Managing Diarrhea During Colostomy Irrigation

Replies
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695
Osto

I want to move to irrigation. My question is what if you have diarrhea? The other day I had 4 outputs into my colostomy bag over 2 hours. I noticed what I ate for dinner was in the last output, well I noticed the fruit. All 4 outputs were runny not like my normal output that is more solid.

What do you do if this happens and all you have is a stoma cap?

AlexT

I know nothing about irrigation but how long after eating dinner did you have the output? How many times a day do you normally empty?

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Osto
Reply to AlexT

Once or twice. Once in the morning, and once at night. Sometimes, nighttime one does not happen.

I have a belly so I don't get a proper seal. Think of a belly button. When I'm laying down, my stoma is an outie. When I stand up, it's an innie, and my skin shifts down. Because of this drastic movement, it's easy for my barrier ring and wafer to detach from my skin.

I am hoping that irrigation will give me more control.

AlexT
Reply to Osto

That's it? From my reading about irrigation, you'll be spending way more time irrigating than you will be emptying your bag twice a day. Plus, I think you have to pretty much irrigate on a fairly set schedule.

Osto
Reply to AlexT

Yes, but because of my belly fat issues I can't keep my skin clean. I place my barrier ring close to my stoma and because of the drastic changes, the barrier ring and wafer detach from my skin and stool keeps going under the barrier ring and leaks out the side of my wafer.

 
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AlexT
Reply to Osto

Oh, gotcha.

Bill

Hello Osto.
Thanks for your interesting question.
The process of irrigation involves pouring water into the stoma to clean it all out so, technically, this would be diarrhoea as most people would envisage it. However (with certain exceptions),  irrigation has the advantage of getting rid of the output during the irrigation process,(so their often is no output of any kind)  which puts you in control of its management. After irrigation, many people don’t have any output at all for varying periods of time. I tend to irrigate every day at the same time (in the evening) so that I am fairly sure of the freedom from managing the stoma during the following day.
I prefer a stoma plug rather than a cap, but that’s just a preference because it helps with other issues.
If you have anxieties about whether you will have output (runny or hard) during the day, then I might suggest that you don’t immediately go for the caps or the plugs, but still wear a bag until you can be confident that you don’t need these devices anymore. 
Recently, I have had a few problems with a collapsed colon (amongst other things) and the stoma nurses advised that I stopped irrigation and went back to wearing bags. I thanked them for their well-meaning advice but decided that the advantages of irrigation far outweighed any of the additional problems I was experiencing.. Hence, I am still doing it against their advice. 

I figure that we should all try to find the methods and devices that suit our particular circumstances and be our own advocates for what works best.
If you are a suitable candidate for irrigation, it would be a pity not to give it a go, as many people will attest that it provides a much more manageable stoma experience.

Anyway!  If it doesn’t work for you, then there is always the option of reverting back to what you were doing before. 

Best wishes

Bill

gentlejohn

Why did you have a colostomy? Have you had radiation? Irrigation is used to regulate output. If you have a rapid transit time, irrigation might not work as well unless some medication that slows down that transit time is used. This is something to discuss with an enterostomal nurse who would be teaching you the technique of irrigation anyway. Stoma caps or security pouches would be used only after you have predictable outputs from irrigation.

Osto
Reply to Bill

Thank you! I'll look into the stoma plug. Not sure I can irrigate with a wafer on because my stoma opens towards my skin. That is part of the issue, so my stool comes out at the same level as my skin. No way to say it won't work till I try, but that sounds like something to try as it would be nice to have the bag on while I figure everything out.

Osto
Reply to gentlejohn

Rectal cancer, I was in a trial to see if chemo and radiation would destroy the cancer. It was not successful. Full resection and Barbie butt was what I got to completely remove the cancer.

So far with the exception of one day, I pass stool in the morning and sometimes at night with light amounts of stool throughout the day. Maybe a couple teaspoons. I can always feel it when I am about to pass my stool during the one or two times a day.

WIOstomyGuy

I started irrigation about a year ago and it's been a life changer. I have a very inconsistent work schedule, so I don't think I get all the advantages others do with very consistent irrigation. I do not think it is recommended if you are experiencing diarrhea. I have not had that happen since I started. Even though I am not perfect, I often wear only caps and enjoy the freedom. I am still not in a place where I don't have an emergency pack readily available. Whether it be my car, office, or anyplace. I am still prepared for the worst. Good luck!!

WIOstomyGuy
Reply to Osto

Do you use convex barriers?

Osto
Reply to WIOstomyGuy

Thank you, I have only had diarrhea one time since my surgery 5 weeks ago...... Red Baron Pizza has always been a trigger for me.... I had two slices :(.... I can only eat pizza from a couple places never frozen.

Thank you for the overall info.

Osto
Reply to WIOstomyGuy

I'm using Coloplast 2-piece convex system with two barrier rings. I was using one, but two gives me a better hold. My stoma moves a lot between laying down, sitting, then standing. When I'm laying down, I have an outie, sitting it's a not deep innie, standing it's a big innie. Because of how much it changes, my wafer has a hard time staying attached to my skin.

That is why I want to try irrigation. For me, it's not hard to have a scheduled time to irrigate.

Bill
Reply to Osto

Hello Osto.

In the stoma world it is often difficult to decide what is best until you actually try something for yourself.

As I have said many times, I make my own baseplates - onto which I attach manufacturer's devices. In the past 6months I've been experimenting with a slightly different approach, which might be of interest to you if you want to irrigate and use a bag afterwards. (with the same baseplate).

The three items are from Coloplast:

1) Assura irrigation press plate  60mm 12820

2) Assura irrigation sleeves 2 piece 60mm 12836

3) Sensura click ostomy bag 2-piece with dual filter. 60mm 14896

I have made an addition to the baseplate to fit my stoma but I can say that these devices work quite well as a three-piece interchangeable set.

I would also say that I prefer these irrigation sleeves to the Hollister ones because there is more space at the top for managing the irrigation process.

Coloplast are good at sending out samples, so there would be no harm or expense in trying out this combination. However, I still think that if irrigation works for you, then a bag should be unnecessary. (once you gain confidence).

Best wishes

Bill

Osto
Reply to Bill

Bill

Thank you for the info and the product numbers! I tried to find a plug on Coloplast's website and could not find it. I'll call them today as I want to sample a bag that looks like it has a greater amount of flexibility. 15869 Coloplast one-piece bag.