This topic is about a person who has been managing their colostomy through irrigation every morning for four years. However, they are now facing some challenges due to a peristomal hernia, which is a bulge around the stoma area. This hernia has been awaiting surgical repair since September 2020. Recently, they have been experiencing some difficulties and concerns:

- They feel sharp pain when inserting the irrigation water and can only manage to use half of the usual amount before needing to lie on their left side.
- The process of draining water and stool now takes about 45 minutes, whereas it used to take only 20 minutes.
- There has been no noticeable increase in the size of the hernia, as confirmed by a scan in February 2022.
- They are worried about what might be happening internally, have skipped meals out of fear, and want to continue irrigating but are anxious about the pain.

They have already consulted with the surgeon who will perform the hernia repair, but no immediate solution was provided for the pain during irrigation.

Here are some pieces of advice and insights that might be helpful:

1. Experiencing severe new pain during irrigation should prompt a quick medical review. It might be a good idea to contact the surgeon or a stoma nurse again instead of continuing to endure the pain.

2. One person with a similar situation found that the irrigation cone would not pass the hernia. They switched to using an adapted anal catheter and a pressure container to push water past the herniated area. This method helped them maintain effective irrigation for several years.

3. A stoma nurse mentioned that ongoing input/output issues could be due to the colon "collapsing on itself," which reduces peristalsis. In such cases, the nurse recommended stopping irrigation and returning to using a pouch, at least temporarily.

4. If irrigation continues to cause significant pain or does not empty properly, it might be safest to pause irrigation and use regular ostomy bags until further surgical or professional advice is available.