powerful orgasm. The floor helps hold the nozzle in. This may not be the greatest position for filling and cleaning the bowel, however. Reclining is similar to sitting, but you lean back against something.

Reclining in the bathtub is quite comfortable, except that the tub may be cold. You don't have to worry about leakage here. Leaning over the edge of the bathtub is similar to getting on your hands and knees, but it leaves your hands and arms free, and is a little easier to stay in that position for a while. Sitting on the edge of the bathtub is comfortable, and is the way to do a faucet enema, described in the Equipment section in the third part of this FAQ.

A FIRM "DO NOT" - Never ever try administering an enema to someone who is positioned or suspended upside down. Apart from the fact that expelling will cause all sorts of problems, this position is both extremely painful and dangerous. For good reasons this method was used as one of the most effective torture technique in the Middle Ages. Filling the intestines with water in this position causes extreme pressure on some of the more tender organs such as the liver, kidneys and stomach, which is where the pain, the almost instantaneous nausea AND the damage comes from. This method was (and in some countries still is) frequently used for torture since the method does not leave any external markings, hence there is no obvious external evidence of torture. Combining it with a water-filled stomach leaves the victim almost without the ability to breath as well (the combination of both methods was known as the "Water Torture" during the Middle Ages).