Lying on the back is a favourite position, especially for the first enema of a session. This way you have a feeling of more control and it is easier to adjust the little tap for the water flow. You can watch the bag slowly deflate and you can also watch the abdomen expand as the water enters the colon. You will probably be most comfortable if the knees are raised. You will first see the belly swell very low, just above the crotch, as the sigmoid expands. Then you will see the left side start to bulge as the water enters the descending colon. You will be in a position to massage the bowel as well as feel the shape and position of your colon.
The Sims position has the recipient lying on the left side with the right knee brought up near the chest.
In this position it is not easy to turn the little tap on and off to regulate the water flow
It is good if you have someone to help you in this position.
The Knee-chest position has the enema supported by the knees and the shoulders with the chest sagging down so that the chest almost touches the floor (get on all four, put your head down and your bottom up). This places the abdomen nearly upside down so that the water can flow down from the rectum to the transverse colon by gravity. In cases of deep-seated constipation this position will help the water reach way up into the colon for a good cleaning out. It is also useful in a technique for floating air or gas in the colon above the water so that the air can be expelled.
Some people like to move in different positions during the enema eg: 1/3 on your left hand side, 1/3 on your back, and 1/3 on your right hand side.
Most people will find it difficult to retain an enema for more than 5 minutes. The enema should generally be retained between 15 and 45 minutes. It is better to hold less water (500ml) for longer than large amounts of water (1-2ltr) for a short time. Especially if you use some herbal solutions for the Enema.