This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.

How to use Enema

Leaflet attached to the packaging: information for the user

ENEMA, (32.2 mg + 139 mg)/ml, rectal solution

(Dinatrii phosphasdodecahydricus+ Natrii dihydrogenophosphas monohydricus)

You should carefully read the contents of the leaflet before using the medicine, as it contains

important information for the patient.
This medicine should always be used exactly as described in this patient leaflet or as advised by your doctor, pharmacist, or nurse.

You should keep this leaflet, so you can read it again if you need to.
If you need advice or more information, you should ask your pharmacist.
If you experience any side effects, including those not listed in this leaflet, you should tell your doctor, pharmacist, or nurse. See section 4.
If within 5 minutes of administering the medicine, there is no improvement or the patient feels worse, you should contact your doctor.

Table of contents of the leaflet:

1. What is ENEMA and what is it used for
2. Important information before using ENEMA
3. How to use ENEMA
4. Possible side effects
5. How to store ENEMA
6. Contents of the packaging and other information

1. What is ENEMA and what is it used for

ENEMA is a rectal solution. It works by cleansing the large intestine.
It prevents water absorption in the large intestine, causing softening of the stool mass. The increase in volume and softening of the stool mass lead to immediate stimulation of the bowel movement reflex.

Indications

ENEMA is used for: constipation, cleansing of the large intestine before diagnostic tests, before and after surgical procedures, cleansing of the intestine from contrast medium deposits after radiological examination, and cleansing of the intestine before and after childbirth.
If within 5 minutes of administering the medicine, there is no improvement or the patient feels worse, you should contact your doctor.

2. Important information before using ENEMA

When not to use ENEMA

if the patient is allergic to disodium phosphate dodecahydrate and sodium dihydrogen phosphate monohydrate or any of the other ingredients of this medicine (listed in section 6),
if the patient has intestinal obstruction, anal stricture, ulcerative colitis, rectal bleeding,
if the patient has: heart disease, high blood pressure, kidney disease, inflammation or symptoms of appendicitis,
if the patient experiences: abdominal pain, nausea, and vomiting,
in children under 3 years of age,
in dehydrated patients.

Warnings and precautions

Before starting to use ENEMA, you should discuss it with your doctor, pharmacist, or nurse.
Due to the risk of electrolyte and acid-base balance disorders, such as hypernatremia (elevated sodium levels), hyperphosphatemia (elevated phosphate levels), hypokalemia (low potassium levels), hypocalcemia (low calcium levels), and acidosis, special caution should be exercised in cases of:

patients with renal function disorders (the medicine can be used if the clinical benefits outweigh the risk of elevated phosphate ion levels in the blood),
patients receiving diuretics or medications that may cause electrolyte and water balance disorders in the body,
patients with a colostomy,
weakened or elderly patients,
patients with electrolyte disorders in the body (especially elevated phosphate levels in the blood) - in these patients, the medicine should be used with caution and it is recommended to monitor ion levels before and after administration of the medicine,
patients with ascites, changes in the rectal mucosa (ulcers, fissures),
if within 5 minutes of administration, there is no bowel movement, you should contact your doctor, as retention of the rectal solution may cause dehydration,
in unconscious patients, patients with limited consciousness, and patients with heart disease, the medicine can only be administered in the presence of qualified personnel,
if after using the rectal solution, bleeding or severe intestinal cramps occur, you should discontinue the medicine and consult your doctor. Before using the medicine, it is recommended to perform a blood ion level test. In cases of suspected electrolyte disorders and in patients who may experience elevated phosphate levels, the electrolyte level should be monitored before and after administration of the medicine. You should expect liquid stools after administration of the medicine. Additionally, it is necessary to consume a large amount of fluids after using the medicine to avoid dehydration. Repeated and prolonged use of ENEMA may lead to habituation.

Children and adolescents

The medicine can be used in children from 3 years of age only if prescribed by a doctor and under their supervision. In children under 5 years of age, the medicine should be used with special caution.

ENEMA and other medicines

You should tell your doctor about all medicines you are currently taking or have recently taken, as well as any medicines you plan to take.
In patients using calcium channel blockers, diuretics, lithium preparations, or other medicines that may affect ion levels in the blood, there may be changes in ion levels in the blood, such as hyperphosphatemia (elevated phosphate levels), hypokalemia (low potassium levels), hypocalcemia (low calcium levels), dehydration with elevated sodium levels (hypernatremia), or acidosis.
Due to the existing relationship between elevated sodium levels (hypernatremia) and decreased lithium levels in the blood, concurrent use of ENEMA and lithium preparations may result in decreased lithium levels in the blood, and thus decreased effectiveness of lithium preparations.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to have a child, you should consult your doctor or pharmacist before using this medicine.
Due to the risk of electrolyte disorders, it is not recommended to use ENEMA during pregnancy and breastfeeding. An exception is a single application of the medicine to women before and after childbirth.
Due to the possibility of phosphate ions passing into breast milk, it is recommended to discard expressed milk for 24 hours after using the medicine.

Driving and using machines

The medicine does not affect the ability to drive and use machines
The medicine contains methyl parahydroxybenzoate, which may cause allergic reactions (possible late reactions).

3. How to use ENEMA

This medicine should always be used exactly as described in this patient leaflet or as advised by your doctor, pharmacist, or nurse. If you are unsure, you should consult your doctor, pharmacist, or nurse.
The solution should only be administered as a rectal enema.
Adults: 120-150 ml.
Children: with a body weight below 14 kg - 30 ml, with a body weight between 14 and 27 kg - 60 ml, with a body weight between 28 and 40 kg - 90 ml.
In dehydrated patients, the enema volume should be reduced, as the medicine may cause further dehydration.
Repeating enemas at short intervals should be avoided.
The medicine should not be used more than once a day or as advised by your doctor.
The medicine is administered rectally by injecting the appropriate volume of the solution in the evening on the day preceding the examination or surgical procedure and on the day of the operation. The rectal enema on the day preceding the operation can be repeated if complete cleansing is not achieved. The rectal solution should be at room temperature.
After using the medicine, the patient should be given an additional dose of fluids orally.
Laxatives should not be used for more than one week.
To administer the enema, you should replace the cap with the applicator cap, which is located in the individual carton (does not apply to the preparation intended for closed healthcare facilities). Remove the protective cap and insert the special tip into the rectum, directing it towards the navel. Slowly press the bottle until its contents are introduced into the rectum. The packaging contains an excess of the solution, so it is not necessary to empty the bottle completely. After administering the enema, you should wait in the chosen position until the urge to defecate occurs (2-5 minutes) and then defecate.
There are three positions that allow for the administration of the enema. The first position (Sims) and the second position (knee-chest) require the assistance of another person. The third position allows for self-administration of the enema.

Person lying on their side with their knees pulled up to their stomach in a position allowing for rectal enema administration

Person in a knee-chest position with their head bowed down and their arms supported during enema administration

Person lying on their stomach with their arms supported and their legs raised in a position allowing for self-administration of the enema

Using a higher dose of ENEMA than recommended

The medicine is available in a single-dose packaging, which excludes the possibility of overdose. However, in patients who should not use the medicine and in particularly sensitive patients, there may be disturbances in electrolyte and acid-base balance, acidosis, and dehydration. There may also be disturbances in the functioning of the circulatory and respiratory systems. If the above symptoms occur, you should contact your doctor.
There have been reports of fatal cases related to electrolyte and water balance disorders due to the use of this type of product in excessive doses, administration to children, or patients with constipation.

Missing a dose of ENEMA

You should not use a double dose to make up for a missed dose of the medicine.

Stopping the use of ENEMA

If you have any further doubts about the use of the medicine, you should consult your doctor, pharmacist, or nurse.

4. Possible side effects

Like all medicines, ENEMA can cause side effects, although not everybody gets them.
The frequency of side effects cannot be determined based on available data.
Metabolic and nutritional disorders
Elevated phosphate ion levels in the blood (hyperphosphatemia), decreased potassium levels in the blood (hypokalemia), and accumulation of excessive amounts of acidic substances or decreased amounts of alkaline substances in the blood (metabolic acidosis).
Transient decreased calcium ion levels (hypocalcemia) and transient elevated sodium levels (hypernatremia), resulting in dehydration. However, ENEMA has a reduced phosphate content, which reduces the risk of electrolyte disorders. Additionally, ENEMA is a medicine used sporadically, and any potential electrolyte and water balance disorders are usually transient.
General disorders and administration site conditions
Irritation of the rectal mucosa, chills, blisters, stinging, rectal itching, pain.
Gastrointestinal disorders
Nausea, vomiting, abdominal pain, bloating, diarrhea .
Frequent use may lead to disturbances in the functioning of the large intestine.
Immune system disorders
Allergic reactions, e.g., hives, itching.

Reporting side effects

If you experience any side effects, including those not listed in this leaflet, you should tell your doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products
Al. Jerozolimskie 181C,
02-222 Warsaw,
phone: +48 22 49 21 301,
fax: +48 22 49 21 309,
Website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the marketing authorization holder.
Reporting side effects will help gather more information on the safety of the medicine.

5. How to store ENEMA

The medicine should be stored out of sight and reach of children.
Store in a temperature below 25°C.
Do not use the medicine after the expiration date stated on the packaging after: Expiration Date (EXP). The expiration date is the last day of the specified month. Lot means batch number.
Medicines should not be disposed of via wastewater or household waste. You should ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the packaging and other information

What ENEMA contains

The active substances of the medicine are: disodium phosphate dodecahydrate (Dinatrii phosphasdodecahydricus) and sodium dihydrogen phosphate monohydrate (Natrii dihydrogenophosphasmonohydricus). 1 ml of the solution contains 32.2 mg of disodium phosphate and 139 mg of sodium dihydrogen phosphate, calculated as anhydrous substances.
The other ingredients (excipients) are: methyl parahydroxybenzoate, purified water

What ENEMA looks like and what the packaging contains

A bottle with a cap containing 150 ml of liquid and an interchangeable applicator cap that allows for easy expression of the contents, placed in a cardboard box.
For closed healthcare facilities:
A bottle containing 150 ml of liquid, capped with a cap that has an integrated applicator allowing for easy expression of the contents - packaged in 50 units per collective carton.

Marketing authorization holder and manufacturer

Laboratorium Galenowe Olsztyn Sp. z o.o.
ul. Spółdzielcza 25A
11-001 Dywity
phone: +48 89 648 00 78
(logo of the marketing authorization holder)
The content of the patient leaflet is available in a format suitable for the blind and visually impaired at the free phone number 800 706 848.

Date of the last update of the leaflet:

Country of registration
Poland
Active substance
sodium phosphate
Prescription required
No
Manufacturer
Laboratorium Galenowe Olsztyn Sp. z o.o.
Importer
Laboratorium Galenowe Olsztyn Sp. z o.o.
This information is for reference only and does not constitute medical advice. Always consult a licensed doctor before taking any medication. Oladoctor is not responsible for medical decisions based on this content.
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Microlax
Dosage form: Solution, 4.465 g + 0.0645 g + 0.45 g
Active substance: sodium lauryl sulfoacetate, incl. combinations
Manufacturer: Delpharm Orlenas JNTL Consumer Health (France) SAS
Prescription not required
Aurogo
Dosage form: Powder, 13.7 g
Active substance: macrogol, combinations
Prescription not required
Bisacodil Vp
Dosage form: Tablets, 5 mg
Active substance: bisacodyl
Prescription not required

Alternatives to Enema in other countries

The best alternatives with the same active ingredient and therapeutic effect.

Alternative to Enema in Spain

LAINEMA 14/3 g/100 ml RECTAL SOLUTION

Dosage form: RECTAL LIQUID, PER 100 ml: 14/3 g

Active substance: sodium phosphate

Manufacturer: Lainco S.A.

Prescription required

ENEMA CASEN 139 mg/ml + 32 mg/ml RECTAL SOLUTION

Dosage form: RECTAL LIQUID, 3.2 g / 13.9 g

Active substance: sodium phosphate

Manufacturer: Casen Recordati S.L.

Prescription required

VEROLAX NIÑOS RECTAL SOLUTION

Dosage form: RECTAL LIQUID, 1.8 ml glycerol

Active substance: glycerol

Manufacturer: Angelini Pharma Espana S.L.

Prescription not required

VEROLAX ADULTOS RECTAL SOLUTION

Dosage form: RECTAL LIQUID, 5.4 ml glycerol

Active substance: glycerol

Manufacturer: Angelini Pharma Espana S.L.

Prescription not required

KANOVA NIÑOS 2.25g RECTAL SOLUTION

Dosage form: RECTAL LIQUID, 1.8 ml glycerol / single-dose container

Active substance: glycerol

Manufacturer: Lainco S.A.

Prescription not required

KANOVA ADULTOS 6.75g RECTAL SOLUTION

Dosage form: RECTAL LIQUID, 5.4 ml of glycerol/single-dose container

Active substance: glycerol

Manufacturer: Lainco S.A.

Prescription not required

Online doctors for Enema

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for Enema – subject to medical assessment and local rules.

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Tomasz Grzelewski

Dermatology20 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

seasonal and perennial allergies
allergic rhinitis and chronic nasal symptoms
asthma and breathing difficulties
food and medication allergies
urticaria, atopic dermatitis and skin reactions
recurrent infections in children
sports-related health questions
general family medicine concerns

Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.

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Alina Tsurkan

Family medicine12 years of experience

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including:

Respiratory infections: cold, flu, bronchitis, pneumonia, and lingering coughs.
ENT conditions: sinusitis, tonsillitis, otitis (ear infections), sore throat, allergic rhinitis.
Eye conditions: allergic or infectious conjunctivitis, red eyes, irritation.
Digestive issues: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), constipation, bloating, nausea.
Urinary and reproductive health: urinary tract infections (UTIs), cystitis, prevention of recurrent infections.
Chronic diseases: hypertension, elevated cholesterol, weight management.
Neurological complaints: headaches, migraines, sleep disturbances, fatigue, general weakness.
Children’s health: fever, infections, digestive issues, follow-ups, vaccination guidance.

She also provides:

IMT medical certificates for driving licence exchange in Portugal.
Personalised preventive care and wellness consultations.
Interpretation of test results and medical reports.
Follow-up care and medication review.
Support in managing multiple coexisting conditions.
Remote prescription management and medical documentation.

Dr. Tsurkan’s approach is evidence-based and holistic. She works closely with each patient to develop an individualised care plan that addresses both symptoms and root causes. Her goal is to empower patients to take control of their health and maintain well-being through lifestyle adjustments, routine check-ups, and early intervention.

Book a video appointment

Lina Travkina

Family medicine12 years of experience

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

Preventive consultations and check-up planning.
Medical advice and follow-up consultations.
Test interpretation and diagnostic guidance.
Structured support for undiagnosed complaints.
Second opinion on diagnoses and treatment plans.
Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
Post-operative recovery support and pain management.
Preconception counselling and postpartum support.
Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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Jonathan Marshall Ben Ami

Family medicine8 years of experience

Dr. Jonathan Marshall Ben Ami is a licensed family medicine doctor in Spain. He provides comprehensive care for adults and children, combining general medicine with emergency care expertise to address both acute and chronic health concerns.

Dr. Ben Ami offers expert diagnosis, treatment, and follow-up for:

Respiratory infections (cold, flu, bronchitis, pneumonia).
ENT conditions such as sinusitis, ear infections, and tonsillitis.
Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
Urinary tract infections and other common infections.
Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
Acute conditions requiring urgent medical attention.
Headaches, migraines, and minor injuries.
Wound care, health check-ups, and ongoing prescriptions.

With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

Book a video appointment

Andrei Popov

General medicine6 years of experience

Dr. Andrei Popov is a licensed pain management specialist and general practitioner based in Spain. He provides expert online care for adults dealing with both chronic and acute pain, as well as a wide range of everyday health concerns.

He specialises in diagnosing and treating pain conditions that affect quality of life, including:

Chronic pain lasting more than 3 months.
Migraines and recurring headaches.
Neck, back, lower back, and joint pain.
Post-traumatic pain following injury or surgery.
Nerve-related pain, fibromyalgia, and neuralgia.

In addition to pain management, Dr. Popov helps patients with:

Respiratory infections (colds, bronchitis, pneumonia).
High blood pressure and metabolic conditions such as diabetes.
Preventive care and routine health check-ups.

Online consultations last up to 30 minutes and include a detailed symptom review, personalised treatment planning, and medical follow-up when needed.

Dr. Popov’s approach is rooted in evidence-based medicine, combined with individualised care tailored to each patient’s history, lifestyle, and clinical needs.

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Yevgen Yakovenko

General surgery11 years of experience

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

12+ years of clinical experience in university hospitals in Germany and Spain.
International education: Ukraine – Germany – Spain.
Member of the German Society of Surgeons (BDC).
Certified in radiological diagnostics and robotic surgery.
Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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Tetiana Fedoryshyn

General medicine29 years of experience

Dr Tetiana Fedoryshyn is a senior general practitioner, certified nutritionist, and psychologist with over 29 years of clinical experience. She combines classical internal medicine with modern approaches in lifestyle medicine, functional nutrition, and emotional health support.

Her focus is on helping patients regain health through deep understanding of symptoms, personalised nutrition plans, and evidence-based correction of deficiencies, stress-related conditions, and metabolic imbalances. Dr Fedoryshyn works with adults experiencing chronic conditions, fatigue, hormonal disruption, and post-stress exhaustion.

She integrates medical analysis, psychological insight, and real-life behaviour change tools to offer treatment plans tailored to each patient’s biochemistry, mental state, and lifestyle.

Main areas of practice:

Chronic condition management and medical counselling
Weight loss programmes based on metabolic profiling
Diagnosis and treatment of micronutrient deficiencies
Recovery from stress, burnout, and hormonal imbalances
Emotional support and psychosomatic symptom care

Her approach is never one-size-fits-all – each consultation begins with a deep dive into your unique health history, test results, and emotional landscape. Consultations are available in Ukrainian, Polish, and Russian.

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Mar Tabeshadze

Endocrinology10 years of experience

Dr. Mar Tabeshadze is a licensed endocrinologist and general practitioner in Spain. She provides online consultations for adults, offering medical support for a wide range of endocrine conditions and related health concerns.

Diagnostic consultations for suspected endocrine disorders
Management of thyroid conditions, including in pregnant women
Early detection and treatment of type 1 and type 2 diabetes, with personalised therapy plans
Obesity treatment: identifying underlying causes of weight gain, combining medication and non-pharmacological strategies, and long-term support
Diagnosis and treatment of endocrine-related skin, hair, and nail issues
Ongoing care for patients with osteoporosis, pituitary, and adrenal gland disorders

Dr. Tabeshadze takes a patient-centred approach based on evidence-based medicine. Her goal is to help patients achieve hormonal balance, manage chronic conditions effectively, and improve overall well-being through targeted, personalised care.

Book a video appointment

Anna Biriukova

General medicine5 years of experience

Dr Anna Biriukova is an internal medicine doctor with clinical experience in cardiology, endocrinology, and gastroenterology. She provides online consultations for adults, offering expert medical support for heart health, hormonal balance, digestive issues, and general internal medicine.

Cardiology – Diagnosis and treatment of:

High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
Leg swelling, chronic fatigue, reduced exercise tolerance.
EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
Post-COVID-19 cardiac monitoring and care.

Endocrinology – Diabetes, thyroid, metabolism:

Diagnosis and management of type 1 and type 2 diabetes, and prediabetes.
Individual treatment plans including oral medications and insulin therapy.
GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
Metabolic syndrome – obesity, lipid disorders, insulin resistance.

Gastroenterology – Digestive health:

Abdominal pain, nausea, heartburn, gastroesophageal reflux (GERD).
Stomach and intestinal conditions: gastritis, irritable bowel syndrome (IBS), indigestion.
Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).

General internal medicine and preventive care:

Respiratory infections – cough, colds, bronchitis.
Lab test analysis, therapy adjustments, medication management.
Adult vaccinations – planning, contraindications assessment.
Cancer prevention – screening strategies and risk assessment.
Holistic approach – symptom relief, complication prevention, and quality of life improvement.

Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.

Book a video appointment

Maryna Kuznetsova

Cardiology16 years of experience

Dr Marina Kuznetsova is an internal medicine doctor and cardiologist with a PhD in medicine. She provides online consultations for adults with chronic and acute conditions, with a strong focus on cardiovascular health. Her approach is based on current clinical guidelines and evidence-based treatment strategies.

Areas of expertise: