In his book, The Brain Maker, Dr. Perlmutter lists what you need for a probiotic enema: an enema bag or enema bulb, as well as a good probiotic supplement that preferably includes a large number of Bifidobacteria. You start by making sure you have a complete bowel elimination. The next step is to make the probiotic mixture. Dr. Perlmutter suggests using 3 to 6 probiotic capsules or 1/8 teaspoon powdered probiotic, and mixing this with 12 ounces of lukewarm water. The easiest and safest place to take the enema is in your bathtub. Dr. Perlmutter recommends holding the enema in for 30 minutes, if possible (emphasis on IF). He has prescribed enemas for severe problems, as many as three times a week for 4 to 6 weeks. He says it is essential that you get your doctor’s approval before using the enema.