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Enema bag with tubing, reusable

HCPCS code

Name of the Procedure:

Enema Bag with Tubing, Reusable (HCPCS Code: A4458)


An enema bag with tubing is a medical device used to introduce fluids into the rectum and colon through the anus. This procedure helps clear the bowel by causing a bowel movement.


  • Conditions Addressed:
    • Constipation
    • Preparation for colorectal surgeries or examinations
    • Colon cleansing for certain medical treatments
  • Goals/Outcomes:
    • Relieve constipation
    • Cleanse the bowel for medical procedures
    • Improve bowel function and hygiene


  • Symptoms like chronic constipation or fecal impaction
  • Pre-operative or diagnostic preparations (e.g., colonoscopy)
  • Certain treatments requiring a clean colon (e.g., radiographic exams)


  • Pre-procedure Instructions:
    • Follow specific dietary restrictions, such as a clear liquid diet.
    • Avoid certain medications as advised by your doctor.
  • Diagnostic Tests/Assessments:
    • None required specifically for using the enema bag, but other pre-operative tests may be necessary depending on the medical condition treated.

Procedure Description

  1. Preparation:
    • Fill the enema bag with the prescribed fluid (such as saline solution, water, or bowel cleansing agents).
    • Ensure the liquid is at room temperature.
  2. Execution:
    • Lubricate the enema tubing tip.
    • Lie down, preferably on your left side with knees drawn to the chest.
    • Gently insert the lubricated tip into the rectum.
    • Gradually release the fluid into the colon by allowing it to flow from the enema bag through the tubing.
    • Retain the fluid for several minutes if possible to enhance effectiveness.
  3. Completion:
    • Expel the fluid and waste by using the bathroom.
    • Equipment Used:
    • Reusable enema bag
    • Flexible tubing
    • Lubricant
    • Anesthesia/Sedation:
    • None required.


The entire process typically takes 15-30 minutes.


This procedure can be performed at home, in a hospital, outpatient clinic, or surgical center.


  • At home: The patient or a caregiver.
  • In medical settings: Nurses or medical assistants under the supervision of a healthcare provider.

Risks and Complications

  • Common Risks:
    • Mild discomfort or cramping
    • Minor rectal irritation
  • Rare Complications:
    • Bowel perforation
    • Severe dehydration or electrolyte imbalance
    • Infection
  • Management:
    • Hydrate well and follow instructions carefully.
    • Seek medical attention if severe pain, bleeding, or signs of infection occur.


  • Rapid relief from constipation
  • Effective bowel preparation for medical procedures
  • Improved bowel hygiene


  • Post-procedure Care:
    • Stay hydrated by drinking plenty of fluids.
    • Rest briefly if feeling any discomfort.
    • Follow any additional post-procedure instructions given by your healthcare provider.
  • Recovery Time:
    • Typically, immediate return to normal activities; some may need a short period of rest.
  • Restrictions/Follow-up:
    • No major restrictions unless otherwise advised by your doctor.
    • Follow-up appointments as needed based on the underlying medical condition.


  • Other Options:
    • Oral laxatives
    • Stool softeners
    • Rectal suppositories
    • Manual disimpaction
  • Pros and Cons:
    • Oral laxatives and stool softeners are less invasive but may take longer to work.
    • Rectal suppositories are also less invasive but less thorough in cleansing the bowel.

Patient Experience

  • During the Procedure:
    • Mild discomfort or cramping may be felt.
    • The sensation of fullness as the fluid enters the colon.
  • After the Procedure:
    • Relief from constipation.
    • Some transient minor cramping or discomfort.
  • Pain Management:
    • Use a gentle technique to minimize discomfort.
    • Over-the-counter pain relievers if needed and recommended by your healthcare provider.

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