A 4 quart bag can be made from a Faultless brand ice bag. Drill a hole in the center of the plastic cap, and adapt as above with the pipe nipple, etc. Get an 8-32 Eye Bolt with machine screw threads, 2 8-32 fender washers as large as available, and 2 8-32 nuts.

Poke a hole in the center of the end of the bag opposite the filling mouth just big enough to take the eye bolt. Screw one nut onto the eye bolt. Place a washer on the eye bolt. Put contact cement onto the washer facing away from the ring end. Push into the bag from the outside. Coat the other washer with contact cement, and place over the exposed end of the eye bolt inside the bag. Screw the other nut on to hold the bag between the two washers. This should provide a leak-proof hanging hook for the bag. Glop some contact cement on the inside washer and nut to prevent rust. Voila! A 4-quart enema bag!


Capacity

The capasity of the bowel to resceive enama fluids vary greatly individually, and from time to time for each person. The personal variations are due to factors like the size of the colon, the exendability of each  individual colon, and the muscular resistance in the colon towards filling. The colonic capasity averidge to about 7 quarts if the colon is empty and totally relaxed, but this is seldome the case. A realistic averidge colon capasity is perhaps 4 quarts. Timely variations by the same individual is due to factors like de amount of stool presented, the ampount of gas in the colon, bodily position, and variation in bowel muscular activity.

Fifty or so years ago, most adult patients receiving barium enemas were given 4 quarts of the barium solution and made to hold it during the X-ray procedure. At the same time, the enema bags sold in drugstores held 3 or 4 quarts, and many people felt that they could not be properly cleaned out unless they took the full bag.

It is not wise to take enemas that are tight up to the maximal capacity. It can in worst case hurt the colon physically, and a habit of taken very large enemas can over time make the colon distended and flaccid.


About amount and repetition

If you do not use an isotonic solution of salt you must not use a very big amount. You must not fill your colon to full capacity and you must not repeat the process.

By using an isotonic solution you can use much more of the capacity of your colon and you can repeat the enema several times. By repeated enamas using an isotonic solution you can clean out your colon totally. Let the colon get some time to expell as much content as possible between each repetition.


Guidelines about positions

An enema can be taken in many positions. The preference of position may be different if you take the enema by your own or have someone administer the enema to you.

Laying on your back, and possibly with your knees bent up and your legs spread apart is one alternative. By this position you can easily watch how the enema solution spreds in your abdomen. First you will se that the region above your groin expand when your sigmoid colon fills up. Then the left side of you abdomen engorges as your descending colon fills up. The the rest of your abdomen is pumped up as yor transverse and ascending bowel fills up. In this position you also easily can massage your abdomen to easen the distribution of the solution and to better clean up you bowel inside if you take the enema for medical reasons.

In the sims position the recipient is lying on his left side with his right leg bent up bringing his knee towards his chest. In this position the enema nosle can easily be held and supported by the right hand. In this position the sigmoid and descending colon easily fills, but some more pressure is needed to fill up the rest of the colon that is in the elevated right side.

You can also use the oppsite of the Sims's position, that is laying on your right side and bending up your left leg. In this position you ned some more pressure to make the water flow in, but then the water easily fills up the transverce and ascening colon right down to the innermost parts of your colon.

By the The Knee-chest-position the enemee is supported by the knees and the shoulders, so that the butt and rectal opening is up in the air and the breast and head down. In this position the water easily flows down filling the transverce colon. The position is good to delute deep-seated constipation and to let gas inside the colon easily float up an out.

You can stand upright while taking the enema. If you do so, you have to hold the nozzle firmly in place. This position has the advantage that it allows filling in more water that any other position.

You can lay down on your belly, but preferably with your upper body elevated by means of some pillows or just by supporting your upper body with your elbows. This position restric the amount of water you can hold because of the preassure up on the abdomen, but it may feel very stimulating.

Sitting on the floor allows you to tense certain skeletal muscles, and can lead to a powerful orgasm. The floor helps hold the nozzle in. This may not be the greatest position for filling and cleaning the bowel, however.

You can sit on a chair, in a bathtub or on the floor, bending up and spreading your legs and arching your lower back so that your rectal opening is exposed and easily at hand. This position lets your arms be free to do any manipulation you wish.

Leaning over the edge of the bathtub is similar to getting on your hands and knees, but it leaves your hands and arms free, and is a little easier to stay in that position for a while.


Insertion of the syringe or tube

Lubricate the syringe and the rectal opening well before insertion. It is wise to lubricate inside the opening also.

By an ordinary enama you insert the syringe past the rectal spincter and some more. The angle of insertion is important. When you begin inserting, let the syringe be perpendicular to the rectal opening. When it has reached through the spincter, it is often useful to bend the syringe a little up towards your genital region before inserting rurther. Be very gentle when you insert. If the syringe meets resistance, try out several adjustments of the angle, but do not use any great force.

By colonic irrigation, you use a flexible tube or catheter that has a certain stiffness. You begin inserting as by an ordinary enema, but you keep on ubtil the tube is at the bottom of the rectum, and pass it further up in the end part of the colon. You must be very cautious so you do not hurt the walls of the rectum or the colon. By inserrting very slowly, the tube will usually pass along very easily. If it is problems of getting the tube further, pukk it a little back, twist it a little and then gently push further inside.

If the tube meets stool or firm resistance, do not insert any longer. When you have done one irrigation, it is however often possible to insert deeper by a repeated irrigation.


Filling the fluid into the rectum and colon

You should let the enema fluid in slowly and gently. The method of filling will differ according to the type of equipment you use. If you use a container with a clamp, you can open the clam and shut it in several steps to let the fluid go in by the right speed. If the equipment has a walve, you just regulate the walve to get the right filling speed.

You relaxe as much as possible when you do so. Massage your stomach gently by a hand to make the fluid distribute itself within the colon.

If you do not manage to instill so much fluid into the colon that you think it should hold, you can fill the colon in two steps. First fill until the bowel feels full. Then Lay down and press gently at the lower left side of your stomach with one hand to press fluid further up into your colon. While holding the pressure at the lower left part of the stomach, take the other hand and press gently at the upper left side and then at the upper mid region. This action wil distribute the fluid better in your colon. Then you can try to fill somewhat more.


Retention

It is difficult to retain an enema in more than 5 minutes because of the pressure from the peristaltic action of the bowel. In the first of a series, the bowel is seldome clean, and this adds to the pressure. However, by intence colonic pressure, it is seldome wise to rise up and let go on the toilet seat at once. When rising up, the gravity will add to the pressure, and an accident easily occurs. It is better to wait to the peristaltic motion have passed through the whole bowel, and expell the bowel contents in a quiet moment.

A trick to use is to lie face down on the bed, and wait for three waves of cramps to pass down. After the third cramp, you can expel, and get a real good expulsion. If the cramps are extreme, however, just don't wait. Another aid in retaining the water is to get into the knee-chest position when the pressure builds. This causes gravity to hold the water in.

Another method is to lie on your back, and massage the colon with both hands. Whenever you feel pressure building, or can feel a big bulge with your hands, massage around that area until the pressure relaxes.

Some people recommend rolling from one side to the other every minute or so. The idea is that the water will flow repeatedly downhill, alternately filling the descending and sigmoid colon and then running down to the cecum. This is supposed to break up any masses in the transverse.

Need I mention that some people use a butt plug to hold the water in?


Emptying the bowel

Most often people expell the enemas taken by sitting on the toilet chair. However this position may make it difficult to get the fluid out, the ascending colon must work the fluid upwards against gravity, the transverse colon will sag down holding a large quantity of water, and the descending colon will kink at the junction by the sigmoid because of the weight of the water, and thereby  making a lock for the water. and the total effect is causing a large quantity being stuck in the bowel. You can however unlock the descending-sigmoid junction by getting up and laying down some while, getting into the knee-chest-position, laying at your left side or turn around flexing your body as if you are looking over your right shoulder.

By expelling while laying down in the bathtub, you can avoid these difficulties. This is messy however, and you will need to wash yourself and the bathtub well thereafter. If the colon becomes severely blocked, this may however be neccessary. In the bathtub you will be free to do any movement neccessary to get the water out.

If no water is comming out, do not sit to long on the toilet, because sitting long straining, can cause hemorrhoids.


How to get rid of gas in the bowel

If there is substantial gas in the colon, it may be very difficult for thecolon to lift water when large air bubbles are present. These like to collect at the hepatic flexure, high on the right side, and can be detected by a rumbling sound when you press there. If you want to get the gas out, you can sit on the floor and make sure the gas is at the hepatic. Roll slowly onto the right side, then massage the transverse, following its course with your hands. You will know that you are moving that gas by the rumbling.

When you have the gas moved to the splenic flexure, move quickly to the knee-chest position. Now massage the descending colon upward, from the ribs to the groin on the left side (you're upside down, remember) until the gas has moved to the sigmoid. Use heavy massage in the groin area, to move water out of the sigmoid, and move the gas in. When this is done, get on the toilet quickly, and you should be able to expel a prodigious gas blast. You may have to repeat this procedure several times, but when all the gas is out of the colon you should be able to expel the water quickly.