Colostomy Irrigation: Is My Experience Normal?

Hello, fellow ostomates,

I've had my colostomy for a little over a year now and began irrigating on a regular basis about a month ago. The sense I had from what I read was that you would instill all the water you were using (starting with 250 ml, moving up to 1000 ml), and then would have returns mostly during a 20-minute period after all the water was instilled. My experience doesn't match that.

Usually, there is something ready to come out when I begin. I instill a bit of water & it comes out. Then I instill more and have more returns. This continues, with water and stool, sometimes just water, for the 13 minutes I put the water in. Then, during the 20 minutes, I may or may not have more come out. Does this sound like the typical experience, or should I be putting all the water in without all the stops and restarts when returns come out? Any info would be helpful.

Thanks,

Debbie

Hi. Everybody who irrigates has a slightly different experience. The main question is, after 24 hours, do you still have a clean mini pouch or stoma cap? That's the acid test.

I irrigate using a converted Braun Irypump, which is very efficient. I guess that you use a gravity bag. Is all the water going in, or do you lose a lot during the process? To compensate, I start with 1.5 liters knowing there will be some loss. Also, if you don't have a heavy diet, there might not be a lot to come out in the first place. Lastly, it's important to have a regular routine. Irrigating at the same time every day trains the bowel to work when you want it.

Hope this helps. I'm a BIG fan of irrigation.

Hello Debbie.
Thanks for your post about irrigation as I feel sure that many other newbies to irrigation will be wondering similar things.
Like most things to do with stomas we precede our comments with a cliché that goes along the lines of ‘everyone is different ‘.
I agree with what Douglas John has said, so I won’t be repeating his wise words. 
I started anal irrigation before I had my stoma, so I continued with the same strategy when I first had my stoma. 
I could never get on with the cone so I used an anal catheter instead 
also, I could not get on with the bag and gravity feed  so  (after I tried the Braun system) I made myself a pressurised water system.
Because my colon expelled water from the start, I needed at least 3+litres of water to achieve any satisfactory results. 
Along with the expelled water, came lots of output, which was a sort of preliminary expulsion, before the main event.
This method has served me well over the years. However, there are occasions when the water does not ‘splash back’ in the ‘normal’ way and I have to be careful to stop the input, otherwise, I become bloated with water and it can be painful.
Irrigation, like many other things, is a matter of trial and error. Experiment, to try to find out what works best for you. However, never be complacent that you have found a permanent solution, and always be open to trying something new.

Best wishes

|Bill

 

Hi, Douglas (or is it John?) and Bill,

Thank you both for your responses! I appreciate the support and information.

I am using a Coloplast irrigation bag/stoma cone and it seems to work for me. I've been irrigating for 6 weeks now, every day starting between 8:10 and 8:30 am, with 6 cups of warm water (I started with 1 cup and worked my way up). I've had a handful of times when I don't have any output for 24 hours. Sometimes I have 12 hours, other times I wake up with output in my pouch in the morning, so I got somewhere between 12 and 24 hours without output.

Like Bill, my colon expels water from the start. Usually, there's a bit of output lurking, waiting to come out, so a small amount of water triggers that quickly. Then, I instill some water & it is expelled with output. This pattern continues throughout the entire 6 cups, often with more water going in before it's expelled with or without output. Sometimes, water alone is expelled. I have several "main events" throughout this instilling time (approx. 13-15 minutes). Then, I'll have output once or twice during the 20 minutes afterwards but I wouldn't call them a "main event" - just the same as during the instillation time. I would say that after that 20-minute waiting period, I'm done and working up to feeling confident to put my pouch back on, approximately 35 minutes after starting. I'm not yet confident to go to a smaller bag or cap.

I have the irrigation sleeve draining into a container that has measurements on it. I've been doing this to build my confidence that what goes in is indeed coming out. So, after instilling 6 cups of warm water over 13 minutes, my container indicates I have 6 cups of water/returns in the container. The output seems to make up for any water that is absorbed by my colon. Then, maybe one more "event" and I'm done.

So it's working to the degree that it's working, just not consistently for 24 hours. I was curious about the ongoing expelling of water and returns because I've read that it all comes out in a "main event." Bill, it sounds like my experience is sort of like yours, which is comforting. Maybe I will try 7 cups next time, as the water is not being retained in the colon.

Fingers crossed for tomorrow,

Debbie

Debbie

Well done for persevering. Six weeks is a short time to whip your colon into submission. It was a month or two before I got 24-hour ‘clean'. Don't get too hung up about how much water and poo comes out. What you put in will come out plus debris. Remember, the water is only to stimulate the colon to expel its contents. Try putting in a full 1 liter (plus) from the start. Hold the cone in place in your stoma for a minute or two to relax the colon. Before I start, I fold the bottom of the sleeve and secure it with three freezer bag clips. (No leaks, thank you). That way, I know how much is coming out, and I can sit comfortably and relax while I empty. It takes my bowel about 30 minutes to fully empty (to be safe), but that can vary considerably. It does take time to train your colon, but it will get better. Relax, relax, relax, and don't get stressed if it doesn't work well that day. It will tomorrow. Let me know how you get on.

John

Thanks!