Patient Information

Bowel prep with enema at home


A sigmoidoscopy is done to have a look inside the lower part of your bowel. For this, the bowel must be completely empty.

You must prepare properly

Six hours before the procedure, you will need to start ‘bowel preparation’ to empty the bowel.

6 hours before the appointment

• Have a light meal, such as a sandwich or soup and bread.
• Then have nothing else to eat until after the appointment.
• Drink only clear fluids from now (see box A, below).

4 hours before

• Stop all fluids apart from sips of water

2 hours before

• Stop all fluids

1 to 1.5 hours before

• Have the enema
These instructions are very important. If you do not stick to them, we will probably have to cancel the procedure because we will not be able to see inside your bowel clearly.

Contact the endoscopy nurse helpline if you feel you cannot do the enema yourself or if you have any questions.

Having the enema

red warning circle saying no bowel preparation means no procedure

An enema is a liquid that is passed into the back passage (rectum). This will make you open your bowels.

You should use the enema even if you have recently opened your bowels.

Most people find it comfortable to use the enema at home. It should work within 1 hour so you will not have to worry about going to the toilet on your journey to the hospital. If necessary, you can have the enema at the hospital, but this will need to be arranged beforehand.

How to give yourself the enema

Further information can be found in the leaflet that comes with the enema.

  1. The enema comes in a small tube with a thin nozzle. Have this ready.
  2. Lie on your left side on a towel. Have both knees bent up towards your chest.
  3. Remove the small white cap from the nozzle of the enema.
  4. Gently insert the nozzle into your rectum. 
    Do not continue if you feel any resistance when trying to insert the tube. Forcing it may cause injury. Call the Endoscopy Unit immediately.
  5. Squeeze the contents of the tube until the tube is empty. Whilst still squeezing the tube, gently remove the nozzle from the rectum.
  6. Try to hold the liquid in for 5 to 10 minutes (but no longer), or until you feel the urge to open your bowels.   
  7. Stay close to a toilet. When you open your bowels, it may be frequent, loose and watery. 
    Do not worry if you do not open your bowels.

Possible side effects

It is normal to feel one or more of the following symptoms:

  • bloated
  • mild stomach cramps
  • feeling sick (nausea)
  • irritation of your rectum.

Contact your GP or go your nearest emergency department (A&E) if you have:

• nausea and vomiting

• skin reactions, such as a rash, itchiness or redness

• swelling of the face, lips, tongue or throat.

Box A

Clear fluidsAvoid
fizzy drinks
apple juice, orange juice
black tea or coffee (sugar is allowed)
Oxo, Bovril, Marmite
Horlicks (made with water)
Ovaltine (made with water)
hot chocolate (made with water)
consommé (clear soup)
lemon or lime jelly
sorbet (no fruit bits)
milk, milkshakes
red-coloured drinks
fruit juice with ‘bits’
ice cream

Bowel prep with enema at home - Kingston Hospital Download PDF


Endoscopy nurses helpline 020 8934 6614 (2pm to 4pm only)

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Please contact the Patient Experience Team on 020 893 3850 if you need this information in a different format.
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