Enema Tips for IBD
Let’s be honest. The symptoms of inflammatory bowel disease (IBD) are hard enough, having to use a rectal medication can initially feel like adding fuel to a fire. When I was first prescribed mesalamine enemas for my ulcerative colitis (UC) I told my doctor no. I was nervous, scared, and at the time embarrassed as I had no real concept of what to expect and had to figure it out on my own. After initially declining use of rectal medication my symptoms got worse, and I realized I needed to try this medicine so that I could feel better. I had no clue what I was doing. I was so lost. I put a towel down in my bed and administered the enema as fast as I could to get it over with as quickly as possible. I soon learned how very wrong that technique was.
Over the years, through trial and error and experimentation I have learned a lot and feel called to share my tips. I hope they help you on your enema journey.
If you feel the need to use the restroom before you do this medicine, DO IT. Most of the time that isn’t possible for me. You can try to pass gas instead, sometimes this works. The less gas in your colon the better but don’t feel bad if you can’t make this happen. Most nights I can’t do either so don’t fret if you find yourself in this position too.
Keep the enemas in the foil packaging they come in until you are about to use them. This keeps the bottles softer and easier to use. While, I don’t know the science behind why, I do know it helps. I used to neatly stack the enema bottles in a drawer so nobody could see them but now I always keep them in the foil packaging, until it is time to use!
Shake the enema bottle! It is important to shake the enema bottle before using to mix up the liquid. If you hold the bottle up to a light you will see the medicine is separated out until you SHAKE the bottle. Always shake before using and remember to keep your finger on the top to avoid making a mess.
Some IBD warriors find warming the enema between their legs, armpit, or hands is beneficial prior to administering, but I personally don’t find this makes a difference. Find what works for YOUR body.
Remove the cap and squeeze all of the air out, even if that includes some of the medication. I do this into a tissue but you can find what works for you. Exercise caution, sometimes the medication will squirt out and while it’s white in the bottle it dries brown and can stain. However, it is very important to do this or you will fill your colon with air which as you likely know, is very uncomfortable and makes it more difficult to retain the medication inside your colon.
Get comfy first. No really, get comfortable. Grab your blankets, pillows, remote control, cell phone, fur babies or whatever you need to be cozy and as relaxed as possible.
Lay on your left side with your right knee toward your chest and your left leg straight or maybe in a loose fetal position. Find the position that works best for you. I prefer a loose fetal position with both of my knees towards my chest on my LEFT side! Do your best to relax and think healing thoughts.
Go slow when administering the medicine and breathe deeply. I know we want this to be over as soon as possible but faster is not better in this case.
When you have the bottle inserted, tilt the tip toward your bellybutton or the position that feels best for your body. You are aiming for the least amount of discomfort! With the enema in your bum, squeeze the bottle slowly. You will have to grip the bottle tightly and squeeze very hard. Just do it in a slow and controlled way!
Don’t forget to breathe.
After you have slowly squeezed the bottle and you can’t administer any more medication, squeeze your bum as you remove the bottle (like a you are trying not to poop or are doing a kegel). Replace the cap and toss container in the trash or wherever you can without moving positions.
Stay in position and retain as long as you can. In a flare that tends to not be long or at all but when you are able, try to go right to sleep at night! When a gas pain comes try to breathe through it and exercise your best judgement on when to get up and use the restroom and when to breathe through the discomfort. Many times, the discomfort will go away. The more you can relax your body the better.
Don’t be alarmed if you notice the medicine in your bowel movements, that’s normal! What goes up must come down. I tend to head to the toilet when I first wake-up. You will learn how your body reacts to this medication over time and it isn’t always the same. Expect to expel any additional gas that administering the enema may have caused.
Advocate for yourself always. I noticed one pharmaceutical brand was easier and less painful to my body. So, I now ask my pharmacy to order the medicine from the specific pharmaceutical manufacturer that works best for me. This means I must call every time I need a refill to ask for the brand I prefer. This extra hassle is worth it for me.
Be patient and with consistency, acceptance, and time you will conquer this too! Do what feels right and good for your body even if it is embarrassing and uncomfortable. Try to think of this medicine as a medicated ointment or lotion that you need to apply to the inflammation in your intestines. Focusing on the therapeutic aspect may make this easier.
Find more tips on Instagram: @betterbelliesbymolly
