Irritable Bowel Syndrome (IBS) & The Enema

Perhaps this might help with the understanding of I.B.S. : IBS is a disease of the nervous system in the large bowel. It is very much like asthma. In the asthmatic, the nerves in the bronchus are described as being "Twitchy"; they are triggered to go into spasm by very minor air borne elements. They are overly sensitive and can bring on an asthmatic attack very quickly. In the IBS patient, the gut nerves can be so sensitive that minor disturbances, like gas, high fat foods, spices, etc. can trigger a spasm in the bowel.

Likewise, emotional stress can also activate both asthma and IBS attacks. Years ago, Spastic Colon patients (IBS) who weren't getting much relief were sent for psychotherapy sessions to try to get them to calm their emotions.

My wife has had severe IBS her entire life. She's had 2 BaE's, 2 colonoscopies, 3 Flex. Sigs. and all these showed a normal bowel with no physical problems. She takes Anaspaz tabs., which help somewhat. She asks for a 16 oz. bulb enema in the morning and evening. If she is having a particularly bad attack, she will ask for a 2 qt. tap water enema given with a colon tube. Her gut is so sensitive that she can't take any soap in her enemas; they trigger a bad spasm.

Got ibs as well but what kind isnt easy to determine since i also have bile acid malabsorption, i have found that 3x6gram ispaghula husk with 4+4+2 grams cholestyramine keeps my bowels working somewhat ok.

I recently was diagnosed with Irritable bowel syndrome, will enemas help. Or anything else?

Yes, although medical literature probably won't mention that. My wife has had alternating IBS since childhood. This condition is basically hypersensitivity of the nerves in the large bowel. Emotional stress can set it off, foods, gas, almost anything. Before she met me, she missed work due to IBS attacks, had trouble with hemorrhoids and an anal fissure from straining too hard. Her Dr. suggested Fleets for the constipation, but they just caused her to spasm more. I talked her into warm tap water and it helped a lot. The past 29 years have been much better for her, because she has me give her daily small enemas. She does NOT see them as erotic, just a way to get relief.

She cannot handle SSE's, the soap is as bad as a Fleet, but saline and sodium bicarb. work for her. The hotter the water, the better it feels, so I try to use warmer water, but not over 108-110 degrees. About once a month, she has a very bad attack and asks for a 2 qt. bag of tap water. I use a colon tube to get the water higher and to not give her the intense sensation of having to go so badly. We always have her take her Anaspaz tablets an hour before taking a bag to "tone down" the nerves in the gut.

I have talked to other Zity members who have IBS and they have told me enemas also help them, as well.

For DanMichMan...The literature is extensive on IBS, as are websites with first person experiences and recommendations. However, for someone being diagnosed for the first time, be sensible and establish good communication with a GI specialist and work through options that work for you. I tend to get constipated when I'm over stressed, so I concentrate on keeping hydrated, a healthy diet and exercise. If necessary, I'll take Miralax or a warm water bicarb enema. Both are mild and do not upset my insides. I have two girlfriends with just the opposite symptoms -- flares with painful cramps and diarrhea. Both are able to mostly maintain control with medication, staying away from certain foods and alcohol, staying fit, etc. Find a good doctor you're comfortable with confiding in. It can be an embarrassing subject.

I have had IBS-C (with constipation) and have also been gluten intolerant for nine years and I will say unequivocally that enemas help. I have left side colon discomfort and upper stomach bloating several hours after eating, also hard and infrequent stools and gas. Taking a 2 to 3 quart enema a couple of times a week (and sometimes every day when needed) is a lifesaver. It allows me to live my life without feeling completely miserable. I have been told my by Gi Doctor that enemas will not hurt you if they are not abused and that they definitely rinse out toxins. I have taken many prescription and over the counter medications for these conditions but hands-down, an enema gives me relief without making me feel worse. That's just my own experience with IBS but hope it helps!

They might - it depends on what is going on in you. I wouldn't rely on them as a sole or primary treatment.

Note that this is all for constipation-type, I fortunately don't have experience with mixed, diarrhoea, or the type with serious pain.

If you have a good doctor that should be your first resource, but you might not. I swore off GIs after my experience- a variant of "you're not dying, deal with it and quit bugging me" combined with a very poor handling of a drug allergy issue that could have gone very badly.

You're probably ready to punch anyone who tells you "eat more fiber," (along with "it's in your head - just think positive and it will go away"), but the fiber part is important. It doesn't eliminate or even significantly reduce my symptoms, but it does help a bit and is completely safe. YMMV - on some people it seems to clear things up.

Not sure about diet - again it seems to help some people, but no change on me. I avoid any book where someone has a "guaranteed program" because they've never worked for me.

Apart from the fiber I have a "menu" that I rotate around. Mirilax for a while (there are some warnings about long term and high dose use on the back, and since I'm over the recommended dose when I'm on it I try to give myself time off it), enemas when necessary. Stimulants sort of scare me - it's probably irrational, but I worry about "breaking" things worse.

If you're going to try other-than-Mirilax oral laxatives do yourself a favor and try them out when you don't need to do anything for over a day. I have found they are very unpredictable on me, so I stay far away because my work has limited restroom opportunities.

I am a bit surprised that there isn't more on enemas for this, given that getting crap out is what they're good for. You see unsubstantiated stuff on "cure cancer" "stop acne" and other types of things, but little on IBS.

NOTE: VERY IMPORTANT!!! Do stop to make sure you know what you're doing before trying enemas! You can seriously injure or kill yourself if you aren't reasonably careful. I looked into it before deciding to incorporate them. The biggest risks are physically damaging your rectum, using a dangerous/stupid solution, or having a preexisting problem (kidney issues, weak intestine - if you have either of these do talk to your doctor). They can be safe if you are careful with the nozzle (don't force, use a soft tube if there's any question, don't put in too far), and be careful what you put in the enema (big problems with things such as scalding water, hydrogen peroxide, Hibiclens (!), and other stuff. For IBS start as gentle as possible - too much and your colon might get back at you.

One other thing - do a few test runs (or maybe get a closed top bag) at first if you decide to give them a try. I dumped enemas over myself several times accidentally and also have squirted myself with the hose multiple times. Fortunately that was all before the enema had been inside me.

Topic has been moved to provide suitable information about IBS by existing sufferers, those close to them & REPUTABLE medical advice from duly trained / QUALIFIED personage providing a better overview

By the way, those who keep statistics on such things, say that women have higher instances of IBS. There is some genetic connection (thanks, Mom!), and emotional stress is a major contributor. In most women with an irritable bowel, stress seems to stimulate the bowel into overtime action. In a minority of cases like mine, my insides tend to knot up. That's why hydration (not alcohol!!) and just enough fiber and a sensible diet not to cause an over stimulation of the bowel help maintain a balance. Also, learning how to deal with stress and understanding the triggers that cause GI upset. I would sometimes arrive home from business trips with my insides in knots. I would take or ask my husband if he would give an enema to help me relax. That would sometimes lead to a nice "welcome home" encounter, which I admit made it worthwhile! 😃

Of the IBS conditions I rather be trying to manage constipation instead of the opposite. And let's be real, women are the more emotional of our species. Maybe except one of the past architects I worked with. He broke the mold. He's was so creative, but so Type A personality. Luckily, he lasted a short time with us and joined another firm. You don't want to work around toxic people like that. They'll make you sick. He did me a couple times.

I have been dealing with Irritable Bowel Syndrome for years. Most of the time it is manageable and I just deal with it, but occasionally, when I'm under a lot of stress, it can wreak havoc with my life, as the symptoms get much worse. Anyway, I have found over the years that a warm water enema can help ease the cramping and symptoms of IBS. I may need to do several over a weeks time, then taper off to once a week, then as needed until the flare up eases. I have just started doing an enema once a month as maintenance to see if that helps long term. I usually use only distilled water and sea salt, and a full bag (2 qts.). I try to hold it as long as possible. I have read that aloe juice may also be soothing, but I haven't tried that yet. Anyone out there have a similar story? If so, what have you found works for you?

I have been dealing with Irritable Bowel Syndrome for years. Most of the time it is manageable and I just deal with it, but occasionally, when I'm under a lot of stress, it can wreak havoc with my life, as the symptoms get much worse.

Similar, mine is constipation predominant, fortunately without much cramping. Bad news is it has nausea and loss of appetite - first attack led to 20 pound weight loss down near the danger zone. There seems to be slight correlation with stress and when I'm in more pain from other things, but it isn't super strong and most of the time my IBS flare ups seem to be random.

Anyway, I have found over the years that a warm water enema can help ease the cramping and symptoms of IBS. I may need to do several over a weeks time, then taper off to once a week, then as needed until the flare up eases. I have just started doing an enema once a month as maintenance to see if that helps long term. I usually use only distilled water and sea salt, and a full bag (2 qts.). I try to hold it as long as possible. I have read that aloe juice may also be soothing, but I haven't tried that yet. Anyone out there have a similar story? If so, what have you found works for you?

I was reacting to it for years, boosting fiber via diet and supplements, playing around with Mirilax doses, and the like and it didn't really solve the problem, also I was worried about having too much Mirilax (Dr. said shouldn't take it longer than 2 weeks). When things stopped I brought in enemas, starting rarely (no more than 1 every 2 weeks), then the frequency increased (especially when I was loosing weight), then I'd reach points when I was sick of dealing with it and just took an enema every other day or so. Eventually things would start working again, for a while - week, 2 weeks, month, no pattern, but it does seem to be getting "worse".

Now I'm trying periodic enemas (currently every 3 days) to see if they help for maintenance, hopefully tapering down a bit. So far it's better, with a "natural" BM happening every 1-2 days about 3/4 of the time for the past 2 weeks, but my IBS is very unpredictable and that might stop tomorrow. It does bother me a bit because I shouldn't need an enema when things are "working," but if it keeps things working then the ends probably justify the means.

I have a bit more involved protocol than you do. Often an isotonic enema doesn't come out well, with long drawn out expulsions, so I start with something a bit kickier. To keep my guts on their guard I use soapy, bisacodyl, or glycerin semi-randomly (but more soap than the others) for the first enema, usually 2-2.5 quarts, and a 2-2.5 quart rinse at the end. I guess the rinse isn't necessary, but it does seem to help settle my intestines down.

I had a girlfriend the same one who started me on enemas. She had IBS and did enemas. She kept trying to talk me into flora exchange. She wanted mine in her. I knew that was something that had helped others. But we never did it.

I have no experience with colonic fecal transplants either as giver/doctor or receiver, other than being aware that recently there's been press about it curing some otherwise nasty colorectal infections, I believe C. Diff. bacteria. Some of the other docs here should chime in if they are more expert than I. I'd just make sure I did some detailed reading about what, if any, specific or necessary processing is done by the doctor before giving one persons fecal matter to another, including dosing. Any other docs know anything useful?

Eric

Tabitha,

Why did your girlfriend want your colonic/rectal bacteria/poop in her? IBS of some type?

Eric

I echo Doc Eric's request about other physicians chiming in on this topic. I have read everything I could find on IBS in hospital libraries. I never had the time to discuss it with the Gastros. I called on; my limited time had to be devoted to discussing hyper-acidic stomach and esophageal conditions. I don't know of any Gastros that might be Zity members, however other Docs that are on this great site may have info. that would benefit us and the many members who suffer with IBS.

I am NOT a physician, but from what I have read, I see nothing about fecal implants that could help with IBS. My understanding of fecal implants is that they are used to re-populate a bowel that has had Clostridum Difficile running rampant. This has generally been done after oral metronidazole and oral, or IV Vancomycin has been used several times.

On the face of it, I see no inherent reason why IBS would be beneficially treated by a fecal transplant, unless there is some link I don't know of (quite possible) between colorectal flora and IBS etiology or exacerbations. I have had nonspecific IBS for about 50 years and never heard of a link or that type of therapy before. That's why I asked other docs to write in.

Eric

Ericmacson- Because putting good flora in is supposed to take care of bad bacteria and populate then help. There is a woman in youtube who does it to her daughter and she says it helps.

Use of fecal bacteriotherapy is well established in the literature for treatment of antibiotic refractory clostridium difficile pseudomembranous colitis. But has not been shown to be effective for the treatment of other conditions...such as IBS of any type. That's the current state of the science.

I have IBSD, when I was first diagnosed it was called "Spastic Bowel". I have severe bouts of diarrhea not constipation but I think the original explanation I was given holds true for both types. I was told that the bowels went into "spasms" resulting in the cramps, bloating, urgency and difficulty in controlling the bowel movements.

Putting this same idea of a "spastic or spasming colon" to the constipation form of IBS this would result in the colon " freezing or weakening" reacting like on overworked muscle after strenuous exercise that you are not used to,

This would also explain those people with IBS that have alternating bouts of constipation and diarrhea.

Because of this "spasming" it would explain why some people with constipation are helped by enemas for varying amounts of time and others are not helped at all.

This would also support the facts that introducing "good bacteria" into the GI system has little or no effect on the IBS. Why people with IBS with chronic constipation are generally not helped with added fiber or probiotics.

This is just my thoughts on the subject there is no real scientific data behind it.

Rayme,

Thank you for commenting. Being an anesthesiologist I work mostly at the other end, and I knew other docs here had broader training than airways, pulmonary dynamics and unconscious patients. I thought I was right but glad for the confirmation. Starting med school, I actually wanted to be an internist, oncologist, pulmonologist or endocrinologist but got sidetracked into anesthesia (LONG story).

I've been lucky with my own IBS, dx'd first as spastic colon as a 7th grader, then modified to IBS later on. My version consisted almost exclusively of severe debilitating abdominal cramping without any D or C, and I haven't had a truly severe attack since age 30 (now almost 65).

I just love enemas for their own sake, unrelated to IBS, and the only effect IBS has possibly had has been making my colorectal tissues very sensitive to irritation down low and perianally. As a result, I prefer large enemas with long retentions rather than multiple sequential enemas which irritate me too much.

Thanks again,

Eric

Tabitha32, you bring up an interesting possibility. Perhaps some scientist/physicians should undertake controlled, clinical studies to compare the bowel flora of IBS patients with, non-IBS patients. If there IS a difference, that could spell a new era of relief for IBS folks.

Not all that long ago, we thought that all stomach ulcers were due to hyper-acidic conditions in the stomach. It was discovered that patients with chronic gastric ulcers needed to be given antibiotics, along with H2 antagonists, or proton pump inhibitors. So, for these patients there IS a problem with bacteria in this part of the GI tract. It was determined that amoxicillin, or Augmentin worked very well for those with recurring gastric ulcers. The offending organism is Helicobacter Pylori in the stomach.

Recently, Gastro's are now offering IBS patients a "breath test" to look for bacteria that may be present in the large bowel and may be implicated in IBS. In the future, IBS patients may be treated with antibiotics, or possibly fecal implants?

Thanks Eric. I love enemas too...completely for there own sake. Erotic and highly stimulating and exciting. For me they need nothing more than that.

Here's something that's interesting and I'm trying to get my head around.

After several frustrating years being reactive to my IBS-C, which doesn't give me pain but does give me the "constipation yucky" feeling as well as loss of appetite and low-grade nausea in varying mixes, I decided that I would try "scheduled enemas" just to see what happened. I figured it couldn't make it worse, but wasn't expecting much. I had gotten used to my gut having its hissy fits and then, every once and a while, settling back down and behaving normally for a week or two pretty much no matter what I did.

I settled on every three days to start - I guess you could say I pulled it out of my ass. I figured three days wouldn't cause me to get too backed up when things stopped, and it was hopefully infrequent enough to not cause enema dependance. I figured I'd stick with my standard E menu at least to start with: one small SSE or glycerin+water to clear the rectal area if I'm backed up, 2-2.5 quarts SSE, then a 2-2.5 quart tap water final.

Fast forward almost two months. Oddly enough things are working pretty well. I'm generally having a bowel movement every 1-2 days except for one time where it waited the 3 days to the next enema - but the day after that things started working again. I've been able to cut down on the fiber supplement and Mirilax significantly, and my appetite is better with just a few partial-day occurrences of problems.

Part of me knows I should be happy because things are working and working well (probably better than they ever have in my life), but my rational part is rebelling. According to everything I know this should not be working - there should be either no change or things should be worse because of all the enemas. Any input or anecdotes from others here? I know one member commented about either himself or his wife taking enemas weekly for IBS and it seeming to help with cramps, but any other stories or tips would be greatly appreciated.

Fast forward almost two months. Oddly enough things are working pretty well.

Part of me knows I should be happy because things are working and working well (probably better than they ever have in my life), but my rational part is rebelling. According to everything I know this should not be working - there should be either no change or things should be worse because of all the enemas.

"Everything you know" from where? And why shouldn't it be working? I wish more of my IBS-C patents were open to simply taking a couple enemas a week. Is far less expensive than the latest pills for this, one hell of a lot safer, and works remarkably well.

If you also happen to enjoy them, so much the better. Your "rational part" needs to be rational and evaluate the evidence in front of it. There's no magic medical book that says you have to be treated a certain way or it's bad, evil, doesn't count as therapy, or any other nonsense. You've found something that works. Use it.

Doc

"Everything you know" from where? And why shouldn't it be working? I wish more of my IBS-C patents were open to simply taking a couple enemas a week. Is far less expensive than the latest pills for this, one hell of a lot safer, and works remarkably well.

If you also happen to enjoy them, so much the better. Your "rational part" needs to be rational and evaluate the evidence in front of it. There's no magic medical book that says you have to be treated a certain way or it's bad, evil, doesn't count as therapy, or any other nonsense. You've found something that works. Use it.

Doc

If it is OK then I'm glad to hear it. I didn't hear anything about it from doctors (just variations of "eat more fiber" "try Mirilax" "try eliminating ___ and see what happens" and "you're not dying get over it"). I did a search of PubMed and some of the legit refereed journals and didn't come up with much, and most of that was anti-enema. Of course the popular literature was hopeless - I've gotten to where I will stop reading anything where the author claims to be able to fix all instances (in one of those that actually cited sources they were --- wait for it --- all studies done by the author. Hmmm.). What I did find seemed to be more "someone took an enema, bad things happened, no one should ever use enemas" case studies that didn't go into very much detail and some that showed epithelial damage but didn't discuss if it was significant. I did try...

So for 2 years or so I used enemas as a "last resort" when I was feeling bad and not eating. They worked, but I was worried that I would "break my bowels" even more. I had heard some stories about people taking them on schedules, but it didn't seem logical that messing with my large intestine during the times when it was working would be helpful. Eventually I tried it, and though I don't know why it works it does seem to, better than even the doubled daily doses of Mirilax and fiber did. Much better (still on fiber (reduced amount) and a bit of Mirilax). I guess I should focus on the outcome, but dammnit I do wonder why.

Don't quite "enjoy" it yet, but getting there. Definitely open to the possibility, and enjoy parts of it. I guess I just need to keep trying. Enjoy it more than I used to now that I'm on a schedule.

The "I wish more of my IBS-C patents were open to simply taking a couple enemas a week. Is far less expensive than the latest pills for this, one hell of a lot safer, and works remarkably well." is very reassuring, and probably the first time I've heard this. I interpreted even some of the postings on Zity as implying that there was no basis for enemas to treat IBS-C, though that was probably my ignorance talking.

Are you GP or gastroenterologist or something else? Again, thanks.

Looking at some of the earlier posts again and I noticed several posts where colonoscopies were mentioned as a part of the diagnostic regimen. There's good news now - if you get a low-key doctor and have just the constipation-predominant type without any other red flags they are no longer recommending colonoscopies and haven't for the past couple of years (at least).

I have the dreaded IBS . Gas , cramps , very seldom Diarrhea or Constipation . Have found a warm Baking Soda enema , usually I quart to start , followed by one a little larger to be helpful . Some times a third is done , depending on result of first couple . Have been doing this three years .

I am in my mid 70's , have had enemas my whole life , bother me about as much as a cup of coffee does . Currently doing it on an as needed basis . Seems to help me .

IBS really pissed me off the first couple of years, then I mostly have come to terms with it. Realistically it's mostly an annoyance for me because mine doesn't come with debilitating pain, and as my doctor pointed out "it's nothing that's going to cause serious problems now or in the future" (as long as I keep my weight up). It still bugs me some, especially since it's like I have Nero or some similar capricious tyrant in control of my bowels and they seemingly do things for no reason, but as long as I keep fighting with them I usually keep things mostly running. I do generally have problems when I start reevaluating my approach and thinking "I can cut down on ____" (often the blank is filled in with "enemas" because those generally aren't on the "approved treatments" lists in texts (both consumer and professional books and journal articles), so I still have a certain subconscious feeling that they're "bad" and should be avoided even though they seem to be a key to keeping things working well for me).

I think another key has been changing my thinking when things finally start working for a bit to "I get a break" rather than "Good - it's finally gone away." When I would think that it had gone away it was very frustrating in a couple of weeks when I started having problems again.

I have had a dramatic increase in my IBS to the point I was scared I might have cancer (it doesn't help that a year ago an old classmate discovered stage 4 colon cancer). I called my gastro doc to find he had retired and a new doctor had taken his place. It didn't help at all that this woman was very pretty but -- far better -- very "up to date" on the latest greatest. She put me on seven fiber tablets a day but the most effective change was a daily probotic, which has really helped. If you take probotics switch back and four between brands so your gut won't get used to only one flavor. She did a colonoscopy -- a "must" every 5 years after 50 and I'm better and smarter. I asked her about enemas and she was interested in volume/frequency. I told her 3 qts about every two weeks and she nodded but couldn't resist, "If you need any help just let me know ... " Damn, no sooner do you solve one problem than ... er, another rises up.