Chapter 16: Irrigation
|We have moved to a new site, with a new name and a new look!
We're now at:
You'll find all the same content, and a cool new design. With more features and services than ever before, its the best site we've ever had!
You will be automatically taken to Ostomyland.com in a few seconds. If you are not, please click either the link above, or this link here!
See you there!
Webmaster and Colostomist
Take me to Ostomyland.com
Irrigation - A Possibility? A Viable alternative and a personal story.
Written by Robert Picken.
For all colostomists of whatever age the shock of the two worlds before
and after your operation can be very daunting. The days before, when the
natural muscle control that had been learnt as a child, meant you hardly
had to think about the process of evacuating waste products from your
body, you dealt with it automatically, it just happened! This contrasts
vividly with the complete lack of control following the operation.
Suddenly the bag that has been attached over your newly acquired stoma
fills with excreta and you are aware of that aroma (despite the filter
in the bag) which you just hope and pray others will not be aware of.
For whom is it most unpleasant? Those of your nearest and dearest who
know and care for you or those who don’t know and wonder why you are
embarrassed and edging away from them.
This what partly prompted me to investigate how I could once more gain
some sort of bowel control. My surgeon and stoma nurse both challenged
me to tackle the problem and see if I could get to grips with it. Like
so much in life you must want to achieve it very much and that is what
spurs you on. Irrigation is an alternative way of dealing with the
problem a distinct possibility.
I can assure you I am delighted to have achieved my goal It educated my
bowel to a possibility! Through irrigation I have gradually given me the
daily freedom of just wearing a small cap or plug. I have the most
unique sense of triumph imaginable. It is a revitalising and
invigorating experience. Over the years I have been privileged to know
young colostomists as well as older people who have achieved this
Let me explain what is involved. Irrigation consists of giving your
bowel a washout or enema through your stoma. For some it may be required
daily1 for others, alternate days. For most the whole procedure takes
about three quarters of an hour. For others it may take a little more
than an hour, but it is still worthwhile if you have the time and
patience. However it is not for all colostomists. Firstly, you must have
permission from both your surgeon and stoma nurse before attempting it.
(What will prevent you trying is if you have a hernia on your stoma).
If you are determined to have a ‘go’, your stoma nurse will supply you
with the equipment required :-
1 A water bag, complete with hose and cone.
2. Plastic sleeves.
3.Sheets of ‘wipes’.
4.Disposable bags, caps and plugs.
Additional extras from around the house
1 A means of hanging up the water bag - a fixed hook, metal meat hook,
string, firm shower rail window catch etc. approx. just above head
height and within easy reach.
2 A plastic indoor child’s watering can.
3.A wooden ‘spring’ clothes peg.
4.Absorbant toilet paper.
The plastic see-through water bag is rather like a hot water bottle in
shape without the stopper and a handle to hang it up by it will hold the
four pints of water at blood heat. Some suppliers make these water bags
with a built in thermometer which helps to get the water temperature
just right at 37 C (98.F.). Attached to the base of the bag is a hose
approx.120 cms. Long.
with a plastic cone at the end and a control switch. The open ended
plastic sleeve ( 1 metre in length} has an adhesive ring near the top
which sticks over the stoma.
Ready - steady - go....
1. Ensure the bathroom temperature is comfortable and that you have all
the equipment you need to hand.
2. Most people irrigate sitting on the loo, but I find it easiest to lie
on a towel in the (empty) bath with a cushion at my head!
3. Having chosen your position, fix the empty water bag securely above
head height using a strong hook/rail/window catch etc. A length of
string can be useful for fine adjustments. (The ‘head’ of water is
necessary to penetrate your inner reaches). Hang the bag on the hook.
4. Using the water can, fill the suspended bag ¾ full with water from
the hot tap, then add enough water from the cold tap until blood
temperature is reached 37oC. (98.4oF). If using a bag with a built in
thermometer, you can easily see the green indicator moving down the
scale. Approx. 4 pints is needed.
5. Now for irrigating Strip off the old bag, cap or plug. Stick the
sleeve over your stoma, settle into a comfortable position with the end
of the sleeve hanging between your legs and down into the bo (or in the
direction of the bath plug hole).
6. Place the cone into the stoma through the top of the sleeve and
stop/start the control to allow water into the bowel, making sure the
water goes into the bowel and not straight down the sleeve. It is in
fact just like filling the petrol tank of your car make sure the
displaced air can escape. This procedure takes some 5 to 6 minutes if
there is no hold up. (Sometimes the perastalsis of the bowel or the
involuntary muscular movement which pushes the waste material along the
colon kicks into action so patience is required).
7. The flow-back starts almost immediately so be ready with a full
watering can to pour water down the inside of the sleeve to reduce smell
and direct the waste away rapidly. If you are in the bath, quickly told
the bottom of the sleeve to the top, peg into place and move over to the
bo for the rapid evacuation of the bowel. (standing or sitting) For your
own comfort, keep the watering can at the ready to wash down each flood
of faeces if this comes in bursts you can, if you are a fellow1 manage
to shave during the quiet spells by hooking up the bottom of the sleeve
with a peg?
Normally this phase is the busiest part of the procedure and certainly
the most satisfying, seeing how much you are moving on. You will notice
that at first there will be very small stool formation but very soon it
is totally without form - very much wet mud apart from tiny bits of
undigested food like sweet corn etc. It this stage of irrigation ends
with a good gurgle and explosive spatter this is a useful indication
that the bowel is pretty well empty and very soon you will be able to
put on a small bag or even a smaller cap or plug. For the next 23 or 47
hours you will then be able to forget you even have a colostomy no more
ballooning bags, and in my case eating anything I like....what a joy!!
8. Finally the clearing up process. The use of an air freshener, or
opening a window or just striking a match (make sure you are not near a
smoke detector!) wilt help towards clearing the air for the person
following you in the bathroom. Put equipment away remembering to wash
out your water bag and dispose of your used sleeve and bag etc.
N.B. Without doubt from my own experience it has been very helpful to
have a couple of clementines or satsumas each day to keep the whole
process flowing freely.
I trust that all this does not put you off irrigating . Once you have
developed your own personal technique and routine you will feel so
different, so ‘normal’. The transformation gives me a feeling that I am
walking on air and am specially blessed. The new found freedom is
certainly worth all the effort