１、湯浣腸（微温湯浣腸）の薦め
初めに湯浣腸というものを説明します
湯浣腸とは水道水で良いのですが、３０°〜３６℃く
らいのぬるいお湯を普通
の浣腸（グリセリン浣腸）のようにおしりから入れて出すこと
をいいます。一種の（腸を洗うという意味で）腸洗浄でもあ
りますが、それほど沢山の量ではなく３０〜６０mlくらいが１回
量ですので、肛門のちょっと奥を洗い流す程度のものです
が、それが肛門には良いのです。特に軟便の方は一回の排便ではすっきり
とは便が出ず、残便感があることが多いのですが、この湯浣腸を行うとその
残便感がとれてお尻がすっきりとします。私はそれを「お尻のうがい」と呼
んでいます。歯磨きをしてその後に「うがい」をするのと同様に湯浣腸はお
尻の便をした後の「うがい」の様なものです。ウォッシュレット（肛門洗浄
装置）が最近便座に着けられるようになって結構肛門の感じが良くなったと
云われますが、その比ではありません。遙かに少ない量で肛門がすっきりと
しますし、実際きれいになります。このすっきりした感じが肛門にはよいので
す。考えてみれば肛門は食物の出口に当たります。口腔の衛生がさけばれ
て歯磨きが奨励されている割には肛門の衛生はあまりさけばれません。ウォ
シュレットくらいなもので、肛門は排便するところだから汚くて当たり前の感じ
が否めません。本当にそうでしょうか？肛門の衛生についてもあまり聞いたこ
とはありません。トイレで紙で拭くが原則で、後はあまり気にせずにいます。
パンツが少しくらい便で汚れていても洗濯しておしまいではないでしょうか？
それで肛門は良いのか？これが私の発する問
いです。肛門科
には多くの肛門疾患で困っておられる方々が受診されますが、多くの場合、
肛門の直ぐ奥には便があります。しかし本人にとってそれは異常事態とは感
じてはおられません。肛門の痛みだったり、出血だったり、腫れだったりと
云った訴えはされますが、実際肛門の直ぐ奥にある便についての違和感は
感じてはおられないのです。かく云う私も少しくらい便があってもそれほど気
にはならないことがあります。つまり肛門は便に対して鈍感になっていると云
えます。でも、鈍感だから異常だといっているわけではありません。鈍感な
のには訳があります。確かに少量の便が肛門にあってそれがいちいち気にな
るようでは四六時中便所に入り浸りになって何も出来なくなってしまいます。
従って肛門が便に対して鈍感なのは良く分かりますが、それが実は肛門疾
患と絡んでくることが多いのです。問題もあるのです。便がすっきり出ない
と、普通そんなものかと思いこんで、それが当たり前になってしまいます。
実はそれが肛門疾患の始まりでもあるのです。便が出にくい事は「便秘」と
してお医者さんでも取り扱われていて、下剤などを中心に治療されているこ
とは分かりますが、それほど熱心に排便について治療されているところはあ
まり多く無いようです。（便秘外来を持っておられる病院も一部にはあります
が）お医者さんや薬局では主として下剤や整腸剤を中心に薬物治療が盛ん
です。漢方薬も結構使用されています。し
かし、グリセリ ン浣腸や特に湯浣腸の話は余り聞きません。そこで湯浣腸の薦めを書きました。実は湯浣腸の薦めは排便管理と密接に関係があります。便を出すと云うことは食べることと同じくらいに大切なことです。実際排便で悩んでおられる方は大変多いと思われますが、その割には食事療法（食物繊維の多い食事）や薬物療法（下剤が中心）等は盛んに行われていますが、直接肛門に対する処置である（グリセリン）浣腸や湯浣腸をしたりすることはまるでいけないことのように扱われています。浣腸が癖になるから駄目だとか、出来るだけ浣腸はしないでおきましょうとか云われていますが、本当なのでしょうか？私達のクリニックではそれこそ長い間（数十年に渡って）浣腸や湯浣腸を患者さん達に勧めてきています。排便で苦しんでおられる患者さんが浣腸や湯浣腸を使うようになって排便が楽になったと云われる患者さんが随分おられます。便秘に対して下剤や食事療法も決して悪い療法ではありませんが、浣腸療法も実は大変効果のある治療の一つなのです。只（グリセリン）浣腸は確かに刺激性が強い場合もあり、いずれの方にも通用するものではありません。しかし湯浣腸の場合は別です。湯浣腸は刺激性が強くないので日常的に使えます。何しろ「お尻のうがい」なのですから。お湯を肛門に入れて直ぐに出す。正にこの湯浣腸はお尻のうがい効果があります。増田医院で手術をされた患者さんでもう数十年経った今でも湯浣腸だけはしていると云った方々も結構おれれます。それほど湯浣腸は生活に密着して使用されている場合があるのです。浣腸や湯浣腸は一見面倒に見られがちですが、慣れてしまえば実はそんなに面倒でもありません。むしろ便秘には必要な物品ではないかと思われるほどです。それで皆さんにもこの湯浣腸をお勧
めする次第です。
とくに軟便の方には
(Translated by ChatGPT)
“Warm water toilet seat” can clean stool of anus but not clean stool of rectum.But “lukewarm water enema” can clean stool
of rectum, so to feel comfortable after defecation. "Lukewarm water enema" is a substitute for "warm water
toilet seat," but " warm water toilet seat" is unlikely
to be a substitute for “lukewarm water enema”.There is a big difference in amount of water used between the two.When
you used “warm water toilet seat”, the longer the used time, the more volume
of water you have.On the other hand if you used “lukewarm water enema”, you clean
stool of rectum and anus with total 100 ml, even if used 2-3 times, it use less
than a glass of water.In addition,” warm water toilet seats” are not everywhere, and in
the case of “lukewarm water enema”, there is an advantage that you can do it
anywhere if you have a disposable enema such as”
Ichijiku enema”. It seems that a “portable warm water toilet seat” device
has been made recently, but the size of the container seems to be quite large.
Lukewarm water enema is a process where lukewarm water, around 30°C to
36°C, is gently injected into the rectum from the buttocks, similar to
a regular enema (glycerin enema). It serves as a type of colon cleansing,
but the amount of water used is not extensive; it usually involves around
30 to 60ml per session, merely enough to cleanse the area just inside the
anal opening. However, this process is beneficial for the anus. Especially
for those with loose stools, they often experience an incomplete bowel
movement and a feeling of residual feces after defecation. By performing
this Lukewarm water enema, that sense of incompleteness disappears, leaving
the rectum feeling refreshed. I personally refer to it as "a rinse
for the buttocks." Just as we brush our teeth and follow up with a
mouthwash, Lukewarm water enema is like a post-defecation "rinse"
for the anus. Although the installation of bidet toilets (washlets) on
toilets has improved the sensation for the anus, it is incomparable to
Lukewarm water enema. With this method, only a small amount of water is
needed to refresh the anus, and it becomes genuinely clean. This refreshing
feeling is beneficial for the anus. When you think about it, the anus is
the exit for our food waste. Despite emphasizing oral hygiene and promoting
tooth brushing, anal hygiene is often overlooked. People may feel that
since the anus is where feces are expelled, it's only natural for it to
be dirty. But is that really the case? I haven't heard much about anal
hygiene. The general practice is to wipe with toilet paper, and beyond
that, people don't pay much attention.
They are troubled by various anal conditions, and in most cases, there is feces
just inside the anus. However, they don't perceive it as an abnormal situation.
They may complain about anal pain, bleeding, or swelling, but they don't
feel any discomfort concerning the feces just inside the anus. I, too,
sometimes have a little stool present, but it doesn't bother me much. In
other words, the anus is not very sensitive to feces. However, being insensitive
doesn't mean it's not a problem. There are reasons for this insensitivity.
Certainly, if there were a small amount of feces in the anus and it bothered
us each time, we'd be spending all our time in the restroom and unable
to do anything else. So, it's understandable that the anus is insensitive
to feces. However, this insensitivity is often associated with anal diseases.
Therein lies the problem. If the stool doesn't come out easily, people
tend to think it's normal and just accept it as a given. In reality, this
is the beginning of anal diseases. Difficulty in passing stools is treated
by doctors as "constipation," and it is indeed treated with medication,
primarily laxatives. However, there aren't many places where the treatment
focuses intensely on promoting regular bowel movements (although some hospitals
have specialized outpatient departments for constipation). Doctors and
pharmacies mainly rely on drug treatments, such as laxatives and gastrointestinal
agents. Traditional Chinese herbal medicine is also widely used.
However, not much is heard about glycerin enemas, especially Lukewarm water
enema. So, I wanted to recommend Lukewarm water enema. In fact, the recommendation
for Lukewarm water enema is closely related to managing bowel movements.
The act of defecation is as important as eating. Many people seem to suffer
from constipation, and although dietary therapy (high-fiber diets) and
medical therapy (primarily laxatives) are actively used, direct treatments
for the anus, such as (glycerin) enemas and Lukewarm water enema, are treated
as something entirely undesirable. People are cautioned against becoming
dependent on enemas, and are advised not to use them too often. But is
that really true? In our clinic, we have been recommending enemas and Lukewarm
water enema to our patients for a very long time (over several decades).
Many patients who were suffering from constipation and started using enemas
or Lukewarm water enema have reported that their bowel movements have become
more comfortable. Treating constipation with laxatives and dietary therapy
is by no means a bad treatment, but enema therapy is also a very effective
form of treatment. True, (glycerin) enemas can be irritating, and they
may not work for everyone. However, this is not the case with Lukewarm
water enema. Lukewarm water enema is not highly irritating, so it can be
used regularly. After all, it's like "a rinse for the buttocks."
You simply inject warm water into the anus and expel it right away. This is precisely the refreshing effect of Lukewarm water enema. Even patients
who underwent surgery at the Masuda Clinic still use Lukewarm water enema
after many decades. Some people have integrated Lukewarm water enema into
their daily lives. Enemas and Lukewarm water enema may seem inconvenient
at first glance, but once you get used to them, they are not that bothersome.
In fact, they might even be essential for treating constipation. That's
why I recommend Lukewarm water enema, especially for those with loose stools.
