If the patient experiences pain or if resistance is felt at any time during the procedure, the nurse should stop the procedure and confer with the practitioner. Increasing the force during enema administration may lead to painful colon distention. The enema tube is to be inserted a maximum of 7.5 to 10 cm (3 to 4 in) in an adult. The patient should not bear down and then relax the rectal sphincter because this causes the enema tip to be expelled.