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How Often Should You Use an Enema?

October 05, 2020 by Dr. Evan Goldstein

Regardless of the subject, it never hurts to circle back to the basics periodically, and we’d like to revisit a topic we’ve touched on in other places at various points: enemas. Read on to find out what an enema is, what it’s used for, and why it’s not a good idea to do them any more than is necessary.

What is an enema?

An enema is a broad term used for inserting various types of solutions into your rectum and sigmoid colon for a myriad of reasons, including, but not limited to preparing for a medical procedure, like a colonoscopy, sigmoidoscopy, surgery, or to treat constipation or fecal impaction. Depending on the situation, an enema may be administered at home by yourself or at your doctor’s office by a medical professional. There are also different types of solutions, including saline enemas, mineral oil enemas, medicated enemas, and coffee enemas.

When is the right time to do an enema?

It’s important to remember that an enema is associated with several things: inducing bowel movements, administering special types of medication (i.e. those that treat inflammatory bowel diseases, like Crohn’s disease and ulcerative colitis), or colon/body cleansing.

When someone is preparing for a medical procedure, surgery, or exam, it is imperative that their rectum and sigmoid colon are clear of any fecal matter. Using a combination of laxatives and enemas will help ensure this is accomplished. Additionally, when someone has an extreme case of constipation or is experiencing fecal impaction, administering an enema is typically the last resort. It’s important to note that when it comes to colon/body cleansing, there’s no scientific evidence that confirms (or denies) that coffee enemas are helpful to treat any medical condition.

What is the difference between an enema and a douche?

When it comes to anal sex, there is a common misconception that enemas and douches are one and the same, when in fact they are quite different.

  • An enema is typically administered in scenarios involving medical applications or occasional bouts of severe constipation.
  • A douche is meant only to cleanse the area–it should not illicit you to have a bowel movement, nor is it meant to, because it only washes out the distal rectum. The stool is higher than what is irrigated while douching. The act of squeezing it into your rectum is what gets you “ready” for bottoming.

How often can you do an enema?

Over-the-counter enemas are not intended to be used on a regular basis and should be avoided entirely as possible. If necessary, they should only be prescribed by a medical professional. If you are doing an enema for the purpose of delivering medication, clearly it’s warranted and your doctor will define an appropriate duration for safe use.

What are the negative side effects of doing an enema?

The chemicals contained in enemas can cause cells to become irritated, creating excess amounts of mucus and dryness in the area. Enemas can also disrupt the anal microbiome, which affects the normal balance of the good bacteria and bad bacteria that resides in the rectum and anal canal. As a result of this dryness and irritation, there’s a chance that micro-cuts and tears can happen, and with the absence of the protective layer, it can lead to a higher chance of transmission of HIV and other STDs, as well as other significant complications. For this reason, enemas should never be used as a preparation for anal receptive sex. Enemas should only be prescribed by a medical professional and typically only as a last resort, unless administered before a medical procedure, surgery, or exam or as part of a treatment for a chronic disease.

Other risks of frequent enema use

There are two other possible complications of doing enemas regularly. The first is becoming dependent on doing enemas to elicit a bowel movement. The nerve endings and its propulsion during defecation diminish its response, muting the defecation reflex. This, in turn, combined with chronic use, can lead to enema dependency. The second is related to muscle function. Like any other part of our bodies, muscles get used and overused. Laxity is a common occurrence because, after all, the ass is no different from, say, our wrinkly faces. When you compound daily defecation with anal play, you can see over stretching and weaker sphincter muscles potentially develop over time. Large enema bulbs or shower hoses, along with the extent of using them, lead to the “balloon” effect. This directly stretches the muscles, sometimes beyond its normal capacity, which affects its recoil capacity. Over time, this can not only lead to enema dependency, but also weaker or looser muscle function. In other words, you may experience diminished normalized defecation and/or loss of pleasurable sensations during sexual play for both you and your partner(s).


Safe, informed sex is what we preach at Bespoke Surgical, and the information above is definitely useful for anyone interested in safe penetrative anal play. People may throw the two terms around interchangeably, but the purposes of enemas and douches are very different and really shouldn’t be confused. Enemas are generally something you shouldn’t do until they’re necessary for specific purposes, whereas using an anal douche developed specifically for anal sex prep is up to your discretion. Knowing the difference will be huge for your sexual health.

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About the Author

Dr. Evan Goldstein is the Founder and CEO of Bespoke Surgical. Dr. Goldstein has extensive experience educating and shedding light on health care issues relating to the gay community, and has been published in several national publications including The Advocate, OUT Magazine, Vice, Refinery 29, NY Mag and more.

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