Colostomy irrigation is a procedure for flushing out the colon to regulate bowel movements in patients who have a colostomy, a surgically created opening between the colon and the abdomen. People with stomas cannot evacuate their own bowels and must wear a fecal collection pouch to collect waste. Using colostomy irrigation allows the patient to remain continent for 24 to 48 hours, with some practice, and can make patients feel more comfortable with their colostomies.
In a colostomy irrigation, the patient usually sits on the toilet. An irrigation kit is set up and the patient cleanses the hands and the area around the stoma before filling an irrigation bag with warm water and opening the stoma to allow water to pour into the colon. Then, the water is allowed to flow back out, carrying fecal waste with it. The first few tries tend to be messy and it can take a month or more to achieve extended continence after colostomy irrigation.
Not everyone with a colostomy can use colostomy irrigation. Patients must discuss their cases with a surgeon to learn more about their options. Generally, if the stoma is located in the descending colon and the patient does not have a history of inflammatory disease in the intestines, colostomy irrigation is an option. The stools need to be reasonably well formed and cannot be runny or mucusy; just as when people with intact intestines have diarrhea, when a colostomy patient has loose stool, continence is not as reliable.
Patients who use colostomy irrigation for management of their bowel movements train their bowels over time. The procedure can be performed once a day or once every other day, depending on how the patient’s bowel responds, and it should be done at the same time, usually around an hour after a meal. Patients are usually advised to learn to care for a stoma and colostomy bags initially after surgery, and to wait at least a month before trying colostomy irrigation.
Irrigation kits can easily be packed for traveling, as long as patients will have access to clean, warm water in their travels. People traveling with a colostomy in regions where sanitation is not as reliable may need to wear fecal collection pouches, as introducing bacteria into the gut through contaminated water could have unpleasant consequences.
Patients interested in learning how to use this technique to manage a colostomy can work with a patient educator at home or in a clinic. The educator can demonstrate how to perform the procedure safely and provide the patient with supervision the first time so the patient is assured that he is doing it correctly. Other colostomy patients often have tips and tricks they are willing to share as well.