Disposable Enema Bag: Guidelines for Classification, Applications, and Standardized Use​

In the clinical nursing and diagnosis and treatment system, the disposable enema bag serves as a core consumable for intestinal care. With its sterility, convenience, and adaptability, it is widely used in scenarios such as intestinal cleaning, drug delivery, and decompression. Its standardized use is directly related to the efficacy of diagnosis and treatment and patient safety. This article systematically sorts out the classification standards, clinical applications, and operating procedures of disposable enema bags to provide professional references for medical practitioners.​

Classification System of Disposable Enema Bags​

Based on differences in materials, structural functions, capacity, and clinical applications, disposable enema bags form a multi-dimensional classification system to meet diverse diagnostic and therapeutic needs.​

Classified by Material​

There are three main types of mainstream products classified by material. The first is the polyvinyl chloride (PVC) enema bag, which has the advantages of low cost and high transparency, making it easy to observe the flow rate and remaining amount of enema fluid. However, it exhibits poor flexibility at low temperatures and may cause local mucosal irritation in some patients. It is mostly used for short-term, routine enema procedures, such as symptomatic treatment of constipation in outpatient settings. The second type is the polyethylene (PE) enema bag, which is lightweight, chemical-resistant, and compatible with various enema fluids (such as soapy water, normal saline, and traditional Chinese medicine decoctions). With better biocompatibility than PVC, it is suitable for bowel preparation in most hospitalized patients. The third type is the ethylene-vinyl acetate copolymer (EVA) enema bag, which has excellent flexibility, no odor, minimal irritation to the skin and intestinal mucosa, and good high-temperature resistance. It can be used in scenarios requiring warm enema fluid (such as elderly patients and individuals with sensitive intestines) and is the preferred choice in intensive care units (ICUs) and pediatric departments.​

Classified by Structural Function​

They can be divided into four categories by structural function. The basic-type enema bag consists of a liquid storage bag, catheter, flow regulator, anal tube, and hanging rope. With a simple structure, it is suitable for routine enema operations. The temperature-controlled enema bag is equipped with an insulation layer or temperature monitoring scale on the outer side of the liquid storage bag, which can maintain the enema fluid at a suitable temperature of 38-40°C, avoiding intestinal spasm caused by cold fluid stimulation. It is suitable for postoperative patients and children. The filter-equipped enema bag has a micron-level filter at the catheter inlet, which can filter impurities and drug residues in the enema fluid to prevent anal tube blockage. It is particularly suitable for scenarios such as enema with traditional Chinese medicine and self-prepared enema fluid. The dual-lumen enema bag contains two independent catheters: one for injecting enema fluid and the other for draining intestinal contents, achieving “simultaneous infusion and drainage”. It is mostly used for intestinal decompression and cleaning in patients with intestinal obstruction, which can reduce the risk of sudden increase in intestinal pressure.​

In addition, classified by capacity, they can be divided into small-capacity (100-250ml), medium-capacity (500-1000ml), and large-capacity (1500-2000ml) types, corresponding to local drug delivery, routine cleaning, and comprehensive preoperative bowel preparation respectively. Classified by application, they can be subdivided into cleaning-type, drug-delivery-type, and decompression-type, each with different functional focuses.​

Core Clinical Applications of Disposable Enema Bags​

The clinical value of disposable enema bags is concentrated in three major areas: intestinal cleaning, therapeutic intervention, and diagnostic assistance, making them indispensable nursing tools in multiple departments.​

Preoperative Bowel Preparation​

This is its primary application. Before sterile surgeries such as colorectal surgery and hysteroscopic surgery, injecting enema fluid (such as compound polyethylene glycol electrolyte solution) through a disposable enema bag can completely empty intestinal contents, reduce the risk of intestinal contamination during surgery, and decrease postoperative complications such as infection and anastomotic leakage. For patients requiring examinations such as colonoscopy and barium enema radiography, the cleanliness of the intestine directly affects the accuracy of diagnosis. Disposable enema bags can achieve a visual intestinal environment through fractional enema, assisting doctors in accurately judging lesions.​

Treatment of Intestinal Diseases​

Disposable enema bags play a key role in the treatment of intestinal diseases. For patients with functional constipation and fecal impaction, injecting enema fluid such as normal saline and soapy water can soften feces, stimulate intestinal peristalsis, and quickly relieve defecation difficulties. For patients with inflammatory bowel diseases such as ulcerative colitis and proctitis, using a filter-equipped disposable enema bag to inject traditional Chinese medicine decoctions or anti-inflammatory drugs can allow the drugs to act directly on the intestinal mucosa, improving local efficacy and reducing systemic side effects of medication. In addition, for poisoned patients, enema can remove residual toxins in the intestine, buying time for rescue.​

Intensive Care and Care for Special Populations​

Disposable enema bags are indispensable in intensive care and care for special populations. Patients in the ICU who are comatose or bedridden often suffer from constipation due to weakened intestinal motility. Regular intestinal care using disposable enema bags can prevent fecal intestinal obstruction. In the pediatric field, for infants and young children who cannot defecate independently, small-capacity EVA disposable enema bags can gently clean the intestines while reducing the risk of mucosal damage. For hospice care patients, disposable enema bags can be used to relieve intractable constipation and improve patient comfort.​

Standardized Usage Methods of Disposable Enema Bags​

The use of disposable enema bags must strictly follow the principles of aseptic operation and standardized procedures, covering three links: pre-operation preparation, operation implementation, and post-operation care to ensure safety and effectiveness.​

Pre-operation Preparation​

Preparation should include both patient assessment and supplies verification. First, assess the patient’s condition, consciousness state, and anorectal status (such as the risk of hemorrhoids, anal fissure, and rectal perforation). Enema is contraindicated for patients with intestinal perforation, gastrointestinal bleeding, and severe cardiovascular and cerebrovascular diseases. Supplies preparation includes: selecting a properly sized disposable enema bag (choose capacity based on application, 1000ml is commonly used for adults, and below 250ml for children), enema fluid (prepared as prescribed by the doctor, temperature 38-40°C), lubricant, sterile gloves, toilet paper, bedpan, and medical trash can. Check whether the packaging of the disposable enema bag is intact and within the validity period. After confirming no damage, open the packaging, pour the enema fluid into the liquid storage bag, expel air from the tube (to prevent abdominal distension caused by air entering the intestine), and close the flow regulator.​

Operation Implementation​

Accurate control of body position and operation techniques is required. Assist the patient to take a left lateral position, flex the knees, move the buttocks to the edge of the bed, and place a treatment towel under the buttocks. The operator wears sterile gloves, lubricates the front 5-10cm of the anal tube with lubricant, opens the flow regulator to expel air, and then closes it. Use the left hand to separate the patient’s buttocks to expose the anus, and hold the anal tube with the right hand to insert it slowly into the rectum: 10-15cm for adults and 5-10cm for children. Do not force advancement if resistance is encountered; adjust the body position or withdraw the tube slightly before reinserting. After confirming the correct position of the anal tube, hang the liquid storage bag 40-60cm above the edge of the bed (reduce to 30cm for children), open the flow regulator, and control the flow rate of the enema fluid (60-80 drops per minute for adults and 20-40 drops per minute for children). Closely observe the patient’s response during the enema. If the patient experiences discomfort such as pale complexion, abdominal pain, palpitations, or cold sweats, immediately close the regulator, remove the anal tube, assist the patient to defecate, and provide symptomatic treatment.​

Post-operation Care and Supplies Disposal​

Post-operation care and supplies disposal should be standardized and detailed. After the enema fluid is infused, close the flow regulator, wrap the anal tube with toilet paper, and pull it out slowly. Assist the patient to lie flat and retain the enema fluid for 5-10 minutes (shorten to 3-5 minutes for cleaning enema, and extend to 15-30 minutes for drug enema) before defecation. After defecation, assist the patient to clean the anus and organize the supplies. Disposable enema bags are single-use medical supplies and must be disposed of as infectious medical waste after use; reuse is strictly prohibited. Daily attention should be paid to: maintaining aseptic conditions throughout the enema process to prevent cross-infection; strictly separating supplies for different patients, with one anal tube per patient; and accurately controlling the temperature of the enema fluid to avoid intestinal irritation caused by overcooling or overheating.​

Precautions and Risk Prevention and Control​

Before using a disposable enema bag, its qualification must be verified, and products that meet medical device standards should be selected. During operation, contraindications and indications must be strictly mastered to avoid risks caused by blind operation. For elderly and frail patients, the pressure and flow rate of the enema fluid should be appropriately reduced to reduce the burden on the circulatory system. After enema, observe the patient’s defecation, stool characteristics, and vital signs, and report any abnormalities to the doctor in a timely manner.​

In summary, the appropriate classification selection, application adaptation, and standardized operation of disposable enema bags are the core of ensuring the quality of intestinal care. Medical practitioners must accurately grasp the key points of each link, give full play to their clinical value, and provide safe and efficient diagnosis and treatment services for patients.​