Most enemas contain a liquid solution designed to soften stool, stimulate the bowel, or both. The exact ingredients depend on the type of enema, but the most common over-the-counter version is a sodium phosphate solution, a mix of phosphate salts and water in a small squeezable bottle. Other types use saline (salt water), mineral oil, glycerin, or soap mixed with water. Here’s what’s in each type and how they work differently.
Sodium Phosphate Enemas
The most widely sold enemas (like Fleet) contain two forms of sodium phosphate dissolved in water. A standard dose delivers 19 grams of monobasic sodium phosphate and 7 grams of dibasic sodium phosphate in about 118 milliliters of liquid. These salts work as an osmotic laxative, meaning they pull water from the surrounding tissue into the bowel. That extra fluid softens the stool and stretches the intestinal wall, triggering the urge to go. Most people feel results within 5 to 10 minutes.
Sodium phosphate enemas are effective but carry real risks when misused. The FDA has warned that sodium phosphate products can cause acute kidney injury, particularly when used at higher doses for bowel cleansing rather than simple constipation relief. People over 55, anyone with kidney disease, and those taking blood pressure medications or common anti-inflammatory drugs like ibuprofen face higher risk. The FDA also recommends these products not be used by children under 18 for bowel cleansing purposes.
Saline (Salt Water) Enemas
A plain saline enema is simply water mixed with sodium chloride, the same salt used in IV fluids. It works through a gentler version of the same osmotic principle: the salt solution draws a small amount of water into the colon, softening stool and promoting movement. Saline enemas come in a range of volumes. Small-volume versions use less than 500 milliliters and clean the lower colon. Large-volume enemas, between 500 and 1,000 milliliters, push fluid higher and cleanse more of the bowel. Hospitals and clinics often use saline enemas for children because the concentration and volume can be precisely adjusted by weight.
Mineral Oil Enemas
These contain 100% mineral oil and nothing else. Rather than pulling water into the bowel, mineral oil coats the stool and the intestinal lining, acting as a lubricant. This makes the stool slippery enough to pass without straining or irritating the bowel wall. Mineral oil enemas are commonly used for fecal impaction, where stool has become too hard and dry to pass on its own. They tend to work more slowly than phosphate enemas, sometimes taking 15 to 30 minutes or longer.
Glycerin Enemas
Glycerin enemas typically contain a small amount of glycerin (around 3 grams per 100 milliliters) dissolved in water. Glycerin is classified as a hyperosmotic laxative. Like sodium phosphate, it draws water into the bowel, but it works locally and is considered milder. These are often used for infants and young children when a gentle option is needed.
Soap Suds Enemas
Soap suds enemas combine castile soap with saline. A common hospital ratio is 27 milliliters of castile soap (about three small packets) added to 1,000 milliliters of normal saline. The soap mildly irritates the intestinal lining, which stimulates contractions that move stool along. Only pure castile soap is used because harsher soaps or detergents can damage the bowel lining. These are typically administered in a clinical setting rather than at home.
Stimulant Enemas
Some enemas contain a stimulant medication that directly increases intestinal activity. The most common is bisacodyl, which belongs to a class of drugs called stimulant laxatives. Instead of relying on fluid volume or osmotic effects, bisacodyl triggers the muscles lining the intestine to contract more forcefully, producing a bowel movement. Stimulant enemas are generally reserved for more stubborn constipation that hasn’t responded to gentler types.
Coffee and Herbal Enemas
Some people use homemade enemas with coffee, herbal infusions, or other non-medical solutions, typically as part of “detox” or alternative health routines. These are not supported by medical evidence and carry serious risks. The Mayo Clinic notes that coffee enemas have been linked to multiple deaths. The dangers include electrolyte imbalances (particularly dangerous for anyone with kidney or heart conditions), rectal tears from inserting tubes, and burns from liquid that’s too hot. There is no documented health benefit to colon cleansing with coffee or herbs.
The Physical Kit
Beyond the liquid itself, a typical disposable enema kit includes a squeezable plastic bottle pre-filled with solution and a smooth nozzle tip, usually made of plastic or silicone. The tip is designed to be inserted about two inches into the rectum. Many pre-packaged enemas come with the nozzle already lubricated. Reusable enema kits sold separately include a bag or bulb (silicone or rubber), tubing, and a detachable nozzle that can be cleaned between uses. For hospital-administered enemas, the setup is larger: a hanging bag connected to flexible tubing with a rectal catheter, allowing for controlled delivery of higher volumes.
Volume Differences for Children
Pediatric enemas are smaller and dosed by weight and age. For infants and toddlers between 6 months and 2 years, clinical guidelines call for plain saline at 10 milliliters per kilogram of body weight, with a maximum of 300 milliliters per dose. Children aged 2 to 12 who weigh under 25 kilograms receive a single pediatric sodium phosphate enema of 67.5 milliliters. Larger children under 12 may receive two pediatric-sized enemas (133 milliliters total), and those over 12 get the adult dose of 133 milliliters. Pediatric enemas also use a narrower nozzle tip sized for smaller bodies.