Every once in a while I feel backed up. A tap water enema really helps to clean out my pouch. Feel light as a feather after.
Any harm to doing this every so often?
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Typically no problem using a warm tap water enema from time to time. At one point I was using them prior to bed to try to clean things out so I wouldn't have to get up so often.
Yes, they are generally fine as long as your GI/surgeon agrees and if you only use lukewarm water. I have used them a couple of times to prepare for scopes, and once while I had pouchitis to try to irrigate.
I also think it is important not to use too often to become dependent on them.
It does make me sleep through the night which is great!
Yes, I would agree as well. It's probably not something you should do often, unless your GI or surgeon has advised it. Interesting points--I have read that enemas are "prescribed" in cases of individuals who have difficulty fully emptying their pouches, which can lead to fecal stasis/retention, which is thought by some to be a contributing factor in pouchitis. In these cases the GI would recommend nightly tap water enemas to help clear out the pouch. Enemas may also be recommended for those with stricture, to help empty the pouch. But again, these are all things to discuss with your surgeon.
Yes it is safe, and even recommended if you have problems of incomplete emptying with resulting stasis and bacterial overgrowth. Some people have even avoided revision surgery this way. It is OK for regular use too. There is no dependency like chronic use of laxatives with a colon.
But, use only tap water, no additives like soaps, coffee, etc.. Also, do not use enema kits for "high colonics" or similar things. Just a simple rinse with a few ounces from an empty "Fleets" type enema container, or the enema feature of a bidet.
I also agree it is good to be sure your doctor is on board with this option. Not so much for a safety issue, but because self treatment can lead to delayed medical treatment. So it is good to be sure you do not need other treatment first.
Jan 
I would caution against using tap water that comes from a well or has not been treated.
Perhaps bottled water would be best.
Good point Jay. You certainly do not want to introduce pathogenic bacteria or paracites into your system.
I was thinking of municipal tap, not untreated well water. However, if the well water is safe to drink, it is safe for an enema. No need for bottled for this purpose.
Jan
I've used a tap water enema/cleanse regularly for over 7 years. I started this regimen shortly after the creation of my j pouch. It enables me to sleep through the night and go for long stretches between bathroom visits. I've had no problems, however I am planning to move out of the country and have been advised by my doctor to use only purified bottled water (and to be sure to avoid bootlegged water-bottled water that is actually tap water). My doctor also mentioned that carbonated water filters out toxins and should therefore be a consideration.
@JEK posted:I've used a tap water enema/cleanse regularly for over 7 years. I started this regimen shortly after the creation of my j pouch. It enables me to sleep through the night and go for long stretches between bathroom visits. I've had no problems, however I am planning to move out of the country and have been advised by my doctor to use only purified bottled water (and to be sure to avoid bootlegged water-bottled water that is actually tap water). My doctor also mentioned that carbonated water filters out toxins and should therefore be a consideration.
Um...was he able to name at least one “toxin” that the carbonation “filters?” In any case, the purified bottled water suggestion is probably wise in places with questionable water supplies.
Due to issues related to a chronic cough I have, I have lately been doing sinus rinses with saline water. In principle this is exactly the same as a rectally inserted enema- you are putting water into a bodily activity. You are just squirting it up your nostrils rather than up your rectum.
The instructions that come with the sinus rinse, as well as the medical advice I received from my ENT doctor, was to ONLY use bottled, distilled or purified water when mixing it with the salt packet. I would think it would be particularly dangerous if one of those flesh eating amoebas were in the tap water and I shot that up my nose. I would probably be all done. Can you imagine having something eating your brain?
I have a house water filter that gets changed often which makes it safe to use. I’ve been doing a water enema for over 15 years because of a sluggish jpouch. I definitely would use distilled water when traveling.
Most water filters are “taste and smell” filters which aren’t certified to make biologically unsafe water okay to drink. Some water filters are designed to remove biological contamination (and often things like lead), and they are generally labeled with that information. As CT shared there have been a couple of terrible cases of amoebas getting into the brain from the sinuses; you’d be more likely to get Giardiasis than a brain infestation from a contaminated enema. That being said, *if* the water is safe to drink then I’d have no hesitation using it for a tap water enema, but I boil my filtered sinus rinse water every day.
Scott, do you think I am OK using Poland Spring bottled water for my sinus rinses? I can't imagine those horrible amoebas surviving the bottling process.
@CTBarrister posted:Scott, do you think I am OK using Poland Spring bottled water for my sinus rinses? I can't imagine those horrible amoebas surviving the bottling process.
You’re unlikely to get brain-eating amoebas even if you use water from a mud puddle. That being said, distilled water would be a better choice than Poland Spring. It costs very, very little by the gallon.
Are you saying that the amoebas could be in Poland Spring bottled water? I thought they need warm brackish water to survive?
@CTBarrister posted:Are you saying that the amoebas could be in Poland Spring bottled water? I thought they need warm brackish water to survive?
I was *not* saying that Poland Spring water is hospitable to amoebas, though I don’t know how quickly they might die if introduced into that environment. However, bottled spring water is not guaranteed to be sterile - just like tap water. The small potential microbial load is generally safe for your gut, which gives it an acid bath in the stomach. It’s fine to drink, but isn’t your best choice for sinus rinses. The vast majority of sinus rinses performed with spring water would cause no problem, but I choose not to take that small, unnecessary risk.
I just went to a functional doctor who advised I stop using tap water for my enemas I do daily. Even though it’s safe to drink she said the chlorine and whatever other chemicals that’s in tap water could kill the good bacteria in my pouch! Never thought of that? She said use filtered water instead! She actually advised against drinking too much tap water too…
I figured there'd be a discussion on here somewhere about this. I have a tract and some pouch structural issues that warranted a recommendation for a daily enema.
My friend who has chronic constipation but has a colon tells me that enemas are only safe if they have perfectly balanced salt concentrations, like the fleet saline enemas. So making your own is unadvised. But my surgeons and my doctor have told me to go ahead, use tap water, use a high colonic kit, etc, you can't hurt yourself, it's fine. The gut isn't sterile so if the water is safe to drink then you can use it. (They are of course assuming I'm not doing kale juice or coffee enemas which...nope.)
After reading this thread I think so much of this "knowledge" is hearsay. Do we really know? Has it been tested? Are the rules different for colons than for J pouches? I sort of assumed that a mature J pouch is going to reabsorb water after a while, maybe not as well as a colon, but better than if it were a regular small intestine that hasn't been...repurposed, so to speak.
I would assume the doctors are advising me based on some kind of reasoning but i'm not sure what. Maybe anything potable is fine, even daily, because it's just not in there long enough to start creating osmosis problems? And the colonics kits honestly do work better than those stupid 4 ounce bottles. I need to use at least 4 of them to clean out the pouch and that gets expensive.
They used what was essentially a colonics kit on me in the hospital to do a fast pouchoscopy prep and the nurse literally filled the bag in the bathroom sink. Seemed fine. Nobody freaked out. So maybe we're all making too much of this?
Just to be overly cautious I've been making my solution with reverse osmosis water plus a couple packets of that NeilMed sinus rinse salt since it's formulated to go inside body orifices.
I was told directly by my surgeon during those first months when I had poor pouch function that it was perfectly safe to perform warm tap water enema .
I did several times, it worked fine. Over the last two years my pouch function and pelvic floor has recovered sufficiently that I no longer need to perform them any longer.
Tap water enemas are fine, and the Fleet bottles can be refilled (you might need a dab of KY Jelly to refresh the lube). I’m fussier about sinus rinses because I keep reading about occasional catastrophes from contaminated rinses, but I don’t think there’s been a single report of complications due to tap water being used in an enema.
@Scott F posted:Tap water enemas are fine, and the Fleet bottles can be refilled (you might need a dab of KY Jelly to refresh the lube). I’m fussier about sinus rinses because I keep reading about occasional catastrophes from contaminated rinses, but I don’t think there’s been a single report of complications due to tap water being used in an enema.
Here is a news report on the latest "catastrophe" on using tap water for a sinus rinse:
I think everybody misunderstood why i mentioned the sinus rinse. I was not asking any questions about sinus rinsing. I was merely suggesting that the salt packets that come with those kits may be usable in an enema if you want to make your own saline.
I'm aware of the brain amoeba stories but it isn't relevant to this discussion.
Not sure how my words got misunderstood as I think I typed them pretty clearly. Maybe everybody was reading too fast.
I didn't misunderstand your post. There are places in the body that require significant biological control of anything introduced, like a sinus rinse. The pouch doesn't require that, nor does it require an osmotically balanced enema.