This topic is about dealing with constipation, pain, and bloating during colostomy irrigation, especially when a para-umbilical hernia is present. The person sharing their experience usually irrigates every other day but sometimes faces issues with minimal return, leading to discomfort and eventually passing a large, soft stool. Doctors have ruled out an obstruction, and after a particularly difficult episode, they were prescribed Lactulose, which helped after a week. They are seeking practical advice to manage or avoid these episodes. Here are some helpful insights and suggestions:

1. A hernia can interfere with the flow of water and stool during irrigation.
- Try gently pushing the hernia back with the flat of your palm. Then, use a wide neoprene exercise or abdominal support band, which you can find at stores like Walmart. Cut a hole for the stoma so the band holds the hernia in place while keeping the appliance accessible.
- Some people find it helpful to irrigate, wait for about 30 minutes, and then try irrigating again if the first attempt doesn't yield much return.

2. Make sure the full volume of water enters the colon during irrigation. If the water flows back out immediately, the hernia might be blocking the flow.

3. Consider increasing the frequency of irrigation to every 12 hours. This can help prevent the stool from solidifying and blocking the herniated section.

4. If a hernia is preventing water entry, you might need to adapt your equipment.
- Using a hand pump with an adapted anal catheter that can be guided past the hernia bulge might be helpful.

5. If you continue to experience low returns and a "stop-start" output, it might be worth discussing with a stoma nurse. Persistent issues could indicate "colonic inertia," which is when the colonic muscles aren't working effectively, rather than a mechanical blockage.

6. If irrigation becomes unreliable, consider using a temporary or backup pouching option, sometimes called a "safety-net bag," until the situation stabilizes or the hernia can be repaired.

7. Many people continue to irrigate successfully despite having a hernia. For them, surgery or stopping irrigation is a last resort, but results can vary from person to person.

8. Always consult with a healthcare professional before trying new mechanical techniques. The shared tips are based on personal experiences and not medical expertise.