The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) classifies klismaphilia under the diagnosis of "Paraphilias, Not Otherwise Specified". The diagnostic code is 302.9. Proactive treatment for klismaphilics is not generally recommended, due to the lack of any significant desire to be "cured". Health treatment for klismaphilia thus is typically only focused on ensuring the techniques employed and chemicals used are not harmful to the practitioner. Caution should always be maintained on the part of the practitioners experimenting with new techniques and concoctions; in certain cases cramps produced by the chemicals used have led to hospitalizations, in other circumstances the effects can even be life-threatening.

Most psychologists believe that paraphilic sexual interests cannot be altered. Instead, the goal of therapy is normally to reduce the person's discomfort with their paraphilia and limit any criminal behavior. Both psychotherapeutic and pharmacological methods are available to these ends.

Cognitive behavioral therapy, at times, can help people with paraphilias develop strategies to avoid acting on their interests. Patients are taught to identify and cope with factors that make acting on their interests more likely, such as stress. It is currently the only form of psychotherapy for paraphilias supported by evidence.

Antiandrogens are used in more severe cases. Similar to physical castration, they work by reducing androgen levels, and have thus been described as chemical castration. The antiandrogen cyproterone acetate has been shown to substantially reduce sexual fantasies and offending behaviors. Medroxyprogesterone acetate and gonadotropin-releasing hormone agonists (such as leuprolide acetate) have also been used to lower sex drive. Due to the side effects, the World Federation of Societies of Biological Psychiatry recommends that hormonal treatments only be used when there is a serious risk of sexual violence, or when other methods have failed. Surgical castration has largely been abandoned because these pharmacological alternatives are similarly effective and less invasive.

Klismaphiles can gain satisfaction of enemas through fantasies, by actually receiving or giving one, or through the process of eliminating steps to being administered one (e.g., under the pretense of being constipated). Klismaphilia is practiced by men and women, although men are more likely to be klismaphiles, as with most paraphilias. Klismaphiles might gain pleasure from a large, water distended belly or the feeling of internal pressure. Often, klismaphiles report discovering these desires after a chance administration of an enema sometime in their childhood, but some do report discovering these feelings later on. Klismaphilia is practiced both heterosexually and homosexually. The paraphilia may be used as a substitute or as an auxiliary by its practitioners for genital sexual activity. Usually, klismaphiles carry out normal lives and successfully engage in this behavior secretly. If this is the case they will probably try to conceal the pleasure they receive from these administrations.

For administering enemas not intended for medical purposes there are specialty items, such as the aluminium nozzle shown to the right, that are commonly used in activities involving klismaphilia. Such items are available on the Internet and in sex shops in a great variety of sizes, styles, and materials.