This Higginsons (also known as In-line Bulb Enema Syringe) is a Single Piece unit. What this means is there are no joints between the Bulb & the tube. Joints expose the unit to leaks and improper suction. More importantly, bacteria from the feces can get lodged into these joints, creating unhygienic and unsafe conditions. So, a single piece Higginsons syringe is always recommended. Adding the Higginsons Syringe to your enema set up, allows you to overcome liquid flow obstructions through occasional pumping. This helps greatly in avoiding cramps and achieving a thorough colon cleanse.