Thoughts on Stoma Caps for Irrigation?

I will be starting to irrigate soon. And I was wondering what everybody thinks about the stoma caps. Has this been very helpful for those of you who are using them? I am really looking forward to freeing myself up from the pouches.

Deanna

Hello Deanna.

I don't use the caps but I do use stoma plugs by Coloplast. I like these because they isert into the stoma and keep my hernia from closing up the hole. 

Best wishes

Bill

Bill,

I do like the sound of that as I have a very small hernia above my stoma. Can you tell me a little bit more about this?

Deanna

Hello Deanna.
There's not a lot to tell really. I have a peristomal hernia and the peristalsis muscles around that area are so strong that they block the outlet securely and completely. I know this by sticking my finger in the hole (as the stoma nurse originally showed me).This way I can literally’ feel’ what the problems are within ‘finger-distance’ inside the stoma. The first thing I find is that the hole is blocked and I have to push and prod in different directions before I can find a way through. The second point is that once the finger passes the muscular obstruction, the peristalsis starts up and tries to push the obstacle( my finger) out, like it would with any faeces. At first I was surprised and amazed at the force involved and it made me realise why nothing (not even wind) could pass through the gap when the muscles had closed over it.
If I left my finger in there and was determined that it would not be pushed out –then after just a few minutes the muscles relaxed and withdrew. This is, of course what they do naturally, but at the time it was all new to me.
Sometime in the past, I read somewhere on here, that the bowel could be ‘trained’. So, I figured that if I could push a finger-like obstacle into the stoma and secure it there, then the peristalsis might be able to be ‘trained’ to relax.
I tried all sorts of things that did not work as well as I wanted because the bowel acted like an octopus and could squeeze its way into any small hole, crack or crevice and left me with a relatively dangerous and embarrassing situation.
However, previous to my stoma, I had been using anal plugs for incontinence and they were made of a material that let the gas through but not the faeces. I tried those but, when they expanded inside, they were the wrong shape and both difficult and painful to remove.
I shared all this information with the stoma nurse and she suggested the stoma plugs, which are shaped like a tampon and made from the same material as the anal plugs.
I’ve been using these for years and they have been quite effective at keeping the hole open and letting the gas out without any accompanying faeces.
Hence, I think they have been successful for me.
As a side note: I also had trouble with the irrigation cone method, where the cone was not long enough to get past the stomal obstruction.
Having anally irrigated prior to the stoma,I decided to try that method ( with an adapted anal catheta on a pressurised water delivery system) in the stoma. This has also worked well for years for me. However, I always give out the same warning to others as the medics gave to me when anally irrigating.
These cathetas are not for the feint-hearted or the reckless, as they have been known to puncture the colon lining. Partly, this is because there is little or no feeling in there and partly because the individuals concerned used too much force to get the devices into where they needed to be. This is why the cone method is the one that is recommended. 
I hope this goes some way to answering your question
Best wishes
Bill

Can you share about what is the pressurized system? I use a gravity bag with a cone and have not had much luck. The water seems to absorb into my tissue because it never comes out. Or I can't get the muscle to open and relax to get the cone in. I have been too sick with kidney infections to keep up with it. But I want to try again.

Hello Gimo.
I made my own pressurised system from an adapted garden sprayer (with a Coloplast regulator and anal catheter end) because it holds 5 litres of water, which is the right amount for my needs. It also has a large screw top, which allows me to carry other stoma stuff in it when travelling.
Perhaps should add, that I also tried a portable, electric camping shower, with a plastic cereal container for the water. This was fine for about a year when the thing simply stopped working, so I went back to the manual garden pump.
For those who do not fancy DIY, I would recommend having a look at the Braun pressurised irrigator; ( I think you can find it on ‘Braun medical’ website) The first version of which, I did a review on some time ago and I have finally located it for you. However, the review is old (like me!) and may well need updating (by someone else!) to cater for Braun’s modifications.
Best wishes
Bill

REVIEW of BRAUN ‘IRRIMATIC’:
Electrical Irrigation Pump for (Stoma and Rectal) Intestinal Flushing.

I wish to be as objective as possible about this gadget so I will declare my interest and position at the outset.
I have a colostomy and have been irrigating successfully for about 18months. After my surgery and the initial healing process, one of the (peristalsis) muscles inside the stoma seemed to migrate across the hole and close it up. This made getting the cone in and passing water into the stoma much more difficult, to the point of becoming impracticable and unsatisfactory. I did not want to simply keep pushing the cone in as hard as I could and risk rupturing the lining of the stoma so I adapted a hand-pumped pressurised (3 litre) spray that was in the garden shed and connected the cone and piping to that.
This pumped the water with reasonable force passed the obstruction without damaging anything in the process. Once the water was flowing, the cone was easy enough to push in to the stoma in the normal way but following the waterline. This home-made device has been satisfactory and without problems for about 9 months.
Looking ahead to possible travel abroad. I did not think that customs and boarder control would appreciate me taking on board a device with ‘KILLASPRAY’ emblazoned in bold letters across the side of it. Thus, when Braun brought out their device I thought I ought to give it a trial.

Point 1) I had the device with an option of returning it within 30days if it was not satisfactory. This is a very useful option for those who wish to give it a go to see how they get on.

Point 2) This gadget seemed expensive:
Totalling £322.37 including VAT & carriage costs. (£260.64 excl; VAT )
(I made mine for nothing so this might have influenced my perspective on the price)

Point 3) It is not available on prescription in the UK.

Point 4) It comes complete with everything you need to complete the task.
This includes cone, sleeves etc. Although I find that the type of sleeves Braun supplied are not to my liking. However, that does not detract from the gadget itself as it is easy enough to use someone else’s sleeves.

Point 5) The Irrimatic looks good, is well designed and fit for purpose. (for most people)
(It was not so good for me as it only has 2 litres capacity and I waste a lot of water initially whilst trying to insert the cone into my blocked stoma. I need at least 2.5 to 3 litres capacity otherwise I would have to refill half way through the procedure. Instead I filled up my own gadget as well as theirs and used the Braun first.

Point 6) General:
The Braun Irrimatic is and does what it says it does.
I liked the easy fit hose and the slightly protruding lights on the front. These can be seen if the device is on the floor the floor - from where it works perfectly well. The pressure is easily adjustable via a swivel switch on top and it is adequate for ‘normal’ use.
As previously explained it did not flow fast enough for me to press passed the obstacle in my stoma. However, this condition would not apply to most people. Once the cone was in and past the obstacle it did the job as expected.
I liked the square shape as it enabled me to put it on the bath board as well as on the floor.
My own preference would be for the water compartment to have a lid. I could envisage having problems in public toilets carrying an open container from sink to toilet without spilling it.
The instruction manual was easy to read and gives a clear indication as to prerequisites and contraindications.
If there is no electricity in your bathroom – and for safety reasons there shouldn’t be, it can be charged up at any socket. It does not say when it is fully charged but the recommendation is to leave it on charge. (I’m not sure what conservationists would have to say about that!)
The charger and plug does not look like a ‘professional’ device but more like something I would have made up in my shed. I feel that they let themselves down on this design and could have got a better looking adapter from a local electrical shop.

Summary :
For those of you who are seriously interested in gadgets and have this sort of money going spare (and are not into DIY.) I would recommend the Braun Irrimatic.
It has functionality and style. It does look good in the bathroom. It has some drawbacks and minor flaws but it is to Braun’s credit that they are developing new devices for our benefit and they should be applauded and supported in that.
I also feel sure that it would be acceptable as a medical aid to customs officers and the like.
I will be returning my Irrimatic within the time period. However, this is only because I need something with greater water capacity and a faster flow in the initial phase.

I hope you find this review useful

Hi.

I irrigate every day and I use a stoma cap all the time.

The only time you need to be careful is for about 30 minutes after irrigating. Occasionally, you might get a 'fart' which blows material out. For the first half hour, I cover the cap with a larger bag - just cover it, don't stick it on, as 'wet' will push through the pressure release valve in the cap. It leaves a wet stain on your clothes. Blowbacks, as I call them, are however quite rare. If you use an irrigation pump as opposed to a gravity bag, the results are much better. I'd never go without my pump. Go for it. D

Douglas John,

Thank you for replying regarding the stoma cap. My irrigation system has just been ordered and I will be trying it out once it arrives. I am interested in finding out more about the irrigation pump. I like the sound of that. But the bottom line is, Douglas, I would like to go bagless more than not. Don't get me wrong, I'm very happy to not have the issues of my current life, which was absolutely horrible. But going forward, I would like to have the stoma cap instead of the pouch every day, all day.

I am very happy to be finding new options for my ostomy going forward. This will help a lot with clothes and activity.

Deanna

Hi Deanna.

I'd be lost without my irrigation pump, it was a game changer for me, as I loathed and hated pooing into a bag, with all the associated issues of ballooning, pancaking, and the like.

I used a gravity bag to start with and with some success. I found the time that the water took to get into my bowel was sometimes slow, depending on how 'Billy Bowel' was feeling on that day. Sometimes there was reluctance for the water to go in and making me feel frustrated. (I don't have a lot of patience, I'm afraid). Getting the 'Braun Irrigation Pump' was the answer. Pumped water just goes in and I fill up in less than five minutes with 1.2 liters of water. (I've reduced it from 1.5 liters and it works just as well). Irrigation pumps are expensive, but in England, the dear old NHS paid for it, and I also have a spare backup unit in case one fails. If I try to use a gravity bag now, I have little success, Billy is so used to the pumped water. Wearing a cap suits me just fine, it's really just a protective cover for my stoma. If I'm swimming, I have no embarrassment at all about people seeing it. Of course, I do get asked questions which I don't mind at all. I hope that this helps.

D

How has the irrigation been? I recently started and it's been a game changer