An enema (plural enemata or enemas) is the procedure of introducing liquids into the bowel via the anus. Enemas can be carried out for medical reasons, as part of alternative therapies, and also for erotic purposes, particluarly as part of BDSM activities. In earlier times, they were often known as clysters.

Medical usage

The three main usages of enemas are:

• (Mechanical) laxative effect; the patient expels excrements with the enema water in the toilet after administration. Enemas (known as clysters) were the primary method for alleviating stomach aches up to the 19th century in the Western world bourgeoisie and nobility. They may also be used for cleaning the lower bowel prior to a medical or surgical procedure. Enemas given for that purpose may consist only of plain water, or may contain some chemicals in solution (such as soap).

• The administration of substances into the bloodstream in a manner similar to that of suppositories. An enema may also be used for hydratation purposes. See also route of administration.

• A barium enema is used as a contrast substance in the radiological imaging of the bowel.

Enemas are nowadays administered mostly with bulb syringes for small quantities or fountain syringes (bags, similar to douche bags, and often dual-usage, or rigid recipients) for larger quantities. In former times, they were administered using clyster syringes.

A French engraving, ca 1780 shows the long-standing prurient interest in the clyster

Except for the barium enema, enemas are now rare in mainstream medical therapy. They are sometimes used for relieving acute constipation, or for applying topical anti-inflammatories in the treatment of inflammatory bowel disease.

In certain countries such as the United States, enema usage went well into the 20th century; it was thought a good idea to cleanse the bowel in case of fever; also, pregnant women were given enemas prior to labor so as to reduce the risk of feces being passed during contractions as well as inducing contractions. This latter usage has since been largely abandoned, in part because the health benefits are unclear and because women generally found the procedure unpleasant.

Non-medical usage

The paraphilia directed towards enemas is known as klismaphilia. Enemas are available as a service from many practitioners in the sex industry to cater to klismaphiliac desires, and may be used as part of BDSM activities.

A small enema may be taken prior to anal sex in order to remove feces.

Colonic irrigation

Colonic irrigation or colon hydrotherapy is a large enema which cleanses the whole colon. It was in vogue for hygienic purposes at the beginning of the 20th century (see John Harvey Kellogg) and remains popular as an alternative health therapy in most parts of the world. Advocates believe that, when carried out by trained personnel using sterile equipment, it can be a safe and valuable tool for eliminating toxins from the body and restoring normal muscular activity in the colon.

Ritual use

Ritual enemas were practiced by the Maya and many other Central American and South American Indian tribes; some tribes have continued the practice to the present day. Substances used in the enemas include alcohol, tobacco, peyote, and hallucinogenic drugs. While the precise nature of the substances used by the Maya are unknown except from pictures of pots bubbling liquids, it is presumed these contained alcohol or other drugs.

References and further reading

• M. R. Strict, Intimate Invasion: The Erotic Ins & Outs of Enema Play, Greenery Press, 2004. ISBN 1890159514. Deez nuts.

nl:klysma de:Einlauf (Medizin)