Attention CHOP clinicians: patient education should be printed and assigned via EPIC's Teaching Library.
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Balloon Enema Administration Instructions

Patient Instructions:


Gather your supplies:

  • Lubricant (K-Y Jelly®)

  • Foley catheter – typically 22 or 24 French

  • Enema bag/feeding gravity bag

  • Normal saline solution and additives

  • Enfit® connector

  • Luer lock syringe

  1. Prepare enema solution. 

  2. If using an enema bag, cut off the blue tip and connect a purple Enfit connector.

    Cut tubing   Attach Enfit transitional connector
    to enema bag
  3. Make sure the enema bag is clamped, then pour the solution in the bag. 

  4. Hang the bag on the wall (you can use a nail or hook in the wall or use a hanger and hang on the shower curtain rod)

  5. Connect the Enfit connector to the open end of the Foley catheter.

  6.  Prime tubing by opening the clamp and allowing the enema solution to fill the tubing

  7. Use K-Y jelly and lubricate the end of the catheter 

  8. Put your child in a comfortable position.

  9. Insert the catheter 4-5 inches into the rectum 

  10. Fill the balloon of the catheter (blue port) with 20-30mL of air using the syringe provided (Luer lock) remove the syringe after filling. 

  11. Pull back on the catheter in the rectum, after filling the balloon until some resistance is felt (it is possible that you may not feel any resistance). 

  12. Unclamp the bag and allow the mixture to freely flow into the rectum (try to infuse in 5-10 minutes). If your child becomes uncomfortable, you may slow the flow by closing the clamp or hanging lower on the wall. 

  13. If there is leaking or stool that flows backward, this is okay. Try pulling some tension on the catheter if there is leaking. If the solution is not flowing, you may need to flush the catheter if it is clogged. If you still experience leaking around the balloon, deflate the balloon, insert the Foley 4-5 inches and increase the amount of air up to 40-50 ml of air

  14. You may squeeze your child’s buttocks together to decrease leaking as well. 

  15. After the fluid has gone into the rectum, you may sit your child on the toilet. Once your child is sitting on the toilet, remove the air from the balloon of the catheter- the catheter should easily fall out. Typically, we recommend holding the catheter in place for 5-10 minutes 

  16. Have your child sit on the toilet for about 15-30 minutes - until there is no more stool output. 

  17. When finished, rinse the bag with water. Flush the catheter with soapy water using the catheter tipped syringe. Reuse each enema bag and catheter for as long as possible. 


Reviewed March 2024 by Lisa Jang CRNP and Stephanie Collins CRNP

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