Exceeding a safe pressure of an enema.

I have read that a safe maximum pressure for an enema is 2 PSI, which is equivalent to having a bag at a height of 5 feet above the colon.

Many enema users prefer to use a large enema syringe with multiple insertions into the anus. I would be very interested whether anyone could answer the following question:-

When using a 10 ounce bulb syringe for large volume enemas (4 quarts or more) is there a danger that this maximum pressure could be exceeded?

Unless you had a retention nozzle, you would probably leak significantly around the anus with constant insertions and removals of a bulb.

You can absolutely exceed that pressure with a bulb, especially if you have a strong anus and can clench well.

I too wonder if having the bag (using a double balloon nozzle insertion) higher is dangerous to let the liquid flow in too quickly? It seems to me lying flat during a colonic (not the gravity type) could also create enormous pressure going in quickly. But becuase some are geared to let the recipient evacuate simultaniously, maybe that negates what the pressure can do? This is diffferent than a home enema and the distance between the bag height and the recipient's anus. What is a safe height on the higher side for a home enem?. I know the nozzle openings (number and size of) are a consideration in this answer too.

Amanda60, I usually hang my bag at 3 feet above me, but sometimes I will hang it at 5-6 feet and will squeeze the hose to give short bursts until the bag empties.

Today's colonic machines have pressure adjusters to limit the flow rate to a very safe level. The last thing they want are law suits and they are heavily regulated by the state governments.

Years ago, the concept of a "small bowel enema", was done entirely through the rectum, with the patient heavily sedated, so as to not feel the intense pressure of the barium filling the large bowel and forcing the ileo-cecal valve open to also fill the small bowel for radiographic studies. Now, they either use an N.G. tube or have you drink the barium and wait until it reaches the small bowel. I had this done by drinking a quart of barium every 45 minutes. After the third quart, I was running to the rest room to expel, which told them the small bowel was full and the X-Rays could proceed.

The guy that used to take 3 gallon (!) enemas said he used 3 psi. I just mention this but don't recommend it. I have had 7 ft. height with no problem.

Using external pressure is unsafe for me , it is very close as a russian roulette , if not injured this time it will be for the next , and you sure of it ! ! !

About elevation of the can or the box , the diameter of the hose will change the effects too !

A bag have to stand at 15" above the belly button of the receiver , this is when using a 5/16" hose .

If using a very fine hose ( like1/16" ) the value of 15" will be increased , using a hose thicker the value of 15" have to be decreased .

Remember the enema water need time to reach very far areas inside your bowels , going to fast there is a high danger of rupture .

Take a old inner tube from a bike and over pressurize it , some hernia will appear that is one of the risks taken with over pressurised .

The best flow rate is about a quart per minute. Much faster than that is too dangerous, and potentially messy.

Do not use a balloon, use a normal douche nozzle. in this case your sphincter works as a safety valve: if the pressure rises too lose water.

I am not into bulb syringe enemas. But I have taken jug enemas with the jug sitting on the top of a six foot step ladder and me lying on my back on the floor.

I also once put a bag enema and hung it from the top of a staircase, about nine feet above my hips. I had to stand to take the enema. I had a long hose but it still wouldn't reach the floor. Water gushed into me.

Type of nozzle, hose, clamp & other devices can make a LOT of difference in the speed & pressure. My old antique vaginal douche nozzle, which sprays in four directions, is the fastest to empty my jug, even though the hose for it is narrower. If I recall, it empties my 6 quart jug in about 2 minutes

I currently prefer a Klystra KP-2 (I think it is) penis shaped nozzle. It fits on a thicker hose. And I use a one way flow valve & spinner flow meter. This rig is very slow. It empties the same 6-quart jug in over 3 minutes.

I also think the standard recommendation for enema volume & height/pressure are designed to by overly safe for anyone, ever. Almost anyone can take a 2 quart enema. It is almost surely guaranteed to be safe if the water resevoir is not more than 36 inches above your hips.

What fun is that? 😉

Be careful if you have diverticulosis and many people over 50 have it. Blowing out a diverticuli is an unhappy complication and requires surgery and maybe a colectomy or colostomy.

We have discussed this before.

I suggest another approach to find a safe pressure limit. At the end of a fill insert a clear plastic tube whose end is at least 4 feet above your tummy. Wait for a contraction and see how high the water gets. That plus a little more is your safe limit. Probably about 2 1/2 ft. Or a bit over 1 psi.

If you want faster flow, don't raise the bag above the limit, enlarge the opening in the tip.

I use a screw clamp on the main hose and have a flow meter, both from Klystra. In that way, the bag is as high as it needs to be for whatever hanger you have, for example, your shower curtain rod. I screw the clamp down until the flow meter is not going very fast, and take perhaps four or five minutes per quart, which works out to fifteen or twenty minutes for my four quart bag, also from Klystra. That way, there is no danger of having the pressure inside of me being too high.

hankb

I use a screw clamp on the main hose and have a flow meter, both from Klystra. In that way, the bag is as high as it needs to be for whatever hanger you have, for example, your shower curtain rod. I screw the clamp down until the flow meter is not going very fast, and take perhaps four or five minutes per quart, which works out to fifteen or twenty minutes for my four quart bag, also from Klystra. That way, there is no danger of having the pressure inside of me being too high.

hankb

NOT TRUE.

The rate of flow has absolutely no effect on the resulting pressure inside the colon.

The height of the bag /column of water determines the pressure. If you are at your capacity, the pressure inside the colon will be the static pressure of the column of water.

If in fact, 2 psi is the safe max pressure, I believe that would be equivalent to 4 feet above the anus. Atmospheric pressure is 14 psi, and the equivalent water head is 28 feet. The hose and nozzle will reduce the pressure only slightly if the clamp is fully open.

For the record, for anyone who cares, Susie is correct.

14.7 psia is equal to a column of water 34.0 ft high. 4.0 feet is then 1.73 psi. Whether that is harmful I no clue.

The pressure of a water column is .43 psi per foot in height.

One of the great things about this web site is to be fortunate enough to have moderators like Switchablesusie, that is an RN, MSN, with not only professional but practical experience in so many areas where we need a little insight that only a medical professional can offer. Thanks Switchable, for chiming in when we need it most.

The information about the pressure at the bottom of a static water column is correct, and the higher the bag is hung, the greater the pressure at the closed clamp near the end of the tube. However, when we open the clamp, we have a hole at the bottom end of the tube from a nozzle or colon tube, we cannot predict the pressure on the open side. If it flows into open air, the pressure on the downstream side becomes zero.

However, we are letting it flow into our colon, and the back pressure depends on how quickly the colon muscle can relax and expand to accomodate the increased volume within it. If you try to fill yourself too fast, the muscle complains and you get cramps. Though I cannot say for sure, it might possibly be unsafe,. By stopping and starting the flow as many recommend, you are effectively regulating the pressure by giving the muscle time to relax and make room for the new volume within it.

Instead of starting and stopping, I use a screw clamp and a flow indicator to keep the inflow rate at a comfortable value--4-5 minutes per quart-- and do not get cramps for the pressure never gets too high. By using a clamp to restrict the flow, while the pressure on the upstream side is close to what you might calculate, the pressure on the downstream side, the back pressure, cannot be predicted from the classical formula as long the colon is expanding to accomodate the slowly increasing volume. The lack of pain and cramps indicates this is a safe, low pressure way to do it.

hankb

Perfectly correct hankb, about the pressure in the rectum or colon being negligible when the clamp is opened.

However, for others reading this, Susie corerctly says that "If you are at your capacity, the pressure inside the colon will be the static pressure of the column of water" - This may well be more than is wise.

There is a very sage maxim - Everything in moderation!

I would not recommend a bag height over about 4ft. and if any real pain stop the flow wait and decide if you need more solution.

Thanks BigK and Susie for pointing out that you should not exceed your capacity and that if you do, it will hurt. However, it seems like standard procedure is to let the water in until it hurts, then stop a while until it stops hurting, and then let in more. How do they know when to stop? Just by having unremitting pain? You seem to say that at capacity, the water stops flowing, for that the height of the water column stops going down. I read that some can take only 2 or 2-1/2 quarts, whereas others take 3,4,5, and even 6. Can you tell me a bit more about how you determine capacity?

hankb

I can't advise on capacity hankb. I'm only employing the rules of hydraulics, which are the same for rectums as they were for the Dambusters! OK - a bit of common sense thrown in too.

Just an observation from many enemas. When I reach the gurgle that says the bucket has run dry (I use a siphon and it sucks!), the level of the soap solution in the translucent hose will fall until it is about 500 mm above my distended belly. There it pulses up and down a small amount and I can check my pulse rate from it! I lie on my back so I can see it well. That gives a resting pressure of

(500 x 0.43) / (25,4 x 12) or 0.71 psi.

I do not experience much relief at that stage that might tell me the pressure has dropped a bit, though by then there is an imperial gallon inside me (4.5 litres). So the uniform delivery pressure from my bucket (mean height ca. 1680 mm or 5' 6") at the delivery rate provided by my rather viscous soap-and-salt solution and 8mm (5/16") by 4 meter long PVC tubing is only slightly higher than the resting pressure, due to what old-time steam engineers referred to as 'wire drawing.' They meant that high pressure steam forced through a narrow bore pipe encounters large friction losses which reduces the delivery pressure at the business end. Well, enema solution flows rather slowly. Pressure loss due to friction is small, but losses due to viscous flow are far larger, and fully account for what I feel. Naturally, I am not talking about pressure at the height of a cramp, which causes sections of my colon to become quite rigid until it is massaged away. That phase ends when I have about 2 1/2 litres inside me, and every section of my colon is wide enough open so that muscle spasm does not induce further pressure rise.

Is that safe? I'd not care to recommend it to anyone who might sue me, but it has worked for me for more than 30 years.

Johnny

Hankb, when you talk about letting the water in till it hurts, the "hurt" is not, in my experience, real pain (like banging your finger with a hammer by mistake!), more an intense sensation of stretching and pressure in the belly, which some people probably do experience as pain - personally, I enjoy these sensations, but they can be very intense, and when I have taken very large enemas (6 quarts or just over) I have to stop and rub my belly while pushing it outwards, often several times, while taking the final quart. Eventually it all goes in, and although I have tried to take more (another quart) the water woould not flow into me, no matter how much I pushed my belly out and massaged it. I guess 6 pplus quarts is therefore my maximum volume, and it certainly felt (and looked!) like it was, but it was not painful, simply very intense sensations of pressure and fullness which felt wonderful.

Sorry I'm late to this thread but here's my experience.

From medical investigations, the human colon and small intestine can withstand 0.5 of an atmosphere.

That's about 7.3 psi.

In hydrostatic terms, that corresponds to about 17 ft of water-head.

My enema pressure limit is about 6ft of head; that's about 2.6 psi; and I do that regularly.

About volume; I find that an initial small [2-4 pints] enema clears a way through and I do that about 1 hour before the main insertion.

Then, I have a two-gallon [8 quart, 9 litre] bag warmed and installed at 6ft height.

The inflation takes 20 minutes of more and I stop as soon as either the flow stops,or else the transverse-colon discomfort becomes noticeable.

At that stage,I will have taken between 4 and 6 quarts. Never the full amount.

But that's a gallon or more and the feeling is very special; very exciting in fact. Walking about with that volume requires a plug and I've developed the knack of pressing a big one into position quickly when the hose comes out.

The expulsion then takes a further 10 minutes; usually in a number of surges and explosions, with massage round the tubes.

Just about one meter or less above where your rosebud will be when you are in position.

That's just over 3 ft.

Should flow about 1 US quart, or not quite a liter per minute.

Sorry I'm late to this thread but here's my experience.

From medical investigations, the human colon and small intestine can withstand 0.5 of an atmosphere.

That's about 7.3 psi.

In hydrostatic terms, that corresponds to about 17 ft of water-head.

My enema pressure limit is about 6ft of head; that's about 2.6 psi; and I do that regularly.

About volume; I find that an initial small [2-4 pints] enema clears a way through and I do that about 1 hour before the main insertion.

Then, I have a two-gallon [8 quart, 9 litre] bag warmed and installed at 6ft height.

The inflation takes 20 minutes of more and I stop as soon as either the flow stops,or else the transverse-colon discomfort becomes noticeable.

At that stage,I will have taken between 4 and 6 quarts. Never the full amount.

But that's a gallon or more and the feeling is very special; very exciting in fact. Walking about with that volume requires a plug and I've developed the knack of pressing a big one into position quickly when the hose comes out.

The expulsion then takes a further 10 minutes; usually in a number of surges and explosions, with massage round the tubes.

I'm not even going to get into a long rebuttal of this because it is so very wrong.

Can anyone even imagine hanging an enema bag 17 feet high????????????????????????

RIDICULOUS.

Not to mention finding a hose that long! 😃

The Guinness record for highest enema bag hanging is 17 ft., 6 in.

LOL