Large volume water cleansing enema instructions

This is an option for bowel prep the day before beginning your fecal transplant protocol:

• Acquire a 1.5-liter, disposable enema bag. Open the packaging, make sure the flow clamp on the tube is tightly shut and located a few inches up the tube from the nozzle, and fill the bag with body-temperature water.

• Hang the filled bag from a clothes- or towel-hook or other convenient spot about three or four feet above the bathroom floor. The higher the bag the greater the water pressure and speed of filling—if you are new to cleansing enemas, you may want to start with the bag only one or two feet above the ground.

• Place some towels on the bathroom floor near the toilet so you can quickly sit on the toilet and evacuate if you are feeling bowel urgency. It is also possible that small dribbles of water may leak from around the nozzle, and the towels will absorb these.

• Either lie on the towels on your left side (with your left leg straight and your right leg bent toward the chest) or kneel on the towels with your forearms on the floor, the top of your head lightly touching the floor, and the buttocks slightly elevated. Try to find a position you can relax in.

• Reach behind yourself and grab the enema tubing. Make sure the cap is off, revealing the pre-lubricated nozzle. Place the nozzle against the anus—briefly clench the anus, then relax, and as you do so, gently slide the nozzle a few inches into the rectum. It won’t feel particularly comfortable, but if you feel any pain, stop and re-adjust. You can imagine aiming the tubing towards your belly button.

• After insertion, grip the clamp with one hand and open it. The flow rate can be controlled with this clamp. Keeping a hand on the clamp also prevents the nozzle from being expelled.

• Water will begin flowing into the colon—try to relax enough to allow the entire contents of the bag to enter the colon. If the pressure starts to feel like too much, try closing the clamp for a moment to allow the water to work its way around the obstacle, or closing the clamp partially to allow a slower flow of water. Or, try panting hard, so as to make the abdomen move rapidly in and out, sort of shaking the colon. This last technique is particularly good to get the water past a blockage of intestinal gas.

• You may experience irresistible bowel urgency before the entire contents of the bag have emptied into your colon—if this happens (or after you’ve emptied the bag and retained the water for up to a few minutes) simply close the flow clamp, remove the tubing, and sit up on the toilet to expel the water.

• Expect an initial outflow of water, followed by smaller evacuations over the next 30-60 minutes.

• Repeat up to twice if desired, for not more than a total of three times.