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How to give medicines: rectal medicines

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How to give medicines: rectal medicines

This leaflet gives tips about how to give rectal medicines (suppositories and enemas) to children. Leaflets on individual medicines are available on the Medicines for Children website.
This leaflet has been written specifically about the use of medicines in children. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Rectal medicines are administered (given) through the anus into the rectum (back passage, or bottom).They must not be taken by mouth.

  • Ideally your child should open their bowels (do a poo) before you give rectal medicines.
  • Wash your hands thoroughly with soap and hot water before and after giving rectal medicines.

Suppositories

SuppositoryA suppository is a plug of medicine designed to melt at body temperature within the rectum (back passage, or bottom).

  • Wash your hands thoroughly with soap and hot water.
  • Your child should be lying on their side or front.
  • Hold one buttock gently to one side so that you can see the rectum.

Rectum

  • Unwrap the suppository and hold it with the rounded end close to the rectum.
  • Use one finger to push the suppository gently into the rectum. It needs to go in by about 2 cm.

Suppository - inserting

  • You can use lubricating gel to make this more comfortable for your child. You can get this from a pharmacy.
  • Your child should stay lying on their side for about 15 minutes, and ideally for an hour. This will allow the suppository to spread further inside the bowel and make sure it doesn’t come out.
  • Wash your hands again with soap and hot water.
  • If your child empties their bowels (does a poo) within 15 minutes of inserting a suppository, you will need to insert another one.
     

Foam enemas

A foam enema is a medicine that is mixed into a foam that is sprayed into the rectum (back passage, or bottom).

  • Wash your hands thoroughly with soap and hot water.
  • Shake the can vigorously for about 20 seconds.
  • Prepare the foam enema as directed by the manufacturer. For some foam enemas, you will need to remove the safety tag from under the dome. Push a plastic applicator firmly onto the spout of the can and twist the top so the notch beneath the dome lines up with the spout.
  • Hold the can in the palm of one hand with the dome pointing downwards. The can must be upside down for the foam to come out properly.
  • Your child should stand with one foot up on a firm surface such as a chair.
  • Insert the applicator into the rectum as far as is comfortable. You can put some lubricating gel on the tip of the applicator to help. You can get this from a pharmacy.
  • Push the dome down fully once and then slowly release it – the foam comes out of the can when you release the dome. The dome must be pointing downwards. (To give a second dose, press and release the dome again.) Keep the applicator in place for 15 seconds before taking it out.
  • Remove the applicator, put it in a plastic bag and throw it away with your household rubbish. Do not flush it down the toilet.
  • Wash your hands again with soap and hot water.

Liquid enema bottle with syringeLiquid enemas

A liquid enema is a medicine that is mixed into a liquid that is squeezed into the rectum (back passage, or bottom).

  • Wash your hands thoroughly with soap and hot water.
  • Shake the bottle for 30 seconds.
  • Prepare the liquid enema as directed by the manufacturer.
  • For some liquid enemas, you will need to break the seal by twisting the nozzle anticlockwise, and use it to wrap the bag for disposal after use.
  • For other liquid enemas, you will need to remove the protective cap from the applicator and hold the bottle upright.
  • Your child should lie on their left side with the left leg straight and the right leg bent forward...

Giving liquid enema - child on left side
...or kneel with their upper chest and arms resting on a bed.Giving liquid enema - child kneeling

  • Hold one buttock gently to one side so that you can see the rectum.
  • Carefully insert the applicator tip as far as is comfortable into the rectum.
  • Gently squeeze out the enema liquid. Keep the bottle compressed while removing it from the rectum.
  • Wash your hands again with soap and hot water.
  • Your child should remain relaxed in the same position for at least 10 minutes, until they no longer want to open the bowels (do a poo).
  • If your child empties their bowels (does a poo) within 15 minutes of administering the enema, you will need to repeat it.

Is there anything else I need to know?

If someone accidentally swallows a suppository or enema, give them plenty of water to drink and contact your doctor or NHS Direct (0845 4647 in England and Wales, 0845 24 24 24 in Scotland) straight away or take the person to hospital. Take the medicine or packaging with you so that the doctors know what has been swallowed.

  • Your child may find it difficult to keep the enema foam or liquid in place at first, and they may feel that they want to open their bowels (do a poo) frequently afterwards. The time that they can keep the enema in place will increase as they get used to it.
  • You can also put on disposable plastic gloves before using suppositories or enemas. However, some people find it easier to have bare, clean hands.
Publication date: 
09/09/2011