Stoma irrigation: Experiences with saline solution?

Hello all.

I have been irrigating my colostomy for about a year and a half. I was wondering if anyone has experience with using saline solution or anything else for that matter. I feel like sometimes my irrigation affects my electrolyte balance. With the irrigation every other day and living in a humid climate (sweating), I feel that my electrolytes get out of whack. I live in the Philippines where stoma irrigation is not really heard of. I am self-taught on the practice, I just don't really have anyone to ask about it.

Thanks, Clint

Hello Clint.  Thanks for this interesting post, which gives me an opportunity of responding about something that has also bothered me on occasions. (ie. electrolyte imbalance)

I irrigate daily but not with anything other than water and sometimes I get very tired like I used to (many years ago) when long distance running. I thought that the tiredness might be to do with electrolyte imbalance so I tried the high5 electrolyte and magnesium drink and it did seem to help a bit. However, I also have very low blood pressure, which creates similar symptoms, so I don't really know what is the main cause of my problem. 

I am also not sure how flushing with a saline solution or anything other addition to the water would help that much, as the liquid is in and out in such a short period of time that it would not seem to have much chance for absorbing through the colon wall.

However, I am always open to new ideas and approaches, so I hope you get some replies from people who have tried this stuff and can comment in a more practically experienced way.

Best wishes

Bill

Hi Bill, thanks for the reply.

I read somewhere that the salt may inhibit the absorption of so much water. I was thinking that if I used some saline I could cut down on the amount of water I inject. I am currently using almost 2 quarts of water. I get a bit tired after as well but I had an episode the other day that my bp and heart rate went kind of wild. Normally I am around 115/75, bp shot up to 190/110 with 100 heart rate.

I did try a half dose of polyethylene glycol in the water and I was completely done in 15-20 minutes! Just not sure about the long term effects.

Researching water enemas, (in those unfortunate people who don't have a stoma) it says that continued water enemas can create electrolyte imbalance, I just don't see why we would be any different.

One of my biggest problems here is nobody seems to know anything about the whole irrigation process. I am instructing my Drs. on the procedure!

Thanks so much for the reply, this is my first time chatting like this.

Take care!

Clint

Hello Clint. 

I have absolutely no expectations that doctors will know anything at all about the management of stomas . Some of the surgeons know how to perform the surgical procedure. but very few of them are even interested as to what happens to their patients afterwards. I found the stoma nurses are much more knowlegeable and willing to listen to what I have to say on the various stoma-related topics. As for irrigation, I insisted that I would ONLY HAVE THE OPERATION IF I COULD IRRIGATE. This was because I had already been anally irrigating and found it so much easier to manage the whole sorry state of affairs. The medics had no problems with this, so I started irrigation at the eariest opportunity. As for the amount of water I use, This has depended upon how much is displaced in the process of irrigation and so does not enter th colon in the first place.  I have found I need 3 litres. of which, I guess about half finds it's way into the stoma to do the job. I also need to pump it in under pressure, otherwise it doesn't get passed my peristomal hernia. Output is predicatable in that most of it come out within 2 hours but recently there has been a lot more residual output overnight. This doesn't bother me as I leave the sleeve on and there is plenty of space for any overnight output.

I hope this helps

Best wishes

Bill 

Hi Bill.

Here in the Philippines, I have yet to find a nurse that really knows much about the stoma. Thus far in my experience, the surgeon is the most educated about the stoma. I have yet to find a nurse that really has any higher knowledge about stoma care. I think the vast majority of the nurses are working overseas. I would say the median age for nurses here is 25! I am impressed with my doctors though, very caring and thoughtful. Easily accessible and knowledgeable. I have at least 2 of my doctors' cell phone numbers and can contact them at any time.

As for my situation, I had rectal cancer, did the chemo, radiation, etc. here in the Philippines. To make a long story short, I had complications. I had the temporary bag removed from the right side and started trying to retrain my bowel. I developed an abscess that kept getting infected. The surgeon wanted to put the bag back on for 6 months and then start over. I explained to him about the stoma irrigation and that if he would put the stoma on my left side, I would just stay that way. The abscess and infection were by far the worst part of the whole thing. I wasn't sure I could do that again. I lost about 5 kilos during the chemo and radiation. I lost 20 with the infection.

As far as the irrigation goes, I am one of the lucky ones. I started a couple of months after my last surgery and it just kinda worked. I am able to do it every other day, with almost no accidents. I just wear a large stoma bandage. Plus a stoma belt to prevent a possible hernia, that's my biggest fear at this time.

The first couple of times were a bit scary, believe me! I live 5 hours from the nearest decent hospital.

Sorry for the long story.

BTW. I read where you had a heart attack. I hope you are fully recovered and doing well.

Clint

Hi Clint,

I have no information on Saline, but with the worldwide shortage last year, I'm not sure if it would be economical. Shortages mean an increase in cost! Who would have thought? As I was getting chemo, they had to be sure to put back a bag of it for me. Sometimes, they did not have any. I do irrigate and find it so easy and much better than not. I have no issues, but I do have some output in between the every other day schedule. I tried every day, and it was a bigger burden. I still had output then too! So, I take the lesser of the evils. Some people in the US have support through their Ostomy Care Department at the hospital. I did not find them to be so helpful, and like you, I taught myself. With the advice of the experienced folks on here.

Sorry, my notes always mess up after so many lines and won't let me go back. But the experience of the mass on this site has been lifesaving! Hope you will continue to ask questions.

Puppyluv

Hi Puppyluv.

Thanks for the reply. This site has been a huge help to me. Of course, there's always a lot of time to research when you are recovering. I believe it was researching on this site that helped direct me in my choices for recovery.

Thank you for your reply and hoping for your continued success!

Clint

Clint,

You are welcome. Those first few months were tough times, weren't they? I still learn new things every day. I am very lucky that I have very few issues that so many have. I don't have leaks or rashes. I have found the supplies that work well for me. I think that is the worst of it in the beginning. The hospital teaches you how to put on a pouch but it is done when you are having zero output. They use pouches that are given to them by the Supply Reps and are generally the cheapest thing made. What they don't tell you is how to handle the leaks that will come because the cheap pouch does not stick. I think there should be more support for newbies in that regard. It is such an important time and can make or break how we adjust to being an Ostomate. This site certainly filled in the gaps for me and I have made many lasting friends as well!

Puppyluv

Hey Lumenman,

The link below will tell you all you want to know about saline vs water in regards to the colon. Might be a tough read, but it's all there. I'd say "enjoy", but not really much to enjoy about reading this stuff. Maybe "tolerate" is a better valediction or complimentary close.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC322357/

Regards,

Bob

Hello Bob. Thanks for the link which I have now painstakingly read.

It seems to me that this study does not really tell us much more than we already knew in that osmotic filtration has only a borderline significance  ( P=0.05) and the large bowel is more permeable than the rest.

For me, it did not really shed any light on the question asked by Lmnman about adding saline solutions to the water. Indeed, from what I could ascertain from this article, there would be little or no benefit or effect from doing so. 

I hope this helps for those who may not be so inclined to wade through the scientific data as presented in the article.

Best wishes

Bill

Hi guys! Thanks for all the assistance! Bob for the link and Bill for the interpretation. I started to read but got a little confused. As far as the saline irrigation goes, I went ahead and gave it a try. I am my own test animal! Well, initially there seemed to be really no difference but afterward I kept having small amounts of output where I typically don't. We're talking like deer poop. Then this morning on my typical flush, I believe I had the biggest output in my history. If that's too much info, sorry. I don't know if it was the salt or what but really no change in diet.

Thanks again to everyone for the support!

Regards to all.

Clint

Hello Clint,

I have been irrigating my stoma for 2 ½ years and there you have just scared me with a potential hernia, the reason you are wearing a "Stoma belt" to prevent possible hernia. I already have a big belly and I think it has grown for 2 years, is it a hernia or glasses of wine? ... lolllll ... Anyway, I wish with all my heart that I will never have this problem because for now it goes very well with my daily irrigation. Is it common to have a hernia for us who have a colostomy? Because for my part, I do not use any collar and bag because I am kneeling in front of the toilet to introduce the water and when my 1.5 liters are finished, all the residues go directly into the toilet, and afterwards I put a cleansing pad and a Tegaderm film.

What is a cleansing pad?

Hi Shitt Happens.

I am definitely not an expert on any of this. My surgeon told me to be careful lifting, coughing, anything that can put a strain on my abdomen. (I probably am extra paranoid just because of some other complications I had during this whole process). Depending on which site you read, a hernia can be quite common. It's just something I really want to avoid (no more surgeries). As far as the hernia itself, I am under the impression that you would have a localized bulge, not the whole belly. I still do an annual check-up with a CT scan, I believe that your Dr would notify you if something was wrong. Assuming you are still doing follow-up.

As far as the hernia belt itself, I wear a flat panel type belt made by the Nu-hope company, they are light and very flexible. It gives me a little peace of mind when I forget and lift something heavy. I also have a 6-year-old daughter that I can't help but pick up and hug sometimes!!

As far as the cover goes, I wear a 3-inch stoma patch made by Ampatch.

I hope this helps.

Thank you Lmnman for your kind words, it makes me less stressed, and yes I see my oncologist always one time per year for a CT scan:)

Hello Clint. 

As I was filling up my water softener with salt this morning I recalled your post questioning using salinated water for irrigation. It had not really occurred to me before that all the water to my bathroom taps are salinated via the water softener and I have been using it for years without noticing any difference whatsoever between home and when I am away (and maybe not using this type of water).

Best wishes

Bill