Looking for high-volume (quart plus) solution recommendations for IBS management

I'm working on my IBS management menu, especially the rectal part as the oral maintenance fiber and Mirilax is pretty fixed. So far I have tried SSE and tap water (many, generally my go-to enema. Usually it's mild SSE or TW, but when things are going slow I mix it stronger), saline and soda (doesn't work well, very long expulsion times), bisacodyl and soap (powerful but good), and Mayo (powerful but good), and Susie's Rough Ride (exactly as the name indicates, so this isn't one I'll pull out to clear the pipes because it ties you up metaphorically and literally for 4-6 hours).

I'm looking for more suggestions to try. Here's what I would like ideally: solutions that will run the gamut from a nice, calming clean to a "blast the shit out" Ideally they would have minimal after-effects with a rinse (though having some rinse-less ones would be good as well). Solutions that would be easy to clean up after, and probably ones that are a quart or bigger (it seems that I get a better reaction no matter the solution when I fill my sigmoid, and the small solutions only get the rectum). I'd be willing to try ones that don't meet all these critera, though - my only hard limit is safety. No turpentine or hydrogen peroxide or other "bye-bye colon" enemas.

I know that "WHY?" is likely a big question in people's minds. My thinking is several reasons: first, there are sometimes when being "nice" and giving myself a mild SSE or tap water enema just doesn't work well - it gets stuck and I feel just as bad or worse. IBS also seems to be best treated if you vary what you do, because doing the same thing over has reduced effectiveness after a while. There are also times when I want something different (don't we all?) Lastly there are times when I'm so frustrated with my gut that a strong, very crampy solution has an emotional as well as physical cathartic effect.

I'll probably try a M&M at some point just to say I've done it (though the cleanup doesn't appeal). I'm not sure if I'll try a garlic enema because I don't want a garlic scented enema bag (I've seen what can happen with plastic containers). I might try a "3-6-9" (tripled 1-2-3 enema) because that might be large enough to work well. Any other suggestions?

I'm guessing you already have a diagnosis of IBS constipation. Your Doc probably isn't too keen on enemas as they may think there is potential to make things worse. Without trying to agree with this view (I'm certainly not qualified) I'd suggest avoiding any show your colon who's boss approach : )

I'd try finding a partner who will give you an occasional small bulb plain water enema. No more than 8 or 10 ounces squeezed in gently but not too slowly. Non sexual massage would be a great addition to help get relaxed and more in parasympathetic mode. The colon has its own nervous system and there's a lot of interaction going back & forth with IBS.

Likely IBS-C, almost definitely something in the functional issues camp (I didn't bring up a history of ongoing childhood constipation through to my early '20s), and absolutely, positively not worth looking too deeply into at this point. Doctors don't know about my enemas. PCP recommended Mirilax and fiber (which I take) and a visit to a GI, GI was pretty useless - my read was "quit bothering me, you're not dying." So I take the Mirilax and fiber and have been playing around with other ways to deal with it when the gut still won't cooperate (far too often). Oral laxatives had a certain degree of unpleasantness, and enemas seem to work pretty well, so that's what I take, usually 2-3 quarts light SSE/tap water, but sometimes my colon needs a bigger kick.

I'd try finding a partner who will give you an occasional small bulb plain water enema. No more than 8 or 10 ounces squeezed in gently but not too slowly. Non sexual massage would be a great addition to help get relaxed and more in parasympathetic mode. The colon has its own nervous system and there's a lot of interaction going back & forth with IBS.

I'd love to have my partner give me my enemas (she doesn't want to right now), but they need to be a bit bigger than 8-10 oz. I don't know specifics, but things seem to back up for me in the sigmoid, which is likely tortuous per a radiologist. 8-10 oz of enema doesn't knock everything out. Very interested in the massage - any specific pointers on methods, articles or books on this?

I'd try a search on colon massage. I've seen self help books on this but like taking enemas it's better to have someone else helping. There are massage therapists and PTs who are so highly skilled using their touch they can induce peristalsis. Relaxation from more generalized massage could help before an enema and colon massage afterwards to increase stimulation.

The reason I'm into smaller enemas for IBS-C is a larger volume moves the colon distention upward & opposite to the normal direction you're trying to encourage. Colon massage always goes from ascending - transverse - descending for this reason. Distending just the rectum & lower sigmoid is best neurologically when the colon is otherwise confused : )

Now you've got me wondering a little, because that's another thing that's different between what I see in myself and "ordinary" IBS. Usually when I get backed up there isn't much in the rectum, so smaller enemas (even Fleet) don't get much of anything out. I need to get up around 1.5 quarts or more to get out enough of what is in there.

Note that I'm not wondering enough to go start asking questions about it to doctors. I'm not that dumb.

I think your right about some things better taught hands-on. I had a bit of a learning curve with the enemas that probably wouldn't have been there had someone shown me what to do.

I'm going to look into the massage. I might add that, and I might experiment with smaller enemas, but for the most part I think I'm going to stick with what's mostly working now and not rock the boat too much. I think that between the tap water, SSE, bisacodyl and soap, and Mayo enemas I have a pretty good bag of tricks for now. That and the fact that, at least temporarily, things are working a bit better on their own right now in the colon department.

Edit - I'll still try the abdominal massage, but it looks pretty similar to something I've tried before.

Epsom salt and soapsuds together in the same enema

Might I recommend you try a bit of aloe vera in your solution. Very soothing.

Epsom salt and soapsuds together in the same enema

I thought I had read here that soap plus Epsom salts produces a thick, sticky precipitate that's hard to clean out of bags and hoses. Any truth to this?

Eric

Looking for high-volume (quart plus) solution recommendations for IBS management

PLAIN WATER

PHYSIOLOGIC SALINE 9 g/l

Take your choice.

SS is quite correct, those two are the best and only solutions you should try to control your problem.

It ends up getting clean because after that first round it is just soapsuds

the bag does not get rinsed between rounds, only after the session. So it all ends up going into me and back out

Wow, that's an old one that got dredged up again somehow. I've figured out what usually works for me, and also that it really isn't IBS (no pain, fortunately!).

Not sure what LisaK was referring to, I don't think anyone asked about enema bag cleaning, unless you're talking about the magnesium salts of fatty acids which are insoluble and must be scrubbed out.

Not sure what LisaK was referring to, I don't think anyone asked about enema bag cleaning, unless you're talking about the magnesium salts of fatty acids which are insoluble and must be scrubbed out.

Yes, I think that's what I was referring to, but I didn't think it would be solved by just flushing with more subsequent enemas. It sounded like something of a scrubbing chore and thus maybe something you might want to avoid. In >50 years, I've never had any interest in using MgSO4 in an enema and never have. Soap and salt and bicarbonate and occasionally glycerin are just fine for me.

Eric

Moliere

Choosing the right recipe is key but I would also suggest experimenting with various positions to take the enema. I have always found that elevating my hips so my anus is the highest point vs. my colon enables the enema to drain down into my colon. I use 2 quart enemas and really don't feel the need to use any more than that amount. Getting the enema well up into the colon really makes a huge difference in terms of helping to clear it. Also on my first enema I like to do a low and slow flow which helps to prevent cramps.

Using this method for me makes my enemas soothing and relaxing. Yes I do enemas for purely sexual reasons but making them feel good while I am doing them sets the stage for a orgasmic finale.

Yes, I think that's what I was referring to, but I didn't think it would be solved by just flushing with more subsequent enemas. It sounded like something of a scrubbing chore and thus maybe something you might want to avoid. In >50 years, I've never had any interest in using MgSO4 in an enema and never have. Soap and salt and bicarbonate and occasionally glycerin are just fine for me.

Eric

I tried the Epsom salts a couple times and in most large-volume enema concentrations it didn't seem to do much. Do need to try a scaled-up 1-2-3 sometime though.

I find that usually for me a 3-position works well as long as I get enough enema in. Start in Sims, roll to back, finish in knee-chest. Sometimes just do two, but I find it more comfortable to be out of Sims after about 1.5 quarts as it starts to feel very "heavy" and pull on things if I stay in Sims.

I find that usually for me a 3-position works well as long as I get enough enema in. Start in Sims, roll to back, finish in knee-chest. Sometimes just do two, but I find it more comfortable to be out of Sims after about 1.5 quarts as it starts to feel very "heavy" and pull on things if I stay in Sims.

For most enemas, especially large volumes like 3-5 quarts, I do almost the same, start in Sim's, then to back, then right side down, usually finishing and retaining on my back. To me, on my back is the easiest hold position for my long holds of 30-60 minutes. Unlike the above, I find that knee-chest (kneeling all fours, belly down, sometimes shoulders down with butt up) puts much more pressure on my belly as it's got nothing to support it hanging under me and gets just maximally distended. Now, I really enjoy the distended appearance and feeling, but I don't want to tear anything internally either from too much weight pulling down on my belly.

Occasionally, I'll lie on my filling or full belly just for the interesting pressure and submission feelings.

Eric