I have IBS-C (chronic constipation) and without taking enemas, I would be up a creek without a paddle. Enemas are how I manage my bowels. I am enema dependent to have a bowel movement but because of taking them, my IBS is not front and center in my life.
Could that be called "being up shitless creek?"
For me the bowel problems came before the enemas, so I don't consider myself "enema dependent" in the commonly accepted sense that taking too many enemas caused the problem. Also, and more important, sometimes things just start working for a bit, and this can even be the day after I take an enema. I can (and sometimes do) use other ways to manage IBS, but for me I find that the enemas are an effective, predictable, generally more comfortable component (used with other stuff, not alone!) of my bowel management "program" than some other ways, so I choose to do them. I also ahve been feeling better and have fewer weight swings since I started bringing them in. Enemas can also be fun, which many of the other options are not (but not all the time - sometimes I'm just not feeling well enough to enjoy them for more than the relief, and there are plenty of times when I either do not have the time or want to "save things" for activities with my wife).
I imagine it's "a sign of the times" when enemas are no longer recommended by most doctors, even for constipation caused by strong pain meds. However, a warm water enema mixed with mild soap is proven over generations to be a quick, safe and reliable remedy when a patient is so plugged up. Enemas can be uncomfortable in these cases, but given by an experienced nurse, they work wonders! If a woman needs to take opiates for pain, she should have an enema bag and learn how to use it. It'll likely save her trips to the ER.
There are reasons beyond some vast "big pharma" conspiracy. While you're right that enemas aren't recommended much, Vicki, it's mostly because they're a hard sell, at least until someone is desperate or has tried them and knows they aren't as awful as they sound. In addition doctors do generally go by "do no harm," and they've seen plenty of idiots who can do significant damage with an enema.