<Li> As a bowel stimulant, similar to a laxative--the main difference being that laxatives are commonly thought of as orally administered while enemas are administered directly into the rectum, and thereafter, into the colon . Once the injection is complete, the enema is retained until there is a strong urge to defecate, at which time the recipient may expel any fecal matter loosened by the instilled solution together with the solution itself . The increasing volume of the liquid causes rapid expansion of the lower intestinal tract, often resulting in very uncomfortable bloating, cramping, powerful peristalsis and a feeling of extreme urgency . </Li> <Li> Enemas may also be used to relieve constipation and fecal impaction, although in the U.S. and some other parts of the world, their use has been replaced in most professional health - care settings by oral laxatives and laxative suppositories . In - home use of enemas for constipation and alternative health purposes is somewhat harder to measure . </Li> <Li> Bowel stimulating enemas usually consist of water, which works primarily as a mechanical stimulant, or they may be made up of water with baking soda (sodium bicarbonate) or water with a mild hand soap dissolved in it . Buffered sodium phosphate solution draws additional water from the bloodstream into the colon to increase the effectiveness of the enema, but can be rather irritating to the colon, causing intense cramping or "griping ." Mineral oil functions as a lubricant and stool softener, but often has the side effect of sporadic seepage from the patient's anus which can soil undergarments for up to 24 hours . Glycerol is a specific bowel mucosa irritant and when introduced in very dilute solution serves to induce peristalsis . </Li> <Li> Other types of enema solutions are also used, including equal parts of milk and molasses heated together to slightly above normal body temperature . In the past, castile soap was a common additive in an enema, but it has largely fallen out of use because of its irritating action in the rectum and because of the risk of chemical colitis as well as the ready availability of other enema preparations that are more effective than soap in stimulating a bowel movement . At the opposite end of the spectrum, an isotonic saline solution is least irritating to the rectum and colon, having a neutral concentration gradient . This neither draws electrolytes from the body--as can happen with plain water--nor draws water into the colon, as will occur with phosphates . Thus, a salt water solution can be used when a longer period of retention is desired, such as to soften an impaction . </Li>

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