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Medical Enemas

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  • Medical Enema Description
  • Phosphosoda Enema Instructions
  • Colonoscopy Preparation Phosphosoda
  • Enema-Related Products


    Over time, toxic waste can accumulate in the colon and liver, and then circulate throughout the body via the bloodstream. A clean and healthy colon and liver, then, are essential for the health of all the organs and tissues of the body.

    There are two types of enemas - the retention enema and the cleansing enema. The primary action of the retention enema, which is held in the body for about fifteen minutes, is to help rid the liver of impurities. The cleansing enema, which is retained for only a few minutes, is used to flush out the colon.

    When using any enema, keep in mind that they should never be used if there is rectal bleeding. In such a case, contact your health care provider immediately.

    If you experience tension or spasms in the bowel while using an enema, try using warmer water (99°F to 102°F is a good temperature) to help relax the bowel. If the bowel is weak or flaccid, try using colder water (75°F to 80°F) to help strengthen it.

    After using any enema, be sure to wash and sterilize the tip of the enema bag.

    MoonDragon's Instruction Information: How To Administer A Medical Enema


    Phosphosoda is a laxative that includes Monobasic Sodium Phosphate and Dibasic Sodium Phosphate. It will increase the retention of water in the intestine, thus promoting bowel movement.


    To make the solution for the phosphosoda enema, add:
      2 Quarts Warm Water (102°F)
      1.5 Fluid Ounces (45 ml) of Phosphosoda

    Warm the water and put in the enema the bag. Add the phosphosoda. Mix well.

    Do not use petroleum jelly to lubricate the tip of the enema bag. Instead, use Vitamin E Oil (buy it in oil form or pierce the end of a vitamin E capsule and squeeze the liquid onto the tip). The liquid will both ease the insertion and have a healing effect on the anus and the lining of the colon, if these areas are inflamed. Aloe Vera may also be used for this purpose.

    knee-chest position
    Knee-Chest Position

    The best position to assume when receiving the enema is "head down and rear up". After the liquid has been inserted, roll onto your back, and finally roll over and lie on your left side. As you are doing this, massage your colon to help loosen any fecal matter. Start on your right side and gradually move your fingers up toward the bottom of the rib cage, then across your abdomen and down the left side.

    child's position
    Child's Position

    For a child, place the child on his or her left side. Be very gentle inserting the tip and never force it inside the anus. This could damage the colon and could be very dangerous. Do not give an enema to a child under 2 years of age.

    Note: that 2 quarts is a lot of liquid. If you experience any pain during insertion, stop the flow of the enema bag and remaining in the same position, take deep breaths until the pain subsides. The resume the enema flow. If you expel the liquid before all of it has been inserted, simply begin the process over again. If pain persists, discontinue the enema procedure.

    Hold the solution in your body for 3 to 4 minutes before allowing the fluid to be expelled. After 2 or 3 such sessions, you will find it easier to insert and hold the liquid. Hold the solution as long as you can before expelling.

    Note: Always check with your health care provider before doing an enema.

    (An Example Preparation Guideline)

    This is an example of a preparation guideline. Follow your specific instructions given to you by your health care provider for a colonoscopy exam. If you have problems involving kidney function or a history of kidney disease, be sure to inform your health care provider before using any oral phosphosoda laxative preparation since there can be serious or fatal complications involved with kidney disease and the use of phosphosoda oral laxatives.


    Your health care provider has decided that colonoscopy is necessary to better evaluate your colon, or large intestine. An important examination such as this requires careful preparation. The results obtained from this exam are dependent on your lower bowel (colon) being carefully cleansed and empty. An improperly prepared bowel may mean that the exam will have to be repeated at another time. More importantly, fecal matter (stool) left in the intestinal tract can hide important conditions that may be present. Therefore, it is very important that you follow these instructions as carefully as possible. If the test is worth doing, it deserves the best possible preparation.

    A couple of hints... To fully evacuate the colon, this preparation will cause you to have many liquid bowel movements. Note that individual responses to laxative vary widely. Plan to remain within easy reach of toilet facilities. Many patients find that Charmin Plus toilet tissue minimizes the expected anal irritation from wiping. Also rubbing a small amount of hydrocortisone cream, such as Cort-Aid, around the anal area after each bowel movement can lessen the irritation. On the day of your exam, wear comfortable easily-removable clothing and leave jewelry and other valuables at home. If you are having a menstrual period, it is OK to wear a tampon.

    No laxative preparation is fun. However, this solution has been developed to make your preparation as simple, effective, and painless as possible. Please follow each instruction exactly as given. If you have any questions, please call your health care provider.


    7 Days Before Colonoscopy: Stop taking iron, aspirin, aspirin products or Pepto Bismol. Please note that Tylenol (acetaminophen) does not interfere with the procedure. Please consult with your health care provider if you have any questions about your medication, especially if you have been told not to stop taking these drugs suddenly without medical advice.

    5 Days Before Colonoscopy: Stop taking non-steroidal anti-inflammatories (e.g. Motrin, Advil (ibuprofen), Feldene, Naprosyn, Uprine, Celebrex and Vioxx).

    A Few Days Before the Examination: You will need to purchase a 3 ounce (90 mL) bottle of FLEET PHOSPHO-SODA saline laxative (or two 1 1/2 oz. bottles). This may be found in the laxative section of your local pharmacy (or from the link supplied above).

    You must be on a CLEAR LIQUID DIET FOR TWO FULL DAYS BEFORE YOUR TEST DATE. If you are diabetic or hypoglycemic, ask your health care provider for a different prep.

    Foods Allowed: Black coffee or tea (sugar is permitted), strained soups and bouillon, clear fruit juices, Jello (avoid red), pop or soda, popsicles, and Lifesavers.

    Foods To Avoid: Fruits, vegetables, nuts, milk products, meats, breads and cereals, alcohol. Milk and red colored liquids can interfere with the test.

    To help prevent excessive hunger and weakness during this prep, you are also allowed to drink 2 cans of BOOST (or other recommended brand) Nutritional Supplement on each of the two days of your laxative preparation. No BOOST should be taken the day of the exam.

    The Day Before the Examination: On the evening before your procedure at 7 PM, you will mix three (3) tablespoons of the Fleet Phospho-soda liquid into a half glass of water. For accuracy, use a measuring tablespoon. Drink the entire glass. During the rest of the evening, you must drink at least four 8 ounce glasses of plain water or clear fruit juices. You may drink more. Plan to remain within easy reach of toilet facilities. Consume no alcoholic beverages during this preparation. If you develop vomiting during the prep, temporarily stop for one hour and resume. If vomiting persists, stop the prep and call your health care provider's office for further instructions.
      If your procedure time is at or before 12:00 midday: Please drink the first dose of Fleet phospho-soda at 2pm by adding 1.5 ounces of Fleet phospho-soda to 1/2 glass (4 ounces) of cool water and drink. Follow with 6 glasses (8 ounces each) of clear liquid within an hour of taking the Fleet phosphosoda. Take the second dose at 7pm by mixing 1.5 ounces of Fleet phosphosoda to 1/2 glass (4 ounces) of cool water. Now follow instructions on DAY OF COLONOSCOPY.

      If your procedure time is after 12:00 midday: Please drink the first dose of Fleet phospho-soda at 7pm by adding 1.5 ounces of Fleet phosphosoda to 1/2 glass (4 ounces) of cool water and drink. Follow with 6 glasses (8 ounces each) of clear liquid within an hour of taking the Fleet phospho-soda. The second dose should be taken on the day of the procedure.


    On the day of your test at 6 AM, you are to mix another three (3) tablespoons of the Fleet Phosphosoda in a half glass of water. Drink the entire glass.
      If your procedure time is at or before 12:00 midday: Your preparation is complete when you are no longer passing stool but a clear yellow/green liquid.

      If your procedure time is after 12:00 midday: Please drink the second dose of Fleets phosphosoda 3 hours before the procedure time. Add 1.5 ounces of Fleet phosphosoda to 1/2 glass (4 ounces) of cool water and drink.

    Do not eat or drink anything after this except plain water up to 4 hours before your appointment, then you should remain fasting. You may take all of your regular medications unless otherwise directed. No Insulin. No Coumadin unless your health care provider told you to do so.

    Wear loose comfortable clothing. You may be allowed to keep short sleeve clothing on during the procedure under the hospital gown you will be given. The procedure room may be cold so you may consider bringing socks to wear for your feet. Avoid using fingernail polish. Have your nails bare and clean for the exam.

    You should arrive at the endoscopy center at least 15 minutes before your scheduled appointment. There you will complete your registration, have you change clothing, perform any pre-operative orders which might be required by your health care provider, and answer any questions you might have. Please be on time so that you do not cause a delay which could affect many other patients within the same day.

    Since sedation is utilized, YOU MUST BRING A COMPANION WITH YOU who is responsible and is able to drive you home after your procedure and to assist you with follow-up care. If you do not bring a companion and make arrangements for a ride, your colonoscopy will be canceled by the clinic. Only one companion is necessary, and we ask that they remain at endoscopy center during your procedure and recovery which totals about 90 minutes. You will not be able to drive a car, take public transportation (a taxi may be allowed), operate any machinery, go to work or eat out at a restaurant until the following day. Do not do any strenuous exercise or sign any legal documents after the procedure until you return to normal.

    Please contact your health care provider's office immediately if you have any of the following medical conditions and have not already discussed this with him/her prior to the exam:
    • History of liver, kidney (dialysis), heart or lung disease.
    • Anticoagulation therapy (Coumadin or Heparin).
    • Excessive bleeding during previous surgery or dental extraction.
    • Diabetes.

    Notify your health care provider if you have special health care needs prior to the exam.


    Johnson & Johnson: Important Safety Information Regarding Fleet Phospho-Soda (Sodium Phosphates Oral solution)

    J CLIN GASTROENTEROL - 2002 Apr;34(4):457-8

    Fatal hyperphosphatemia from a phosphosoda bowel preparation.
    Ullah N, Yeh R, Ehrinpreis M.
    Department of Internal Medicine, Wayne State University, Detroit, Michigan, USA.

    Oral phosphosoda is increasingly being used as a bowel preparation for colonoscopy, as it requires that a much smaller volume be ingested and is equally effective and less costly than polyethylene glycol-based electrolyte solutions. Oral phosphosoda has a good safety record, but complications of its use may occur. We describe a patient who died as a result of severe hyperphosphatemia after an oral phosphosoda bowel preparation. A 55-year-old man was admitted with rectal bleeding, abdominal pain, and vomiting. He had a history of diabetes, hypertension, and end-stage renal disease and had successful renal transplant 3 years prior. His initial serum creatinine, calcium, phosphate, and electrolyte levels were normal. He vomited after polyethylene glycol-based electrolyte solution, and an alternate bowel preparation with oral phosphosoda was recommended. He received 90 mL of oral phosphosoda as a single dose. Six hours later, he had cardiorespiratory arrest and was found to have hyperphosphatemia (serum phosphate, 17.8 mg/dL), a high anion gap acidosis, hypoxia, and oliguric renal failure. Resuscitation was unsuccessful. Autopsy showed ischemic colitis. We conclude that bowel preparation with phosphosoda may be associated with severe complications and should be avoided if there is any suggestion of impaired renal function or poor gut motility.


    Class Actions: Fleet Phospho-Soda/Kidney Failure Update

    Attorneys are currently representing people who have taken Fleet Phospho-Soda. This product has been consumed by thousands of victims and is still being used today. They are working to ensure that their clients receive proper treatment and recover damages for injuries suffered because of Fleet Phospho-Soda and generic brands of phosphosoda.

    Fleet Phospho-Soda, an oral sodium phosphate solution "OSPS", is used as a prior to x-ray examinations, colonoscopies and other surgeries. Fleet, the primary manufacturer of Phospho-Soda, manufactured and promoted the product without warning of its dangerous side effects, including kidney damage and kidney and renal failure. Fleet Phospo-Soda has been linked to acute nephrocalcinosis, a condition that forms calcium phosphate tubules in the kidney and can lead to acute renal failure "ARF." Studies strongly point to OSPS as the cause of acute nephrocalcinosis for three reasons:
    1) Renal biopsies have found an abundance of calcium phosphate crystals (the main component of OSPS) in renal tubules;
    2) The time element - acute nephrocalcinosis developed shortly after the use of OSPS; and
    3) Laboratory studies on mice have linked OSPS to nephrocalcinosis.

    An April 4, 2002 Health Canada Advisory warned that OSPS can change the levels of calcium and sodium (electrolytes) in the blood that "can affect the function of the heart, muscles and kidneys." An article published in the September 2003 New England Journal of Medicine warned that OSPS "may have serious side effects, including seizures and acute renal failure."

    Studies have shown that some people are at a greater risk for developing kidney damage and failure after taking OSPS. Specifically, people who have suffered from kidney failure, heart disease and bowel disease are at higher risk and should not take OSPS. Often times, people are unaware of their rights or are reluctant to pursue their remedies because they feel they cannot afford it or do not have the time. But review of your case only requires a little time and expense.

    Their goals in these cases are to:
    • Promote and protect victim's rights.
    • Ensure that Fleet victims receive proper treatment.
    • Recover monetary damages for Fleet users that have suffered kidney damage, kidney failure or renal failure.

    They are also investigating similar claims against the makers of generic versions of Fleet Phospho-Soda which have also been linked to increased risks of kidney damage and failure.

    Touhy & Touhy, Ltd: Fleet Phosphosoda Attorneys
    Fleet Phosphosoda Mass Tort Lawsuit Attorney


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  • Note: Always check with your health care provider before doing an enema.


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