Any water from 50ml – 200ml (2 – 5 fl oz) is enough. It is just to empty the lower part of the rectum quickly. You can use a short burst from your enema kit or shower nozzle but it is quicker is you have a Max Injector or Enema bulb syringe. Inject the water and give it a minute to loosen any stools and moisten the wall of the rectum. A squirt and a squat should only take a minute.
Step 2 – Flush the rectum
Anus and Rectum Details
This step is a quick flush of the entire rectum. You have to make sure it is empty. You don’t want to start pushing stuff from your rectum backwards, up in to your colon (other than the water) when you move to the high volume colonic enema. Again, you do this bit standing. You don’t really want/need the water to go beyond the top of the rectum.
Depending on your anatomy you will need 300-500ml to fill the rectum. Using enema bottles or syringes can be fiddly. You definitely want to use your enema rig for this step and those that follow. Taking it slow is still the key. You are bound to feel pressure build up as the water reaches the top of the rectum. This is the point at which you stop the flow of water and hold it.
Let your insides do the work
You should feel quite a bit of pressure. It tends to keep building up after you stop the flow of water as your inside react to having the rectum filled. The idea is to hold this for 2 to 3 minutes. It can get quite intense. You want to stay close to the toilet incase you just can’t hold the enema.
Even if you think your emptied the rectum entirely in the first step, solids and/or gas might have descended when you squatted the first time. Regardless, stop, hold and wait. You are should feel the pressure or cramping build and release while you wait. The muscles at the top of the rectum will be resisting inflow and start pushing back. Clench your ass and resist the urge to release. Your internal muscles work in cycles. They do not just keep pushing. When they fail to move the stuff in your rectum, they reset and try again from higher up. As the muscle cycle releases, the water will migrate further up, past the top of the rectum and into the sigmoid colon.
You are ready to empty
Don’t start the flow of water again just because you think you can take more when the first cramp subsides. Just let your insides work on water for the next couple of minutes. The Peristalsis will keep working on the water to move it out, mixing everything up as it goes. It will soften and release the mass in the sigmoid colon and rectum.
After a couple of minutes or three episodes of cramping, it is time to release. A fart at the end of the squat is always a good sign. Gas always floats to the top of the liquid and sludge as everything runs down. Gas is your enemy and you want it out before you try to fill yourself up more.
Step 3 – Flush the entire colon
This will take 15 mins. to 20 mins. if you get it right. You want to get it right because this is the big part of the clean out.
Now it is time for 2 quarts (or more) of warm water. Now you want the enema to fill your colon from anus to Cecum. The human colon, if laid out in a straight line on a surface, is capable of expending to hold up to 7 litres (1.8 US gallons). But when constrained within the abdomen it is not free to expand and the limit for most people is 3 litres. Also, keep in mind that your colon is not empty to begin with.
Now your position is more important. Take special note if you haven’t done a lot of total clean outs before. The first position show here on the right (the Left-side Position) is the position most often promoted for administering colonics. It does make filling the first half of the colon easy. But that’s only half the job. Once the Descending colon is filled the enema has to push up hill to fill the transverse colon. As the column of water builds up in the transverse colon, pressure builds up at the Left colic (or splenic) flexure. This will give you a premature sense of fullness and pressure that you might not be abler hold on to.
Watch out for false signals
Just because you feel internal pressure does not mean you are full. You are full when you feel the pressure build up under your ribs on the right side and just in front of, or above the right hip. This is where you Cecum sits and is the widest part of the colon that can hold the most water.
You want the water to be just a little above body temp. Too cold and your colon will cramp and you will not get all the water in. Too warm and your colon will relax too much. It will take your colon several minutes to recover and really slow your progress. You may struggle to empty properly and completely.
Take the enema slowly. This is why it is recommended by many that the enema bag should not be hung higher than your shoulder or head height. If you are using a shower attachment, the water flow must be nice and slow. It should take 3 to 5 minutes to fill the colon.