Instructions for Giving an Enema Using a Foley Catheter
Irrigation enemas are enemas that use saline solution in a high volume to help to flush the colon and to help with chronic constipation. These instructions are for giving an irrigation enema using a Foley catheter.
Important information:
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Children respond to their parents’ attitude. The way that you explain the procedure to your child will affect how your child tolerates the enema. Do not apologize. Be confident and positive.
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Reserve at least an hour in the evening for enema administration. It is important for your child to sit for at least 30 minutes after the enema to help with cleaning out the colon.
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Provide your child with a book to read, a DVD to watch, or a game to play to prevent boredom.
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At first enemas are given every evening to help empty stool from the colon.
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As your child progresses without soiling accidents, enemas may be switched to every other night.
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It is common for your child to complain of cramping during the first few enemas. The cramping improves with time.
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Your child’s healthcare provider will tell you the amount of enema fluid that your child needs.
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The higher you place the enema bag the faster it is going to flow. You can control the speed of the enema by changing the height and adjusting the roller clamp on the tubing of the enema bag.
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The goal is to keep stools soft, prevent soiling accidents, and have daily bowel movements.
Instructions for Foley catheter enema:
Gather supplies:
Prepare the enema
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Measure the Foley catheter at 3 and 4 inches and mark with a pen or a marker.
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Make the solution for the enema:
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Add table salt to warm tap water as instructed by your child’s healthcare team.
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The solution should be warm (body temperature). Cold solution can cause cramping.
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Test the enema solution by pouring some on the inside of your wrist.
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Warm the solution before you pour it into the enema bag.
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Check the balloon in the Foley catheter to make sure it is working properly.
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Pull back 15 ml of air into the syringe.
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Attach the syringe to the balloon port on the Foley.
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Insert the 15 ml of air into the Foley. The balloon at the end of the Foley will expand.
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Remove the 15 ml of air from the balloon.
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Keep the syringe attached to the Foley with 15 ml in the syringe.
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Cut the tubing of the enema bag to remove the part with holes. Attach the connector.
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Attach the enema tubing to the Foley catheter using the connector.
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Clamp the enema tubing.
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Hold the enema bag over a sink and add the enema solution to the bag.
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After the solution is in the bag, open the clamp so that the solution can flow through the tubing of the enema bag and the Foley catheter. When the solution reaches the tip of the Foley close the clamp.
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Hang the enema bag 5 to 6 feet high.
Give the enema
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Put on gloves.
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Lubricate the end of the Foley catheter.
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Place old towels on the floor.
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Have your child lie on the towels, on their left side or in the knee to chest position.
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Insert the catheter slowly past the 3 inch mark until the catheter reaches the 4 inch mark. Your child may feel the catheter but there should be no pain.
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Once the catheter reaches the 4 inch mark, inflate the Foley Catheter balloon. Push the 15 ml of air from the attached syringe into the Foley. This inflates the balloon.
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The balloon on the catheter acts as a cork and prevents the catheter from coming out of the rectum during the enema administration.
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Start out with 15 ml of air; you can increase up to 30 ml total of air depending on your child.
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If the enema catheter comes out from the rectum with 15 ml of air, insert more air into the balloon.
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Pull back the Foley catheter until tension is met and the anus is blocked with the balloon.
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Remove the syringe from the hub of the Foley catheter.
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If the enema solution is leaking, check if the syringe is attached to the catheter.
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The balloon deflates automatically if the syringe is left attached.
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Open the clamp and run the enema solution into the colon.
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Run solution for about 5 minutes or until the enema is empty.
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If your child complains of cramping, decrease the speed of the enema by lowering the height of the bag.
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The solution should empty from the bag into the colon.
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Once the enema bag is empty, clamp the tubing.
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Have your child hold the enema solution for 10 minutes by lying on the towels with the Foley remaining in the rectum.
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After 10 minutes, attach the empty syringe back to the Foley catheter syringe port.
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Pull back 15 ml of air from the balloon in the Foley catheter.
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Remove the Foley catheter from the child’s rectum.
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Have your child sit on the toilet for at least 30 to 45 minutes to empty the enema solution and stool from the colon.
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When your child no longer feels the urge to have a bowel movement the enema is complete.
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Wash the enema catheter with soap and warm water. Rinse with warm water. Allow to air dry.
Contact your child’s healthcare provider with questions or concerns.
Talk to your healthcare provider about the correct saline mixture for your child.
They may suggest one of the following mixtures:
To make 250 mL of saline: add 1/4 teaspoon of regular table salt to 250 mL warm tap water.
To make 500 mL of saline: add 1/2 teaspoon of regular table salt to 500 mL warm tap water.
To make 1000 mL of saline: add 1 teaspoon of regular table salt to 1000 mL warm tap water.
Common household measurements:
8 ounces = 1 cup = 250 mL
16 ounces = 2 cups = 500 mL
32 ounces = 4 cups = 1 quart = 1000 mL
Watch the video: Administration of High-Volume Enema Using a Foley Catheter
https://info.chop.edu/FoleyEnema
Reviewed February 2025 by Keri Dowds, BSN, RN, CGRN, CNE