This topic is about someone who has been successfully managing their colostomy through irrigation for three years. However, after undergoing surgery to repair a parastomal hernia, they are experiencing difficulties with the irrigation process. Previously, they could go almost two days between irrigations, but now their pouch starts to fill by 11 a.m. the day after irrigation. They suspect that the surgical mesh used in the repair might have narrowed the stoma, affecting the flow of water and stool during irrigation, although they still have spontaneous output. They are seeking advice on how to improve their irrigation results and restore the two-day interval between sessions.

Here are some helpful insights and advice from others who have faced similar challenges:

1. Temperature and Volume Adjustments
- Some people find that using very hot water instead of lukewarm water can help initiate the flow during irrigation.
- One person with a small hernia uses 1.5 liters of warm water, noting that the first 500 cc might be slow, but the rest flows more easily once it clears a certain point.
- Using a temperature gauge, like the one on the Coloplast irrigation kit, can help ensure the water is consistently warm.

2. Repeat or Daily Irrigations
- If the first irrigation doesn't fully clear the bowel, performing a second irrigation in the same session might help.
- Switching to a daily irrigation routine instead of every other day can make output more predictable and reduce unexpected pouch filling for some people.

3. General Encouragement
- Many people with small hernias continue to irrigate successfully every 24 hours. Persistence and making small adjustments can often restore reliability in the irrigation process.

These insights might help in managing the changes after hernia repair and improve the overall experience with colostomy irrigation.