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Для процедуры используют **кружку Эсмарха** — резервуар объёмом 1,5–2 л с толстостенной резиновой трубкой и съёмным наконечником [2](https://gutaclinic.ru/articles/procto_examination/)[3](https://MedPortal.ru/enc/gastroenterology/reading/11/)[5](https://drdautov.ru/tpost/alx4dafka1-klizmi). На конце трубки расположен кран, с помощью которого регулируют поступление воды из кружки [5](https://drdautov.ru/tpost/alx4dafka1-klizmi). \n\n**Температура воды** зависит от назначения [6](https://ru.wikipedia.org/wiki/%D0%9E%D1%87%D0%B8%D1%81%D1%82%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%BA%D0%BB%D0%B8%D0%B7%D0%BC%D0%B0): \n* при атоническом запоре — 12–20 °С [6](https://ru.wikipedia.org/wiki/%D0%9E%D1%87%D0%B8%D1%81%D1%82%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%BA%D0%BB%D0%B8%D0%B7%D0%BC%D0%B0); \n* при спастическом запоре — 37–38 °С [6](https://ru.wikipedia.org/wiki/%D0%9E%D1%87%D0%B8%D1%81%D1%82%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%BA%D0%BB%D0%B8%D0%B7%D0%BC%D0%B0). \n\n\n\n## Показания\nОчистительную клизму назначают, например: \n* подготовка к рентгенологическому исследованию органов пищеварительной системы, мочевыделительной системы и органов малого таза [6](https://ru.wikipedia.org/wiki/%D0%9E%D1%87%D0%B8%D1%81%D1%82%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%BA%D0%BB%D0%B8%D0%B7%D0%BC%D0%B0); \n* подготовка к эндоскопическому исследованию толстой кишки [6](https://ru.wikipedia.org/wiki/%D0%9E%D1%87%D0%B8%D1%81%D1%82%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%BA%D0%BB%D0%B8%D0%B7%D0%BC%D0%B0); \n* подготовка к оперативным вмешательствам [6](https://ru.wikipedia.org/wiki/%D0%9E%D1%87%D0%B8%D1%81%D1%82%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%BA%D0%BB%D0%B8%D0%B7%D0%BC%D0%B0); \n* отравления и интоксикации [6](https://ru.wikipedia.org/wiki/%D0%9E%D1%87%D0%B8%D1%81%D1%82%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%BA%D0%BB%D0%B8%D0%B7%D0%BC%D0%B0); \n* задержка стула или каловый завал [6](https://ru.wikipedia.org/wiki/%D0%9E%D1%87%D0%B8%D1%81%D1%82%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%BA%D0%BB%D0%B8%D0%B7%D0%BC%D0%B0); \n* перед постановкой лекарственной и питательной клизм [6](https://ru.wikipedia.org/wiki/%D0%9E%D1%87%D0%B8%D1%81%D1%82%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%BA%D0%BB%D0%B8%D0%B7%D0%BC%D0%B0). \n\n## Противопоказания\nНекоторые противопоказания к постановке очистительной клизмы: \n* кровотечение из пищеварительного тракта [6](https://ru.wikipedia.org/wiki/%D0%9E%D1%87%D0%B8%D1%81%D1%82%D0%B8%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%BA%D0%BB%D0%B8%D0%B7%D0%BC%D0%B0)[9](https://nsportal.ru/npo-spo/zdravookhranenie/library/2022/03/18/klizmy-vidy-pokazaniya-i-protivopokazaniya); \n* острые воспалительные или язвенные процессы в области толстой кишки и заднего прохода [9](https://nsportal.ru/npo-spo/zdravookhranenie/library/2022/03/18/klizmy-vidy-pokazaniya-i-protivopokazaniya); \n* злокачественные новообразования прямой кишки [9](https://nsportal.ru/npo-spo/zdravookhranenie/library/2022/03/18/klizmy-vidy-pokazaniya-i-protivopokazaniya); \n* первые дни после операции на органах пищеварительного тракта [9](https://nsportal.ru/npo-spo/zdravookhranenie/library/2022/03/18/klizmy-vidy-pokazaniya-i-protivopokazaniya); \n* трещины в области заднего прохода или выпадение прямой кишки [9](https://nsportal.ru/npo-spo/zdravookhranenie/library/2022/03/18/klizmy-vidy-pokazaniya-i-protivopokazaniya). \n\n## Алгоритм\n**Пациент ложится на левый бок** с согнутыми и подтянутыми к животу ногами [2](https://gutaclinic.ru/articles/procto_examination/)[3](https://MedPortal.ru/enc/gastroenterology/reading/11/). Под ягодицы подкладывают клеёнку [2](https://gutaclinic.ru/articles/procto_examination/)[3](https://MedPortal.ru/enc/gastroenterology/reading/11/). \n\n**В кружку Эсмарха наливают 1–1,5 л воды комнатной температуры**, поднимают её на высоту 1–1,5 м и опускают наконечник вниз, чтобы выпустить небольшое количество воды и воздух из трубки [2](https://gutaclinic.ru/articles/procto_examination/)[3](https://MedPortal.ru/enc/gastroenterology/reading/11/). \n\n**Заполнив трубку**, не опуская кружки, закрывают кран на резиновой трубке [3](https://MedPortal.ru/enc/gastroenterology/reading/11/). \n\n**Смазав наконечник вазелином** и раздвинув ягодицы, вводят наконечник в задний проход лёгкими вращательными движениями [3](https://MedPortal.ru/enc/gastroenterology/reading/11/). \n\n**После открывания крана** вода под давлением начинает поступать в толстый кишечник [3](https://MedPortal.ru/enc/gastroenterology/reading/11/). Почти сразу появляется ощущение наполнения кишечника, позывы на дефекацию [3](https://MedPortal.ru/enc/gastroenterology/reading/11/). В эти моменты нужно уменьшить скорость подачи жидкости из кружки, закрыв кран на трубке или пережав её [3](https://MedPortal.ru/enc/gastroenterology/reading/11/). \n\n**Кружку Эсмарха опорожнять нужно не полностью** — оставить на дне немного воды, чтобы в кишечник не попал воздух [2](https://gutaclinic.ru/articles/procto_examination/)[3](https://MedPortal.ru/enc/gastroenterology/reading/11/). \n\nВидео с инструкцией по постановке очистительной клизмы:\n\n\u003ciframe src=\"//ok.ru/videoembed/6807184738844?ya=1\" frameborder=\"0\" scrolling=\"no\" allowfullscreen=\"1\" allow=\"autoplay; fullscreen; accelerometer; gyroscope; picture-in-picture\" aria-label=\"Video\">\u003c/iframe>\n\n\n## Возможные осложнения\n**Самостоятельно назначать очистительную клизму нельзя** — процедуру проводит врач [14](https://salismed.ru/akcii/kak-delat-klizmu-kruzhkoj-ehsmarha-rastvory-pravila-tekhnika). Некоторые риски: \n* **Повреждение слизистой оболочки прямой кишки** при неаккуратном введении наконечника [14](https://salismed.ru/akcii/kak-delat-klizmu-kruzhkoj-ehsmarha-rastvory-pravila-tekhnika). \n* **Нарушение микрофлоры кишечника** — вымывание полезных бактерий [14](https://salismed.ru/akcii/kak-delat-klizmu-kruzhkoj-ehsmarha-rastvory-pravila-tekhnika). \n* **Привыкание организма к принудительному очищению** — слишком частое выполнение клизмы может привести к нарушению перистальтики кишечника, вследствие чего опорожнение естественным путём станет невозможным [14](https://salismed.ru/akcii/kak-delat-klizmu-kruzhkoj-ehsmarha-rastvory-pravila-tekhnika). 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