XX ? -- Equipment Use, Cleaning and Maintenance Techniques

This thread is specifically for newbies to learn how to use some of our favorite enema equipment.

How to use and insert a balloon catheter/retention nozzle:

These come in latex and silicone versions and they both have their supporters and detractors. The latex one is softer and the silicone version is firm. Most people have a preference for one or the other.

They also come in different sizes. The latex ones come in balloon sizes 250/250cc, 500/250cc, and the silicone double balloons come in 500/250cc and 750/500cc sizes.

A single balloon nozzle has one balloon, and it will have the balloon resting inside the rectum.

A double balloon catheter or nozzle has two balloons, and the balloon on the end of the tube will rest inside the rectum, while the other balloon will rest OUTSIDE the body and seal against the outside of the anus.

When attempting to use either a single or double balloon retention catheter, it is helpful, sometimes necessary to do a little “rectal rinse” first using a half to one pint of water to make space for the balloon to rest in the rectum. This mini cleanse can be done using a bulb, the enema tube with or without a standard nozzle or anything you prefer. Now, you must be sure ALL the enema solution is expelled BEFORE you try to insert the inner balloon, because if it isn't all expelled, you will leak some remaining brown fluid when doing the insertion, and that will be very messy. I would also recommend doing your entire enema procedure in the bathroom, NOT in bed at all, but you may prefer otherwise.

Once you have cleared the way in the rectum, lubricate the butt cheeks, anus and stick your fingers inside to lubricate the rectal walls. It is also helpful to add lubricant to the balloons themselves.

The firmer silicone nozzle can be inserted by gently but firmly pushing the balloon into the rectum. The softer latex ones often require a twisting motion to get them through the anus and into the rectum. Once the balloon is seated in the rectum, and it helps to insert it a little farther than its final resting place and then pull back out slightly so you feel the anus gripping the tube between the two balloons.

Once the balloons are in position you can inflate the balloons. The inner balloon should be inflated first. Close the chrome valve on the inflation bulb and inflate the balloon. Once it filled, give the tube a little tug to seat the balloon against the inside of the anus. Once that is done, inflate the outer balloon.

A lot about the single and especially double balloons depends on what you like. The latex balloons are more flexible than the silicone ones, so the silicone double balloon catheters of equivalent size can be easier to insert. I usually use 5-7 pumps on the 500cc silicone and 6-8 or 9 pumps on the 750cc silicone double balloon catheter. The 250cc outer balloons get three pumps. That’s all unless you want to risk breakage.

If you use a 750cc balloon and don't pump it up enough, trying to simulate a smaller balloon, the flutes will not be opened and they will then channel the enema water right out of your anus. The balloon must be pumped up so the fluted appearance is gone and the balloon is smooth.

The 500cc balloon, pumped as I described will be smaller and harder than the 750cc balloon when pumped as I described, but there are also differences in shapes. The 500cc balloon is spherical and the 750cc balloon is a blunt football shape. The 750 cc balloon is only slightly wider in diameter than the 500cc balloon when it is inflated, it is mostly longer.

If you over-inflate a silicone double balloon catheter, it is more likely to pop than a latex one, because the silicone one is less flexible than the latex. Latex can be pumped up more than silicone double balloon rectal catheters of the same rated size.

Test them in your hand so you know how many pumps it takes for the double balloon rectal catheter balloon to become a round ball. The 750cc size inflates to become oblong more like a football shape. You want to inflate them enough for the flutes to fully open and become smooth all around. If it is under inflated and the shape is like a "star fruit", the flutes will guide the water right out your anus because you won't have a seal.

The 750 cc double balloon rectal catheter requires a "straight shot" of at least 6 1/2" from thetip of the nozzle to the end of the inner balloon inside your rectum to be cleaned out BEFORE you will be able to insert this. For many people, going that far brings you to the start (or end, depending on how you look at it) of the sigmoid colon. The 500 cc double balloon rectal catheter requires only about 4 1/2" to insert it, and that makes it much easier to insert so the inner and outer balloons will be in the right place. The 500 cc double balloon rectal catheter gets just about as wide as the 750 cc, but the 750 is oblong when inflated, not a round ball shape like the 500cc.

The silicone double balloon rectal catheter is durable, but you must take care of it and keep the valves dry at all times.

My husband and I have several double balloon rectal catheters, and when we use a 750, we use at least 6 pumps, often 8 pumps. The reason you need to almost fully inflate it is because if you don't, the fluted shape will actually direct the water you are trying to retain right out of you and onto the bed, floor, etc. The balloon must be inflated so the inner part is resting against the anal ring and the balloon is fully rounded out. The anus will not seal against the fluted shape of an incompletely filled balloon.

When you are ready to expel, open the chrome valve and the air in the balloon will escape and allow you expel.

HOW TO USE AND INSERT COLON TUBES:

I happen to like stiff, thick colon tubes (42Fr and even much larger, to over an inch in diameter--can you say "fire hose!" because you can easily feel where they are inside the colon which allows you to massage it around the curves, but I am in the minority here with that preference. On insertion, you will probably feel areas where the tubes seems to get stuck a little because the tube is against an area that is curving. Follow my technique, and you should have a successful deep insertion.

This technique also works with more moderate sized tubes like 32-42Fr tubes. You will not have success with a deep 24-36” insertion using a skinny thin tube. Tubes less than 32 FR may be fine for rectal and sigmoid insertions, but they will not get you all the way around the colon.

Depending on the characteristics of the tube (diameter, stiffness) and your ability to know anatomically where it is in your colon and your skill in manipulating it, you could get more than 30 inches, but probably far less than five feet in unless the tube in kinked or folded--and most people don't realize when their tube is kinked or folded inside themselves. Be careful. Read posts on colon tube techniques.

Here's how I insert the colon tube:

The method I use to insert is tube at least partially cleaned out first (the better cleaned out you are, the better) and be laying on your back--that is the position colonoscopy is performed in once you get to the transverse colon going on to the ascending colon and cecum. The reason to be on your back, and take a lesson from gastroenterologists here, is because on your back, your colon is on top of all your other abdominal organs. In the knee chest position, all your abdominal organs "fall" onto the colon inside yourself, and the weight of those organs can prevent easy passage of the tube deeper in the colon. Then when inserting the tube, use lots of lubricant so the anus doesn't get sore. Then allow some water to flow in and close the clamp. Nowto insert the tube, I like to use the "jerking off my husband" stroking method as the tube is gradually advanced. What I mean is keep the tube moving in and out in two to four (or whatever is best for you) inch strokes and keep advancing the tube. I never found just twisting the tube to be as effective as the "jerking off" method, which is actually more or less what gastroenterologists do when they insert a colonoscope. They inflate the colon with air, we will use the enema water. Periodically, depending on how the tube feels inside you, add more water and close the clamp again and advance the tube more. Keep doing this until all the way in. WARNING: the tube will not go in as far as you think. Unless you have an abnormally tortuous colon or the tube folds over on itself inside you,you won't get in five or six feet of tubing. When the colon is described as 5 to 6 feet long, that is how long it is stretched out on a table, not sitting inside your abdomen. Consider the colon to be like the slinky toy. You can stretch it out far, but when it is at rest, it isn't that long. To demonstrate my point, look at a chart showing how the colon lies inside the abdomen. Then, take a rubber tube and trace that out on your belly. You'll see there is no way you are getting five feet of tube inside you without its kinking and folding. Three feet is about the maximum you will get. DO NOT force it, especially as you get the end ofthe tube in to the lower right quadrant where the cecum is. If you have a heavy, stiff tube (which is really what I like because it is easier to feel inside you and "massage" to where you want it to go) you can puncture your colon, which will cause a life threatening infection or you can damage the ileocecal valve if you try to force it into the ileum.

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DO USE CARE AND CAUTION WHEN PERFORMING DEEP INSERTIONS. Keep in mind, the PHYSICIAN CAN SEE where he is going when doing a colonoscopy and YOU CANNOT SEE when you insert a colon tube, which makes it much easier for you to perforate your colon, which will result in diagnostic CT scans, a week long hospital stay, a large abdominal incision, abdominal laparoscopy to make sure you are all clean inside and free of feces in the peritoneal cavity when they sew you back up. Oh, and lets not forget the colostomy bag you will go home with and will wear for anywhere from 6 months (IF they can reverse your colostomy) to maybe FOREVER, not to mention other ramifications and complications of large incisions in abdominal surgery.

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HOW TO CLEAN A COLON TUBE:

After use, fill your bag with very hot water and flush out the colon tubes and hoses very well.

Soap and water or bleach diluted 1:5 or even 1:10 with water is fine for cleaning enema equipment. Boiling is not necessary.

Colon tubes, double balloon rectal catheters, and other tubes should be hung straight and vertically, NOT coiled until they are completely dry. Coiling will dramatically slow down drying and promote mold growth.

Our S&M / enema equipment room looks like a meat locker with everything just hanging straight down from hooks. Nothing is coiled with the exception of ropes.

The use of grapefruit seed extract is a lot of bunk. Here's my post and it contains a scholarly, scientific, refereed journal reference:

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=10399191&cmd=showdetailview&indexed=google

HOW TO CLEAN ENEMA BAGS AND TUBES

For sanitizing and cleaning equipment, almost any soap or detergent or a little bleach, diluted 1 part bleach to 10 parts water will keep your stuff very clean and in great shape.

Here is what I do:

Closed top bags, including the JBL, can be filled with detergent, like dishwasher detergent--NOT sink type dish soap-- because dishwasher detergent doesn’t foam and cleans very thoroughly. (Foaming is bad because it impedes cleaning ability of the solution.) Once the closed top bag is filled about 1/3 to 1/2 full, shake the devil out of it. Then, rinse the bag a few times with clear water and hang it upside down to drip dry. It should be very easy to clean a four quart Klystra bag. The top opening is pretty large. First, take a wet, soapy sponge and drop it into the bag, which should already be wet and soapy. Then make believe you are going to "fist" your bag. That means extend your fingers and tuck your thumb into your palm, just like the initlal anal fisting position!

If you're cleaning the bag, you should soap up your hands, so they will slide easily into the bag just like fisting so once you're in, you can just rub your hand against the entire inner surface (again, just like fisting).

Anyway, once you've thoroughly wiped the inside with the sponge, gently remove your hand and rinse the bag. The rubber of the bag should easily allow you go do this. If your forearm feels tight against the rim of the bag, remember you can use your other hand to push the bag against your hand inside the bag so all surfaces can be wiped. You shouldn't have any problem with this. After use, fill your bag with very hot water and flush out the colon tubes and hoses very well.

Soap and water or bleach diluted 1:5 or even 1:10 with water is fine for cleaning enema equipment. Boiling is not necessary. You can use bleach right out of the bottle if you want.

Closed top bags like the Paris and JBL take a long time to dry. Closed top bags should be hung with the tube side down so it can drip. Open top bags like the Klystra 4 quart, should be hung right side up for best dripping and air access. An open top bag will obviously dry faster. You want it to dry fast, so make your final rinse with hot water and shake it out the best you can. Slow drying will promote mold and mildew growth.

To scrub the inside of tubing and colon tubes, you can take a long piece of bare copper wire (longer than your tube) from the electrical department of a hardware store and bend a very tight loop on BOTH ends. The first loop is to make sure the wire end is smooth and the other end is used to crimp on a tiny piece of gauze or sponge. The wire is first threaded through the wire al the way to the other end and is used to pull the end with the sponge or gauze attached all the way through the tubing. That will effectively wipe the inside walls of the tubing. You may need to experiment a bit to find the exact sponge size to pull through the tubing. Start with a small piece and work up in size if necessary. You don't want a piece of sponge falling off or getting stuck inside the tubing.

Colon tubes, double balloon rectal catheters, and other tubes should be hung straight and vertically, NOT coiled until they are completely dry. Coiling will dramatically slow down drying and promote mold growth. Everything must be completely dry before you put it away.

I often clean the bag and tubes in the shower, with the exception of a double balloon rectal catheter. The double balloon rectal catheter has to be cleaned in the sink and the valves and balloon inflation tubes kept dry.

Our S&M / enema equipment room looks like a meat locker with everything just hanging straight down from hooks. None of our equipment is ever stored coiled except for our ropes.

Open top bags are favored for their ease of cleaning. I have two large clear silicone bags that get toweled wiped inside, then blown dry with a hair dryer at low setting. I do this even if the bag is going to be used again tomorrow. Tubing is a bit harder...I'll drip dry for a minute or two before playing "whirylbird" in the air. If the hose isn't going to be used in the next few days, I'll hook up an aquarium air pump to disperse air through the hose. This will dry it over night if you have a good pump and connector. Then run 20% bleach solution at least once/month, or immediately after a coffee enema. Mold or any questionable odor has never been a problem following this routine.

The best tool for cleaning ur tubing is an air compresser,Soap is the problem with clogged tubing,plus soap will maintain the moisure that cause moid

Drying tubing is actually easy. You can wash it with soapy hot water and/or 1:10 beach solution, blow it out, then hang it vertically with no coils or folds. It will dry in a fairly short time and not get mold.

TAKE THE TUBING OFF THE BAG WHEN DRYING.

Be careful a mold can be seen, but bacteria are much worse. After using an enema bag, clean it by rinsing with very good heat water with soap, especially with household detergent, like enema bag hose and nozzle clean. Never use enema nozzle for vaginal lavage, bacteria risk is great. A.

I clean them with soap or dish cleaner and hot water, then I use desinfection spray (alcohol-based), then I rinse with water.

I use Peroxide is a disinfectant. Exposing all inner, hose and tip surfaces of the enema bag to peroxide for at least thirty seconds should be sufficient to disinfect it. It kills 99.9 percent of bacteria upon contact.

I do not understand the fascination with eliminating germs on your equipment. Unless you are sharing your equipment, the only germs present are the ones that came out of you, so you cannot catch anything you do not already have.

hankb

One problem is mold after poor cleaning and lack of proper drying.

The other problem is the fact that just because the bacteria came from you doesn't mean that in the poorly cleaned bag and/or hose, bad bacteria can't competitively compete and grow out of proportion in the bag or hose and then infect you.

Susie is right: mold can be a real problem, especially in bulbs. I use bleach to kill the mold and then lots of very hot water to rinse it. Bags are much easier to clean, but amber latex tubing SHOWS you the mold building up. With opaque tubing you can't see the mold. Filling the bottom of the bag and all the tubing with dilute bleach for an hour or so is a wise thing. Replacing the tubing every now and then is also a good habit.

Bacteria need three things to grow - moisture, food and warmth. So if you wash your equipment with soap and water until it no longer smells, it's clean and there is no food for the bugs. If it is then thoroughly dried out there is no moisture, any few remaining bugs will die. Keep it in a cool place, and the few remaining bacteria will cease to multiply. Sunlight with its UV component also kills bacteria, but it damages latex and rubber. Viruses are also present in feces but can usually be killed by chlorine, as in bleach, but simple cleansing with soap and water will destroy most bacteria, and most viruses too.

How do you clean a JBL bag after use? Both the inlet and outlet are very small openings. So far what I have done is put a 10% bleach solution in the bag and slosh it around for a few minutes and then squirt it out through the nozzle. Any comments? Is 10% enough bleach? Is bleach more or less effective than hydrogen peroxide?

With my open top Klystra 4 quart bag, I also use the bleach solution, letting it run out slowly through the hose and nozzle. Then I dry it using a hair dryer at the open top entry, letting it blow out through the hose and nozzles.

Will appreciate any tips from others.

Bleach is much more effective than hydrogen peroxide. 10% bleach solution is very good.

To dry the bag, hang it so the fill opening is on the bottom and anything left in the bag can drip out. Do not store it with the stopper plug or rectal nozzle attached.

see this http://www.zity.biz/index.php?mx=forum;ox=display;msg=287670

Washing all equipment parts with soap and hot water after use, and a thorough rinse should be a given. Using a back flow preventer valve should be another. I install mine in the base of open top bags, far from the tip. Any back flow will not pass more that 2-3 inches into the tubing past the tip with a good unit such as those sold by Optimal Health. That device keeps most of the tubing and bag 'clean'.

To dry the equipment after use: disconnect all parts, place a clean washcloth inside the open top bag and manipulate the bag and cloth so all portions of the bag are contacted and dried, remove the cloth and dry the outside. Tubing is hung to drip until being held against a vacuum hose for about two minutes to remove all droplets. Tip is immersed in a baggie with 3% peroxide overnight, then washed and the the whole kit put away until 'next time'.

Depending on usage, every 1-2 months, after use and washing, assemble the kit, pour 1 liter of undiluted 3 percent hydrogen peroxide into the enema bag and let it flow through to the tip then clamp it off. Fold the top of the bag over on itself and shake it several times to wet all the bag's internal surfaces. Hydrogen peroxide's effectiveness in disinfecting inanimate surfaces against bacteria, viruses, parasites and molds depends on its concentration and the length of time the hydrogen peroxide solution is in contact with the surface. The U.S. Food and Drug Administration approves solutions of 3 percent for sale and, according to the Centers for Disease Control and Prevention, a 3 percent solution requires 2 1/2 - 3 hours of contact to disinfect against all pathogenic or disease causing agents, with shorter times leaving many dangerous bacteria alive and able to reproduce. To insure this level of disinfection, leave the bag and tubing filled with the solution for 3 or more hours before emptying the solution. You can also leave it filled all day or overnight without any harm. It should then be rinsed and dried as described above.

Been using this practice for at least 10 years with success.

Use bleach and clean thoroughly, is my best recommendation.

Allow bleach to soak for at least an hour, especially on something you haven used or cleaned recently. You'll be fine.

Susie great advice. thanks

Hello, The problem with bleach is that any spills can cause unwanted discolouring of other fabrics. These days I use Milton sterilising tablets, not sure if you can get them in the US. The routine is wash the nozzles and/or other plugs in warm soapy water and then pop them into the Klystra silicone open topped bag. Fill with cold water, pop in a tablet and then leave for about half an hour. Perhaps un-clamp the delivery line a couple of times during the soaking process. After an hour, hey presto, all is clean, smelling nice and ready for the next adventure. To plagiarise the words of DebGurl, enjoy and play safe!

One other advantage of this routine is that my bag and the delivery hose are always squeekie clean too.

One important thing to remember that's been implied but not said outright is that for most sanitization/sterilization methods but especially for chemicals the object needs to be clean before it can be sanitized/sterilized effectively. For chemicals you also need to be aware of contact time recommendations.

Thank you the advise for cleaning and double balloon nozzle

My wife and I have a variety of enema bags collected throughout the years. My personal favorite is a Klystra 4-quart open top. We always hang the bags high enough to prevent backflow, and when done, rinse and hang them to dry out, clamp open. We keep the bags most used out, not folding or packing them away. Periodically, I give them a rinse in a bleach solution. The Klystra is a high quality rubber bag.

I recently read advice from an enema equipment seller that the best way to clean a bag is to turn it inside-out, scrub with antibacterial soap followed by a peroxide rinse. This seemed good advice, so I wrestled the bag inside-out, and was shocked at what I found. Mold growth was unmistakable. There was some deteriorating rubber, something warned about in the article, a result of the use of bleach. But that mold...

This has me rethinking the equipment issue. While an enema can isn't as 'sexy', they would be able to go in the dishwasher. Also considering a clear silicone bag. Does anyone know if they are more mold-resistant? At least, it would seem the clear ones would be better for seeing any contamination. Would like to hear your experiences and suggestions...

I use an antique glass percolator that is easy to clean with dish soap, then bleach water, and let it drain and air dry. Periodically, I do change out the amber latex tube as it gets some moldy spots.

Dan

This has me rethinking the equipment issue. While an enema can isn't as 'sexy', they would be able to go in the dishwasher. Also considering a clear silicone bag. Does anyone know if they are more mold-resistant? At least, it would seem the clear ones would be better for seeing any contamination. Would like to hear your experiences and suggestions...

I have a clear open-top silicone 4 quart bag from Seeking Health, and cleaning is easy and I have never had a problem with mold or it staying damp for any length of time when hung up (I've had it almost 4 years)

I rinse after use and clean it with a soapy washcloth and rinse inside every couple of uses. I don't know if the 2 quart would be as easy to clean, as it would depend on how wide the top opening was.

I did bleach it once, but it never has seemed really necessary.

Thanks for all the responses. Giving this one a good cleaning, and will clean with bleach after every use in the future. Don't think we'll be using any of our closed-top bags from now on, however.

Great description, Susie. Thanks!

I prefer to use the laboratory 'standard' for sterilizing with bleach and water which is 1:20 (20% bleach and 80% water). No need to leave it set for an hour. One minute and then thorough rinsing is all that's needed. This ratio will kill anything including viruses. I keep a gallon of this mixture in a former distilled water bottle.

I do NOT recommend full strength bleach as it is difficult to rinse thoroughly and may damage certain materials over time. It's also over-kill and unnecessary.

Also, clear vinyl and silicone bags can build up hard-water stains if you have hard water. To remove these stains, use a 1:8 solution of CLR (Calcium, Lime and Rust remover). Pour a little of this solution in the bag and shake lightly to coat the entire inside of the bag (if your clear tubing has hard-water/scum build-up, let the solution flow out through the tubing). Wait about 2 minutes but no longer and then rinse thoroughly with plain cold water and hang to dry. For heavy build-ups, you may have to repeat this several times. I don't know if it is safe for rubber as it doesn't say on the bottle so I would test it on an old bag that you're thinking of throwing away first. Works great when used as directed. It's available in most grocery and hardware stores.

Great description, Susie. Thanks!

I prefer to use the laboratory 'standard' for sterilizing with bleach and water which is 1:20 (20% bleach and 80% water). No need to leave it set for an hour. One minute and then thorough rinsing is all that's needed. This ratio will kill anything including viruses. I keep a gallon of this mixture in a former distilled water bottle.

I do NOT recommend full strength bleach as it is difficult to rinse thoroughly and may damage certain materials over time. It's also over-kill and unnecessary.

Also, clear vinyl and silicone bags can build up hard-water stains if you have hard water. To remove these stains, use a 1:8 solution of CLR (Calcium, Lime and Rust remover). Pour a little of this solution in the bag and shake lightly to coat the entire inside of the bag (if your clear tubing has hard-water/scum build-up, let the solution flow out through the tubing). Wait about 2 minutes but no longer and then rinse thoroughly with plain cold water and hang to dry. For heavy build-ups, you may have to repeat this several times. I don't know if it is safe for rubber as it doesn't say on the bottle so I would test it on an old bag that you're thinking of throwing away first. Works great when used as directed. It's available in most grocery and hardware stores.

The timing you describe is not quite long enough, but even so, the SURFACE of what you are cleaning MUST be completely clean BEFORE the timing with the bleach is begun.

There is no way one minute will kill everything including viruses.

A long time ago, I was at my Grandmother's house and I saw that she had, what I now know to have been, a douche nozzle in a Tupperwear container. I asked her what it was, and she told me, and that she kept the nozzle in half vinegar and half water. She also had a hose coiled up in the container, too, I didn't see the bag anywhere.

But would half water and half vinegar be a good solution to clean up equipment?

For the longest, i got pleasant emotions from seeing the red bag on display. Later, after becoming more germ and chemical conscious, i started developing a reliably simple siphon from gallon water jugs. With a lid lightly applied, dust and bugs have no chance at them. Also they are easily replaced, since no modification is required for the siphon to work.

Now there are two or three exclusive "Lzrd" special arrangements i use.

1. Put a black straight tubing coupler into the suction end that drops onto the bottom of the plastic jug.

2. Use a common plastic enema clamp that hangs on the lip of the jug to hold the tubing secure and properly set onto the bottom of the jug of pregnant juice.

Set this way, "without a higginson pumper" set the jug on the sink prep area and use the faucet to blow the air out of the tubing and fill it with coolness. Clamp it off close to the end and apply what your butt is about to receive.

If you take the aerator fitting off of the faucet, your tubing will slip up into the water spout a little and the tubing hose purge will go much smoother.

A Higginson pumper makes it lots easier, all the way, but consider a simple modification just for fun. Take the tiny flapper out of the exhaust valve of the pump. When you prime your hose, squeeze the bulb, Kink the hose on the exhaust end and let it draw water from the jug. Later you will discover the advantage of this mod.

Thank you, that was very informative! When using a double balloon enema set up does this prevent expelling the enema until a specific time has passed or the balloons are deflated? I want to find equipment that will prevent expulsion until the playmate has determined that the proper volume, time, and any necessary or requested activities have been completed. Is there a comfort difference between latex and silicone devices? Again, thank you very much for the info.