Posted: Thu Jul 23, 2009 9:42 pm Post subject: Irrigation for Ileostomy obstruction (blockage)
Yesterday afternoon, shortly after lunch, I was surprised by a sudden blockage. I was so busy that I didn't even realize that I had no output ALL day. It was 3:00 pm. Cramping, nausea, pain, and belly distension had me paralyzed in pain.
This was my first obstruction that was not post operative adhesion related so I was shocked but not scared.
I massaged the area. Drank hot tea. Prayed. Cried. Moaned. Then crawled to the phone, went to the pantry, grabbed a big syringe that is really used for cake decorating, a plastic cup, and crawled to the bathroom. Then I called a friend to come over in case I had to go to the ER.
I called my GI and we made an ER plan if what I was about to do didn't work. I ran the shower. Pulled off the pouch. Filled the cup with warm water. Performed a stomal enema. I applied a little too much pressure and WOW WEE did it hurt. I almost passed out.
I just wanted to try to do this at home. I knew the chances of it clearing up before I got to the ER was pretty high so what's the point of suffering in that waiting room?
Sure enough about an hour later the pressure subsided and there was a very slow gradual output.
I followed up today. They said it was ok to do some irrigation but it only reaches about 5 inches in. Good to know.
Dr. recommended using a real enema (not the cake decorator) and allowing gravity to flow the water in rather than applying pressure. I recommend warming it up first.
It was a pretty traumatic episode. I didn't care for it at all!
So I recommend keeping a stock of one or two bottles in supply box. The cake decorator syringe worked but now I lost one of my fave kitchen gadgets!
coloplast makes an economical "kit" that even has a built in temp gauge to get the water temp exactly right, it fastens on over your existing 2 piece appliance base. just in case you want to be totally prepared next time.
Minus #1 which is impossible when the appliance is already on, this is exactly what I did.
I did use the UOAA website.
I am all better now!
I did order the cards and will keep in my emergency kit.
Great info the for the rest of the gang.
Thanks for sharing it.
Posted: Sun Jul 26, 2009 2:36 pm Post subject: Re: irrigation kit
[quote="mild_mannered_super_hero"]coloplast makes an economical "kit" that even has a built in temp gauge to get the water temp exactly right, it fastens on over your existing 2 piece appliance base. just in case you want to be totally prepared next time.
argggg why didnt i read this a week ago i just got out of hospital with a bowel obstruction i didnt know us ieleo's could or should do this(irrigate) a whole week in hos has felt like a month i've had crohn's would this be safe or dangerous sounds the latter to me i was going to ring an Ambulace but felt silly i waited about 3minutes in hospital and was quickly admitted never eatin coconut ever ever again agony is sooo right was vomiting water then that was gone. The doc said it was also from scar tissue i do get a few blockages but after massage and lying on my side can help i never though i would end up in hospital shouldnt have waited 24hours ..Was worried they would operate was very lucky so can any one tell me if this is ok 4 crohns people ..Also am going to Malasia for 8 days was worried i couldnt go these things happen at the most inconvenient times lol well cheers guys love mooza Down Under Melbourne..
Hi Angie; I know your pain. When I have a blockage I sometimes irrigate using a feeding catheter my surgeon gave me. It is quite small and flexible and has a rounded end so I can get it a fair distance up my ileum. Works quite well. On a brighter note, how is your luthier cource going, built an instument yet? How is Larrivee doing? I love those guitars!dpottage(at) csolve.net
I'd like to clarify a bit re: ileostomies, suspected food blockages and irrigation.
First, irrigating an ileostomy should ONLY be done if there is a suspected food blockage. It is not a routine form of management. Whoever does it needs to be knowledeable about the stoma, that it is small bowel, etc.
It can be hard to distinguish if it is a food blockage, ileus or adhesions. The best advice: if you are having significant pain for more than 2 hours, (whether or not you tried to relieve the obstruction), please go to the emergency room and get an xray. Doctor's/nurses don't always return calls immediately....If you are hurting badly and they don't respond...GO to the ER!
Irrigation: do NOT use a fleets/rigid enema or tubing. It can perforate your bowel; this is a medical emergency if perforated. It happened years ago to one of my patients. You must use either a cone made for irrigation or soft flexible catheter. If you don't have an irrigation sleeve, no problem. Just empty your pouch more frequently. If you have frequent blockages from food, chew better, stop eating the offending food. If this continues, I recommend checking with your surgeon or GI MD to check out if adhesions/strictures or other issues going on.
Eddie, great post from UOAA page! Reasonable and good protocol. Thanks for posting that! _________________ * Certified Wound and Ostomy Care Nurse
* Registered Nurse
* Bachelor of Science in Nursing
I am fully recovered and past the emergency. I just don't feel comfortable doing the irrigation. I was desperate and the water could only go in about two - three inches which wasn't much help. In the end everything passed but now looking back, I just don't feel comfortable doing that ever again.
I will go straight to the ER next time.
Thank you for this post.
I'm glad you are ok and recovered. I think you were smart to look stuff up, and pretty brave!
Even with a flexible soft cath, the water often spurts out; if using a cone meant for irrigating a stoma and an irrigation set, I worry folks will put too much fluid in their stoma.
I am glad the info is out there on the sight. For me, as a nurse....when someone calls with obstructive type symptoms, I will always tell them go to the ED unless they are a long term ostomate who has been down that road before.......it is the safest thing to do for the patient since I'm not there to check. Not to mention the security of my nursing license _________________ * Certified Wound and Ostomy Care Nurse
* Registered Nurse
* Bachelor of Science in Nursing
thanks for posting this and everyone's responses i just got out of hospital at 2am this morning after my first blockage not only was it painful i was absolutely terrified. I am sat here with a very tender stomach i guess its from the cramping but i am pushing fluids and praying i don't have to go through his again
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