The term “clister” is an older or alternative name for what is medically known as an enema. This procedure involves introducing a fluid into the lower gastrointestinal tract, specifically through the rectum and into the colon. The purpose is generally to cleanse the lower bowel or to administer a therapeutic agent directly to that area.
Defining the Procedure
A clister involves administering a prepared liquid solution into the rectum, the final segment of the large intestine. The delivery apparatus is typically a simple bulb syringe, a pre-packaged disposable unit, or a bag and tube system for larger volumes. The nozzle is gently inserted into the anal opening to allow the fluid to flow into the lower bowel. The solution itself can range from plain tap water or saline to specific medicinal agents. The fluid targets the rectum and the sigmoid colon, the S-shaped last portion of the large intestine. The physical presence of the liquid distends the area, initiating the treatment’s mechanism of action. This low-cost, non-invasive method remains common in both clinical and home settings.
Common Reasons for Use
One of the most frequent uses for a clister is to provide rapid relief from acute constipation or to manage fecal impaction. When oral laxatives are ineffective or immediate evacuation is required, the direct introduction of fluid stimulates a bowel movement. The procedure is often considered when lifestyle changes and oral treatments have failed.
Clisters are also a routine part of preparing a patient for certain medical procedures. Before a colonoscopy, sigmoidoscopy, or abdominal surgery, the lower bowel must be thoroughly cleansed to ensure a clear field of view or minimize infection risk. These cleanses often involve large volumes of fluid to clear the entire lower colon.
Clisters also function as a delivery system for medication when oral administration is impractical or when a drug needs to act locally. Conditions such as ulcerative colitis are sometimes treated with anti-inflammatory medications like corticosteroids or mesalamine delivered via enema. This method allows a high concentration of the drug to reach the affected area with minimal systemic absorption.
How the Treatment Works
The therapeutic effect of a clister relies on a combination of mechanical and chemical actions, depending on the solution used. The primary mechanical action is the volume effect, where the fluid distends the wall of the rectum and lower colon. This stretching triggers a reflex contraction of the bowel muscles, known as peristalsis, which prompts the urge to defecate and pushes the contents out.
Lubrication
A second mechanism involves lubricating solutions, such as mineral oil. Oil-retention clisters are designed to be held in the rectum for a longer period, allowing the oil to penetrate and soften hardened stool. This lubrication coats the fecal mass and the intestinal lining, facilitating the easier passage of dry or impacted stool.
Osmotic Effect
The osmotic effect is typically achieved with hypertonic solutions like sodium phosphate or saline. These solutions have a higher concentration of solutes than surrounding body fluids. This difference causes water to be drawn from the tissues and bloodstream into the colon via osmosis. The influx of water increases the volume of the contents and softens the stool, making it easier to pass.
Chemical Stimulation
Specific agents like Bisacodyl work differently by acting as a stimulant laxative directly on the nerve endings in the colon’s lining. This chemical irritation further enhances muscle contractions and accelerates peristalsis.