A colostomy is a surgical procedure where a part of the large intestine (colon) is brought through an opening in the abdominal wall, creating a stoma. It can be done for a variety of reasons, primarily when the lower part of the colon or rectum isn't able to function on its own. Following surgery, an ostomy pouch is connected to the stoma, where waste is collected. Although ostomy care involves an adjustment, after healing and recovery, you can resume your everyday routine without restriction. Colostomy irrigation can help with ongoing maintenance, and in some circumstances, it may reduce the need to wear a colostomy bag. Here, we'll go over some important information on colostomy irrigation and whether it's right for you.
What Is Colostomy Irrigation?
Colostomy irrigation is a way to help remove stool without having to always rely on a colostomy bag. It's an option for stoma care that some ostomates prefer, as it may reduce the need for wearing an external collection bag, but it's not necessarily right for everyone. The process is relatively straightforward; you use the stoma to help wash out the colon using water, similar to how an enema is used. This is done regularly, typically around the same time each day or every other day, depending on your output habits.
Who Can Utilize Ostomy Irrigation?
Irrigation isn't for everyone, and it can even be problematic for certain ostomates. It should only be utilized for individuals with a descending or sigmoid colostomy. People with an ileostomy and/or conditions such as active inflammatory bowel disease (Crohn's disease or ulcerative colitis) should not use irrigation techniques.
Even those with a colostomy may need to get approval from their doctor to try stoma irrigation, as you need to produce semi-solid to solid stool and have good dexterity. If you experience diarrhea, irrigation won't be enough to avoid wearing a pouch. The process of flushing out the large bowel can also take about an hour, so you'll need to be able to dedicate enough time each day, usually around the same time.
Again, not everyone is a suitable candidate for irrigation, and it's important to get clearance from your doctor, ostomy nurse, and surgeon before trying it.
Benefits of Colostomy Irrigation for Bowel Control
Colostomy irrigation can be a helpful way to bring predictability and freedom back into your daily routine, which can help improve overall quality of life. Some of the most notable benefits that can occur from colostomy irrigation include the following:
- Predictable Bowel Movements: Irrigation helps regulate when the bowel empties, reducing unexpected output.
- Less Need for a Full Pouch System: Many people can wear a small stoma cap or patch instead of a pouch between irrigations.
- More Confidence and Freedom: Knowing when output will occur allows you to plan activities without worry.
- Fewer Pouch Changes: A regular schedule often means using fewer ostomy bags and supplies.
- Healthier Skin: Less leakage and fewer pouch changes can reduce irritation around the stoma.
- Improved Quality of Life: Overall, irrigation gives people greater comfort, dignity, and independence.
Risks and Possible Complications
Of course, there are also a few risks and complications that can occur with irrigation. If you have any questions or concerns about these, it's best to discuss them with your doctor.
- Possible Discomfort: Some people experience cramping, bloating, or mild irritation during irrigation. If discomfort is severe, discontinue and talk to your doctor.
- Incomplete Results: Irrigation doesn’t always entirely empty the bowel, which can lead to occasional leakage.
- Medical Restrictions: People with Crohn’s disease, diverticulitis, or certain complications may be advised against irrigation, as it could further complicate the underlying condition.
Step-by-Step: How to Irrigate a Colostomy
If you're a good candidate for irrigation and have gotten approval from your doctor or surgeon, the first step in the process is to make sure you have all of your supplies on hand. These include:
- Adjustable belt
- Irrigation bag, tubing, and cone tip
- Irrigation sleeve and clamp
- Water-based lubricant
- One-half to 1 quart of warm water
- Colostomy pouch or stoma cap
- Paper towels or a clean washcloth
Once you've gathered all of your supplies and set them in a sterile area (i.e., on a disinfected surface in the bathroom), you can start the irrigation process.
- Fill your irrigation bag with lukewarm tap water (never hot or cold). You don't need to use any sterile water or special cleaning solutions.
- Make sure the irrigation tube is filled with the liquid and doesn't have any air inside.
- Apply the irrigation sleeve.
- Lubricate the cone tip and gently insert it into the stoma; never force it inside.
- Raise the irrigation bag to shoulder level to help fluid flow into the colon. Use a wall hook or hanger to hold it at this level.
- Open the clamp on the irrigation tubing to allow water to begin flowing. Make sure the water enters slowly to help avoid cramping. If cramping does occur, slow or stop the flow until it eases.
- Let all the contents of the irrigation bag enter the stoma and close the clamp once it's empty.
- Keep the cone in place for about five minutes to avoid water from expelling.
- Remove the cone and let the stool and water drain into the sleeve or toilet. This may take anywhere between 30 and 60 minutes.
- After the first return, it's okay to leave the bathroom, but you should stay close in case of any further return.
- After the final return (typically about an hour after finishing), take the irrigation sleeve off and clean the abdomen.
- Clean your irrigation equipment and store it so that it's ready for the next use.
You may want to wear an ostomy pouch following irrigation for the first few attempts. Over time, as you adjust to irrigation, you'll grow in confidence and may decide to forego the pouching system. However, many individuals who utilize this process don't need to wear one, as long as they continue to have firm stools and regular output.
How Often Should You Irrigate?
The frequency of irrigation can vary depending on your stoma and bowel habits, but it's important to discuss these details with your doctor. Most people find that a regular schedule can help increase the predictability of bowel control. In general, you should expect to do this every 24 hours (around the same time each day). Many ostomates find that the morning works best, as this allows the bowel to empty prior to the beginning of the day. Whichever time you choose, the most important thing is to be consistent with it from day to day.
Tips for Success with Colostomy Irrigation
Colostomy irrigation can take a bit of practice, but it will get easier with time and experience. To help, consider some of the following tips:
- Stick to a routine. Irrigating at the same time every day helps train your bowel and keeps output predictable.
- Start with small water volumes. Begin with the amount recommended by your stoma nurse and gradually increase as you become more comfortable.
- Use lukewarm water. Water that is too hot or too cold can cause cramping or discomfort.
- Stay relaxed. Sitting comfortably and taking slow, deep breaths can help reduce cramping during irrigation.
- Keep supplies ready. Having all your equipment organized and within reach makes the process smoother.
- Take your time. Don’t rush; irrigation may take 30 to 60 minutes, including water inflow and evacuation.
- Protect your skin. Clean and dry the area around your stoma thoroughly after irrigation to prevent irritation.
- Track your results. Keep a log of volumes, timing, and any issues to help fine-tune your routine with your nurse.
- Adjust your diet if needed. Eating regular meals and staying hydrated can help maintain consistent stool output.
- Seek help if problems arise. Contact your healthcare provider or stoma nurse if you experience persistent cramping, leakage, or discomfort.
Colostomy irrigation can be a valuable tool for people looking to regain more control and independence after colostomy surgery. While it isn’t right for everyone, many find that it helps reduce the need for continuous pouch wear and can increase the predictability of bowel movements. Regardless of whether you want to try colostomy irrigation or need reliable ostomy products to help support your day-to-day management, Byram Healthcare can help. Byram offers a wide range of high-quality ostomy supplies discreetly delivered to your door. Start your order or contact us today to learn more.
